This blog post is inspired by Tim Gabbett’s work, especially paper If overuse injury is a ‘Training load error’, should undertraining be viewed the same way? from 2016, published in British Journal of Sports Medicine. In the past decade, Tim’s academic work has attracted a lot of attention among S&C coaches. Using brilliant common sense, Tim points out the problems of load monitoring in training, overtraining and undertraining and injury prevention. In his work, he breaks the myths and stereotypes of coaching in a very simple and interesting way, pointing to the proper use of technology and training tools in professional sports. Some of his ideas and thoughts for sure will be the subject of blog posts to come. In the meantime, I highly recommend that you take a look at his work, in case you missed it.
Non-contact soft tissue injuries in football are a consequence of overexertion of the locomotor aparatus. Injury mechanisms involve an excessive increase in training load, beyond the level to which the organism is adapted or to which it can successfully adapt within a reasonable period of time. These injuries are commonly referred to as an overuse injuries. This set of circumstances can be seen as a training load error, most often as a consequence of insufficient expertise or due to poor communication between the coaches and the athletes. In recent years, this topic has been given great importance and is the main field of activity of a large number of Performance specialist.
On the other hand, at the other end of the training continuum, there is an insufficient level of training load, ie undertraining condition. Given the large number of trainings and the growing number of competitive activities in elite European football, this topic did not receive enough attention. The focus is on the players who are the starters and most of the scientific body is focused on their recovery and preparation for the next match. However, insufficient level of training load in general or insufficient level of adequate training load is a very common cause of soft tissue injuries. Let’s look at it this way – (1) An increased risk of injury occurs if the volume of high-intensity activities is very high over a long period of time without sufficient recovery periods, which can include very well-trained athletes, with a high level of chronic workload. But, (2) a more common cause of injury is an insufficient level of training of certain abilities, which is perfectly described as undertraining. Insufficient amount of specific activities easily leads to ‘spikes’ in the training workload, even with moderate changes in volume or type of activity. Thus, undertrained football players are more susceptible to sudden changes in the training load, which is further associated with an increased risk of injuries. We are witnessing that some football coaches unknowingly avoid a chronically high level of training load, due to the fear of overtraining, while negatively affecting the performance of their team and resistance to loads. While I totally agree with the statement that I would rather have an undertrained than an overtrained athlete, I cannot agree with constant fear of productive and progressive training load. This is one of the most common reasons for misunderstanding between Football and Performance staff. Once again, poor communication and mistrust are ruining the process.
If overuse or undertraining is a crime, then poor communication is definitely the main suspect!
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In football, there is often a ridiculous belief that an S&C coach ‘breaks’ players and medical staff ‘fixes’ them. To me, this sounds like two opposing sides that certainly do not work in the common interest. But let’s change our perspective once again – Medical staff can easily make a negative impact on the training process by influencing the amount of training load (although they can sometimes point out problems and help eliminate them). This way, the S&C coach often acutely looks as a bad guy, but helping to build resilience in the long run through a chronically elevated level of training load. So far, poor communication has ruined several relationships in this post: Staff – Athletes, Performance staff – Football staff and Performance staff – Medical staff. It’s a little too much, don’t you agree?
If we make assumption that all members of the professional staff are on the same side and not opposed to each other, good communication between all individuals can play a key role in reducing the number of injuries, good performance and achieving competitive goals throughout the season. In this environment, the team has great benefits from building some very important relationships:
- A Football staff who understands the requirements of Performance staff and vice versa, where Performance team is always the support and not the protagonist of the whole process;
- A Medical staff who understand the ideas of the coaching team, and provide support in building resilience and chronically high workload;
- A Coaching staff that recognizes that the Medical staff now provides support, while creating trust in suggestions related to the training and medical status of the individual;
- Finally, players realize that the entire staff works together and in their best interest.
All of the above is one of the key reasons why large teams have Head of Performance, which, among other things, should use his excellent communication skills to create such a strong connections between different Departments. In such a strong network, players have a higher level of awareness of the importance of the whole process and stronger motivation, which can have incredible significance in different periods and with different groups of players – rehabilitation and return to play, off-season, non-starters, etc.
Tim Gabbett compares the triangle between Medical, Football and Performance staff with the Bermuda Triangle, in which players can easily get lost, given that there is often no understanding for the exact roles and responsibilities in the team between these parties. Regardless of the level of expertise, working in isolation of each of these points in a triangle can be disastrous for the team.
Finally, in support of all that has been said, I would like to point out the work of Jan Ekstrand (whos work I warmly recommend), which is related to injury prevention and communication in Professional environment. In one of his longitudinal studies, Ekstrand and his colleagues concluded that in teams where the level of communication is assessed as weak or insufficient (between Performance, Medical and Football staff, especially Head Coach), there is a higher incidence of injury, a higher incidence of severe injuries and unfortunately a higher incidence of re-injury after the rehabilitation process.
I think in the end we can agree – If overuse or undertraining is a crime, then poor communication is definitely the main suspect!
Sasa Semeredi 