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"Stephen Mellalieu"
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Training Load and Fatigue Marker Associations with Injury and Illness: A Systematic Review of Longitudinal Studies
Background
Coaches, sport scientists, clinicians and medical personnel face a constant challenge to prescribe sufficient training load to produce training adaption while minimising fatigue, performance inhibition and risk of injury/illness.
Objective
The aim of this review was to investigate the relationship between injury and illness and longitudinal training load and fatigue markers in sporting populations.
Methods
Systematic searches of the Web of Science and PubMed online databases to August 2015 were conducted for articles reporting relationships between training load/fatigue measures and injury/illness in athlete populations.
Results
From the initial 5943 articles identified, 2863 duplicates were removed, followed by a further 2833 articles from title and abstract selection. Manual searching of the reference lists of the remaining 247 articles, together with use of the Google Scholar ‘cited by’ tool, yielded 205 extra articles deemed worthy of assessment. Sixty-eight studies were subsequently selected for inclusion in this study, of which 45 investigated injury only, 17 investigated illness only, and 6 investigated both injury and illness. This systematic review highlighted a number of key findings, including disparity within the literature regarding the use of various terminologies such as training load, fatigue, injury and illness. Athletes are at an increased risk of injury/illness at key stages in their training and competition, including periods of training load intensification and periods of accumulated training loads.
Conclusions
Further investigation of individual athlete characteristics is required due to their impact on internal training load and, therefore, susceptibility to injury/illness.
Journal Article
Do we need to adjust exposure to account for the proportion of a cohort consenting to injury surveillance in team sports?
The definitions used in sports injury epidemiology have received much attention,1 2 as have the required sport-specific data fields3 and, recently, the inclusion of female-specific considerations.4 Voluntary informed consent is key when undertaking research with an opt-in rather than opt-out system in place and is typically required to legally comply with data protection and processing regulations (eg, General Data Protection Regulation in Europe).5 This can pose challenges to sports injury epidemiology where data may be recorded for internal medical purposes, but not all data can and or should be used for research purposes. Other methods for match exposure include recording player-specific match minutes through self-report (eg, player or club staff member) or global position systems (GPSs),9 which may overcome assumption issues (eg, matches being longer than the fixed match length of time). [...]player-specific approaches are resource intensive and burdensome from a player, coach, researcher and financial perspective. [...]it is not always feasible to provide this level of exposure detail, particularly in low-resourced projects. Using example data from a male professional rugby union team participating in a multicontinent league, we have modelled the effect of using the approximated exposure based on 15 players participating in every match and then adjusted this exposure based on the proportion of the cohort consented (figure 1).
Journal Article
Professional practice in sport psychology : a review
Sport psychologists working with athletes, teams and sports performers are only as effective as their professional techniques and competencies will allow. This is the first book to offer a detailed and critical appraisal of the conceptual foundations of contemporary professional practice in sport psychology.
Book
Managing player load in professional rugby union: a review of current knowledge and practices
BackgroundThe loads to which professional rugby players are subjected has been identified as a concern by coaches, players and administrators. In November 2014, World Rugby commissioned an expert group to identify the physical demands and non-physical load issues associated with participation in professional rugby.ObjectiveTo describe the current state of knowledge about the loads encountered by professional rugby players and the implications for their physical and mental health.FindingsThe group defined ‘load’ as it relates to professional rugby players as the total stressors and demands applied to the players. In the 2013–2014 seasons, 40% of professional players appeared in 20 matches or more, and 5% of players appeared in 30 matches or more. Matches account for ∼5–11% of exposure to rugby-related activities (matches, team and individual training sessions) during professional competitions. The match injury rate is about 27 times higher than that in training. The working group surmised that players entering a new level of play, players with unresolved previous injuries, players who are relatively older and players who are subjected to rapid increases in load are probably at increased risk of injury. A mix of ‘objective’ and ‘subjective’ measures in conjunction with effective communication among team staff and between staff and players was held to be the best approach to monitoring and managing player loads. While comprehensive monitoring holds promise for individually addressing player loads, it brings with it ethical and legal responsibilities that rugby organisations need to address to ensure that players’ personal information is adequately protected.ConclusionsAdministrators, broadcasters, team owners, team staff and the players themselves have important roles in balancing the desire to have the ‘best players’ on the field with the ongoing health of players. In contrast, the coaching, fitness and medical staff exert significant control over the activities, duration and intensity of training sessions. If load is a major risk factor for injury, then managing training loads should be an important element in enabling players to perform in a fit state as often as possible.
Journal Article
Rating of perceived challenge as a measure of internal load for technical skill performance
Correspondence to Dr Sharief Hendricks, Division of Exercise Science and Sports Medicine, Department of Human Biology, Faculty of Health Sciences, University of Cape Town and the Sports Science Institute of SouthAfrica, Cape Town 7725, South Africa; sharief.hendricks01@gmail.com Whether we are developing young athletes, designing injury prevention programmes, preparing high-level athletes for competition or rehabilitating an athlete back to sport, the technical skill performance of the athlete(s) needs to be considered. In a recent paper, we describe a technical skill training framework and skill load measurements for the rugby tackle.6 The paper was a follow-on from our British Journal of Sports Medicine paper, arguing for a planned contact-skill training programme to reduce the risk of tackle injuries while optimising performance within rugby.7 The technical skill training framework and skill load measurements were based on skill acquisition and skill development frameworks, including (i) the constraints-based framework for skilled performance8; (ii) the challenge point framework9 and (iii) the skill acquisition periodisation framework.10 The technical skill training framework outlines the relationship between the difficulty of the task and the availability of information in the training environment. [...]using skill acquisition and skill development frameworks, we propose an approach to measuring the load of technical skill.
Journal Article
Professional male rugby union players’ perceived psychological recovery and physical regeneration during the off-season
We explored male professional rugby union players’ experiences and perceptions of their mental and physical health and well-being across the northern hemisphere off-season. 34 professional male rugby union players participated in individual semistructured interviews (mean (SD) age=27.5 (4.3) years). Interviews were recorded, transcribed verbatim and analysed using reflexive thematic analysis. The off-season was characterised by three phases players undergo to preserve their mental and physical health and well-being to recover from the previous season and regenerate in preparation for the upcoming season. These included decompression from previous season, cognitive detachment from the rugby environment and preparation for preseason. Successful progression through all three phases was influenced by several variables (work and life demands, contextual factors, experience level). Recovery and regeneration strategies focused on physical distancing/getting away from the rugby environment to cognitively detach. Injured players appear an at-risk subgroup for threats to mental well-being (isolation, anxiety, reduced sense of achievement) as a result of reduced or minimal time away from the workplace due to treatment obligations. Younger professionals are a subgroup at risk of overtraining/injury due to inadequate rest, especially as this group are least likely to seek support/guidance. This study is the first investigation into male professional rugby union players’ experiences and perceptions of their mental and physical health and well-being across the off-season period. It highlights the distinct phases players undertake to mentally recover and regenerate and the need to consider education and support for potential at risk subgroups.
Journal Article
Psychological skills usage and the competitive anxiety response as a function of skill level in rugby union
This study examined the intensity and direction of competitive anxiety symptoms and psychological skill usage in rugby union players of different skill levels. Elite (n=65) and nonelite (n=50) participants completed measures of competitive anxiety, self- confidence, and psychological skills. The elite group reported more facilitative interpretations of competitive anxiety symptoms, higher levels of self-confidence, lower relaxation usage, and greater imagery and self-talk use than their nonelite counterparts. The findings suggest that nonelite performers primarily use relaxation strategies to reduce anxiety intensity. In contrast, elite athletes appear to maintain intensity levels and adopt a combination of skills to interpret symptoms as facilitative to performance. Potential mechanisms for this process include the use of imagery and verbal persuasion efficacy-enhancement techniques to protect against debilitating symptom interpretations. Key PointsNonelite performers primarily use relaxation strategies to reduce anxiety intensity.Elite athletes maintain intensity levels and adopt a combination of psychological skills to interpret symptoms as facilitative.This process occurs through imagery and verbal persuasion efficacy-enhancement techniques.Nonelite performers who are debilitators should implement relaxation-based programs. However, in high activation level sports performers should reduce symptom intensity, restructure cognitions, and then raise activation states again to appropriate levels.Elite performers who are debilitators should implement cognitive restructuring techniques to interpret their anxiety as facilitative via a combination of goal setting, self-talk, and imagery.
Journal Article
Contributors to negative biopsychosocial health or performance outcomes in rugby players (CoNBO): a systematic review and Delphi study protocol
The importance of contributors that can result in negative player outcomes in sport and the feasibility and barriers to modifying these to optimise player health and well-being have yet to be established. Within rugby codes (rugby league, rugby union and rugby sevens), within male and female cohorts across playing levels (full-time senior, part-time senior, age grade), this project aims to develop a consensus on contributors to negative biopsychosocial outcomes in rugby players (known as the CoNBO study) and establish stakeholder perceived importance of the identified contributors and barriers to their management. This project will consist of three parts; part 1: a systematic review, part 2: a three-round expert Delphi study and part 3: stakeholder rating of feasibility and barriers to management. Within part 1, systematic searches of electronic databases (PubMed, Scopus, MEDLINE, SPORTDiscus, CINAHL) will be performed. The systematic review protocol is registered with PROSPERO. Studies will be searched to identify physical, psychological and/or social factors resulting in negative player outcomes in rugby. Part 2 will consist of a three-round expert Delphi consensus study to establish additional physical, psychological and/or social factors that result in negative player outcomes in rugby and their importance. In part 3, stakeholders (eg, coaches, chief executive officers and players) will provide perceptions of the feasibility and barriers to modifying the identified factors within their setting. On completion, several manuscripts will be submitted for publication in peer-reviewed journals. The findings of this project have worldwide relevance for stakeholders in the rugby codes.PROSPERO registration numberCRD42022346751.
Journal Article