Training Load and Injury: Part 1-The Devil Is in the Detail-Challenges to Applying the Current Research in the Training Load and Injury Field.

Background This article sets the scene for a critique of the research underpinning two common clinical assumptions: (1) training workload is a key factor influencing sports injury risk, and (2) it can be manipulated to reduce injury risk. In this summary we address why it is important for clinicians to critically evaluate the evidence behind research conclusions. Clinical question Has research been designed and conducted well enough to help clinicians answer the questions 'what is the relationship between training workload and sports injury risk?' and 'can the metrics based on training workload be used to decrease the injury risk?'. Key findings In the past decade, many sports injury researchers have developed new measures of exposure based on internal and external training workload to study the relationship between training load and injury. Some of these metrics may have been embraced by researchers and clinicians because (1) they are apparently supported by the scientific literature, (2) they are simple to calculate and use (averages and their ratio), and (3) there is an apparent reasonable rationale/narrative to support using workload metrics. However, (intentional or unintentional) questionable research practices and over-interpretation of research results undermines the trustworthiness of research in the training load-sports injury field. Clinical application Clinicians should always aim to critically examine the credibility of the evidence behind a research conclusion before implementing research findings in practice. Something that initially looks promising and inviting might not be as revolutionary or useful as one first anticipated. J Orthop Sports Phys Ther, Epub 1 Aug 2020. doi:10.2519/jospt.2020.9675.