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Health News 27/5/25

27/5/2025

Physios and medical staff being lost to women's sport after lack of investment -
Can you treat headaches with physiotherapy? -
Too many people with back pain call ambulances or visit the ED. Here’s why that’s a problem -
Compression tights and tops: do they actually benefit you during (or after) exercise? -
Can You Get the Same Gains Without Lifting to Failure? -
Head knocks and ultra-violence: viral games Run It Straight and Power Slap put sports safety back centuries -
Australian researchers lead world-first project to address the gap around female athlete health -

Load Management For Injury Prevention

Managing training load is crucial in injury prevention and treatment. A graphic in Tom Goon’s blog visualises how training load outweighs all other factors.

Historically we have advised that training loads shouldn’t increase by more than 10% a week. I’m not sure where this number comes from; I’ve got no problem with it; it seems reasonable, and I’ve quoted it hundreds of times.

There’s a 2015 BJSM podcast interview with Tim Gabbett on load management for injury prevention. Specifically Tim talks about this paper:

Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers
- Billy T Hulin, Tim J Gabbett, Peter Blanch, Paul Chapman, David Bailey, John W Orchard, 2013.

It is research into fast bowlers, but the principles apply just as well to any athlete.

The authors measured the acute workload of the last 7 days (and call it “fatigue”) and compare that to the chronic workload of the previous 4 weeks (which they call “fitness”).

Measuring Training Load

For runners, if the training is reasonably homogenous, we could most simply measure the workload as the total kms/week.

Or we could be more accurate and account for a mixed training program that may include a variety of hills / sprints / cross training etc, by giving each session a rate of perceived exertion (RPE) out of 10, and multiply that score by the number of training minutes:

Training load = session RPE x duration (minutes)

This is called a Foster’s Score, and provides a simple method for quantifying training loads from a variety of different training modalities.

The research subtracted the current one-week average from the previous 4-week average and called this number the “training-stress balance”.

A negative training-stress balance increases the risk of injury by 4 times.

So:

[Last 7 days’ session RPE x duration (minutes)] - ([Last 4 weeks’ session RPE x duration (minutes)] / 4) = TRAINING-STRESS BALANCE

Negative balance = 4 times risk of injury

Essentially this formula means you shouldn’t increase your training load by more than 25% a week.

For people that may be more vulnerable to injury I would change the 4-week average to a 6-week average, therefore, bringing the increase in load each week down from 25% to 16%.

This more cautious group could include:

Pre-season training
Kids going through growth spurts
Athletes returning from injury
Known history of over training injuries
People without any training history
Novel exercise modality

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Health News 27/5/25

Training-Stress Balance

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