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Virtually everyone knows the importance of leg strength in pitchers. Training the lower half of the body usually focuses on the big movements like squats and deadlifts. They dominate the landscape for most athletes, and rightly so. When you look at a pitching motion, the majority of the actual motion from leg pickup to release is performed through an interplay of single leg motion. That interplay could fill a novel, but the main concept is that each leg individually plays an important role in pitching.

Building lower half strength with our younger athletes may deviate from the common thought. The reverse lunge is a staple in our program for incoming collegiate pitchers. Before our athletes ever dive into a deadlift, we teach and train the weighted barbell reverse lunge. Not only is it beneficial for creating strength in a split stance, but anecdotal and empirical research suggests it has a correlation to performance as well as injury prevention. For us, getting strong in a single leg movement outweighs the use of multiple double leg movements throughout a weekly mesocycle.

Performance and Lunge Strength Transfer

The first place to start with the lunge and its relationship to performance is to simply create more leg strength and motor control in the lower half. It has been well documented that leg strength can play a crucial factor in pitching velocity. The true transfer of a lunge movement to pitching is based upon several factors, with training age and the current level of the athlete potentially the most important. The lower the level of the athlete, the more transfer the lunge will have. As an athlete’s ability increases to a high or an elite level, you will find less transfer. Regardless, the lunge can be very beneficial along the path of development for many athletes.

A study by Matsuo in 2001 documented four common patterns (A, B, C, D) in pitchers’ landing legs. Categorizing pitchers by either high velocity or low velocity, Matsuo found that the amount of flexion and/or extension of the front knee varied by how hard each group threw. He classified A and B patterns as more knee extension dominant, and C and D patterns as more flexion dominant.

Groups A and B landed flexed, but drove the knee back hard into extension at ball release. The C and D patterns essentially stayed flexed on the knee through ball release. The results showed that 83% of the high-velocity group displayed a front leg moving from flexion into extension over the course of front foot contact to ball release.

Both studies illustrate the importance of the front leg and the ability to brace and apply force. Again, the athlete’s level matters here in terms of specificity, but building a large base of strength can clearly assist athletes.

Addressing Weaknesses

A new athlete entering a program cannot hide their weaknesses. One of the most common weaknesses that I find in incoming athletes is single leg strength. Many have rarely done anything in the realm of a single leg movement. If they have, it has often been solely with high-rep bodyweight lunges.

There are many reasons that single leg work may be a weakness. One reason may simply be the time availability at the high school level. Many programs have limited time, and therefore coaches may choose to focus on large movements that athletes can do quickly. Single leg work may get lost in that mix or may not rank high enough on the scale of importance for the time available.

Athletes that do train in high school are often thrown into a one-size-fits-all basic program. Even if time is not an issue, programs are commonly built around the big basics such as squat and/or deadlift. Numbers are often important to coaches, and the reverse lunge isn’t a numbers lift. Therefore, it often gets looked over in the grand scheme of programming. Single leg movements aren’t sexy and don’t get the social media views that a big-time squat or deadlift does.

The Lumbar Spine

The prioritization of single leg movements over bilateral through our developmental phase is due to the large rise in back issues with incoming athletes. Pars fractures, and even disc injuries, dominate the landscape of high school/junior college baseball due to the high volume of skill work and low or nonexistent volume of training. Deficiencies in core strength and/or pelvic control, hip mobility issues, faulty movement patterns, and even the mechanics of how an athlete rotates all factor into the equation for a lumbar stress fracture.

The same muscles responsible for transferring rotational force through the body are also responsible for the deceleration of those same movements to protect the spine from injury. The spine undergoes large extension and rotation forces in any rotational movement. Athletes who cannot control end ranges of motion will end up ramming bony anatomy together while decelerating rotational movements. The result are stress fractures in the lumbar spine.

The first step is to eliminate movements that put large forces through the lumbar spine in the form of extension-based patterns. Squats, deadlifts, and RDLs are usually no-no’s for rehabilitating stress fractures. These bilateral movements often put athletes through large ranges of flexion and extension, and put huge forces through the vertebrae, causing once-dormant problems to again rear their head. Stress fractures that are asymptomatic will often stay hidden until they aren’t. If you want to find one, start putting athletes who are largely extended under load and see what happens.

Injury Prevention Benefits

The role of the kinetic chain in any rotational movement, especially that of pitching, cannot be overlooked. The legs, pelvis, and core all play fundamentally important roles in the buildup and transmission of energy. Weaknesses and/or breakdowns in the chain of a throwing athlete can transfer stress distally to the shoulder and elbow.

A 2013 study done by the Ben Hogan Sports Medicine clinic back found interesting results with UCL injuries and single leg testing. It looked at 60 baseball athletes, 30 healthy and 30 recently diagnosed with UCL tears. Players with UCL tears scored significantly lower on the Y Balance Test for both stance (P<.001) and lead (P<.001) lower extremities, compared to the non-injured athletes.

The Y Balance Test requires motor control of the lower half, transfer of body weight to each leg, core control, balance, and mobility to complete. The finished test looks for asymmetries. A deficiency in any of the above, or huge imbalances, could be a red flag for pitchers.

While you should view every study with a bit of skepticism, the findings of this data suggest there could be a potential association between impaired single leg ability and UCL tears in high school and collegiate baseball players.

Josh Heenan, strength coach, and president of Advanced Therapy and Performance in Omaha, Nebraska, has found similar results with the weighted reverse lunge. Based on data from more than 1,400 athletes, he and his colleagues view the reverse lunge as an important movement for pitchers for its correlation to velocity, as well as injury. They have created the “90mph formula” based on years of research with their athletes.

The formula is a roadmap, based on five training metrics, that they have found to be consistent with pitchers that can throw over 90 mph. Being strong in the reverse lunge is one metric in the formula. Those that do throw 90 mph or harder, yet can’t hit all the training metrics in the formula, are exponentially more prone to injury. While not published research yet, Josh and those at ATP have seen and shown the importance of the reverse lunge on lower body strength, and specifically on single leg strength in pitchers.

Progression to the Reverse Lunge

Progressing into the barbell reverse lunge often depends on the level of the athlete. The most common progression we take with our incoming athletes goes from static to dynamic. We work from unloaded to loaded through both those steps.

1. ISO Lunge – Unweighted
   1. The ISO lunge teaches body positioning and the creation of tension.
   2. Low-level athletes will start at 15 seconds each leg with a 10-second rest between legs. We add time over the course of the progression, up to 30 seconds.
2. ISO Lunge – Weighted
   1. When the athlete can maintain 30 seconds, we add weight to the movement in the form of holding a plate in the front.
      1. Start back at 15 seconds each leg.
      2. Build to 30 seconds again.
   2. Note: You can use larger time frames here, but I find that 15- to 30-second sets fit well within the overall program as far as difficulty, ability to maintain posture, and training time are concerned.

Dynamic

3. Single Arm DB Reverse Lunge
   1. Athletes hold one DB in the hand opposite of their front leg.
   2. This achieves two things:
      1. Only holding one DB means a lighter overall load is used and movement efficacy can be prioritized.
      2. The single arm hold challenges the core musculature to a higher degree than holding two dumbbells does. It specifically emphasizes the all-important quadratus lumborum and obliques. Both are incredibly important muscles in back health and pelvic control.
   3. Reps are usually done in the 5-10 per leg range.
   4. Athletes perform all reps on one side before switching.
4. Barbell Reverse Lunge
   1. We prefer the front squat variation.
      1. Athletes must be familiar with the front squat grip before undertaking this movement. The ability to hold the bar correctly sets up the rest of the entire movement.
   2. Athletes alternate lunges in this variation: Right leg then left leg until they complete all reps.
   3. Load the barbell up.
      1. Train this pattern to be strong.

Just because athletes are performing a lunge movement doesn’t mean they can’t use low reps with high loads. Many coaches are nervous to train single leg patterns heavy with the barbell. In many cases they are right, as it is often difficult to maintain balance and/or dump a barbell if something goes wrong during the movement.

That is one reason I prefer the front squat grip variation over the back squat. Holding and dumping the barbell becomes fairly easy and inconsequential when in front. The same can’t be said when the bar is on the back.

Parting Thoughts on Coaching the Reverse Lunge

Coaches also think of lunges as an assistance movement and pigeonhole it to be used only for higher reps and lighter weight. This couldn’t be further from the truth. The use of heavy loads has given us phenomenal gains in the past. Moving through the listed progressions wisely should set athletes up for success with the loaded barbell.

Athletes must show competence to use the weights early on. However, they will often shock you with how strong they really are in single leg patterns. It’s not uncommon for our pitchers, after a full training block, to reach upwards of 80-100% of their front squat max for heavy singles to triples on the reverse lunge.

Don’t be afraid to train with sets in the same zones as you would on other big compound movements. The use of one to five reps per side can be incredibly effective in building a big and strong lower half. Heavy reverse lunges can be an asset in any program.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

References

Bohannon, Richard W., et al. “Relationship of Pelvic and Thigh Motions During Unilateral and Bilateral Hip Flexion.” Physical Therapy. 1985: 65(1); 1501–1504. doi:10.1093/ptj/65.10.1501

Garrison, J. Craig, et al. “Baseball Players Diagnosed with Ulnar Collateral Ligament Tears Demonstrate Decreased Balance Compared to Healthy Controls.” Journal of Orthopaedic & Sports Physical Therapy. 2013: 43(10); 752-758. doi:10.2519/jospt.2013.4680

MacWilliams, Bruce A., et al. “Characteristic Ground-Reaction Forces in Baseball Pitching.” The American Journal of Sports Medicine. 1998: 26(1); 66–71. doi:10.1177/03635465980260014101

Matsuo, T., et al. “Comparison of kinematic and temporal parameters between different pitch velocity groups.” Journal of Applied Biomechanics. 2001: 17(1); 1-13.

McNally, Michael P., et al. “Stride Leg Ground Reaction Forces Predict Throwing Velocity in Adult Recreational Baseball Pitchers.” Journal of Strength and Conditioning Research. 2015: 29(10); 2708–2715. doi:10.1519/jsc.0000000000000937

Living and training at altitude has a number of beneficial effects for endurance athletes. Many high-level endurance athletes, across many different sports, live at altitude full-time, or use periods of altitude training to enhance their performance.

At the 2017 NCAA Cross Country Championships, in Divisions I and II, both the Men’s and Women’s team champions were from schools located at altitude. In Division I on the men’s side, Northern Arizona University, located in Flagstaff at 6,910 feet above sea level, won its second team title. On the women’s side, the University of New Mexico, located in Albuquerque at 5,312 feet, also won its second team title. In Division II, Adams State University, located in Alamosa, Colorado at 7,544 feet, won both the men’s and women’s team races for its 44th and 45th cross country team titles.

Additionally, a survey of medalists from the 2004 Athens Olympics found that 80% utilized altitude training in some form during their preparations.

The difficult questions, when using periods of altitude training rather than living at altitude, are when to go, for how long, and what to do while there in order to make the most of it. Before we can answer these questions, we need to look at the physiological adaptations to altitude to understand why it is beneficial.

How Much Does Altitude Improve Performance?

Altitude training increases aerobic ability by increasing the volume of red blood cells in the body, as well as the density of mitochondria and capillaries. The result is the ability to run faster for the same distance, or further at the same pace, improving endurance performance.

According to the USATF, a 28-day stint at altitude can improve performance by 1-2%, and some athletes have improved up to 5%. That doesn’t sound like much, but for a 31:00 10K runner, that is an improvement of 18-37 seconds, and up to 93 seconds.

Physiological Adaptations to Altitude

Living at altitude results in an increase in naturally occurring erythropoietin. Erythropoietin, abbreviated as EPO, is a hormone produced in the kidneys that stimulates the production of red blood cells. Artificial EPO—synthetic or taken from human or animal sources—was originally developed for cancer patients to increase their red blood cell count, but it has become notorious for its use as a performance-enhancing drug, to exceed the levels naturally and safely produced by the body.

This increased red blood cell production depends on the altitude at which you live, and for how long you live there. Higher altitudes and longer residences result in the production of greater amounts of red blood cells.

In addition to greater oxygen availability as a result of more red blood cells, the efficiency of oxygen use also increases, as a result of the increase in bisphosphoglyceric acid, or BPG. BPG stabilizes deoxygenated red blood cells, allowing for greater oxygen removal from the cells to the working muscles.

Training at Altitude Variations

In order to maximize the effects of altitude, there are different ways an athlete can choose to live and train in a high-altitude environment.

Live High Train Low

Live high train low (LHTL) gives the benefits of altitude without as many of the negatives. The athlete still gains the physiological effects of living at altitude, while maintaining the ability to run sea level paces or sea level workouts. This is only possible in a few locations in the U.S., where there is easy access to both high and low altitudes within a short travel distance.

You can also simulate this type of training at sea level with the use of expensive altitude tents or altitude chambers. Altitude tents simulate the effects of altitude by increasing the percentage of nitrogen in the air, which decreases the percentage of oxygen.

Most altitude training, especially when athletes do short periods of it, will be live high train high (LHTH).

Live High Train High

When training at altitude, it is not always easy to travel to sea level or even lower altitudes. In these circumstances, living and training at the same or similar altitudes are employed. This format allows for the physiological changes to occur, but does require some adjustments to be made to training to accommodate the demands of altitude.

Adjusting Your Training

The reduced availability of oxygen essentially results in a reduced ability to run, as well as a reduced ability to recover from hard efforts, especially before adaptations have occurred.

Running slower, especially on easy days, is necessary to allow for proper recovery. This is because not only does living at altitude affect the acute ability to perform work, but the chronic effect slows down the recovery process.

Running for minutes, rather than miles, will result in the effect of running at sea level, without the psychological pressure to hit a certain mileage goal. Running for the same number of minutes a typical run for mileage would take at sea level is a good goal to shoot for. For example, instead of running for 10 miles at a 6:30 pace, at altitude you should just run for 65 minutes.

This same principle can be applied to tempo runs—running at a given effort for the same amount of time rather than a particular distance. This requires some discipline, because it is tempting to run too fast, in an attempt to run sea level pace or what you think altitude pace should be, especially when wearing a GPS watch. However, just like at sea level, when you run your tempo runs too fast, too much lactate is produced and the purpose of the workout is lost.

When performing interval workouts, you can modify them in three different ways for a given workout. If that given workout would be 6×1600 @ 5:00 with 2:30 rest at sea level, here are three examples to modify that.

1. 1. The first, and simplest, modification would be to perform the same distance, with the same rest, but at a slower pace to accommodate the altitude. Given an altitude of 7,500 feet, this would result in a workout of 6×1600 @ 5:18 with 2:30 rest. The problem with this workout is that when you go back to sea level and try to race at a 5:00 pace, it will feel challenging neuromuscularly. You will not be efficient at that pace because you have not run it, despite being aerobically fit from the altitude training. This type of modification is good, but it should also be matched with workouts that will neuromuscularly prepare you for the pace of sea level racing.

1. 1. The second strategy, to accommodate sea level pace, would be to increase the recovery between the intervals, in order to run them at the same pace. This would result in a workout of 6×1600 @ 5:00 with perhaps 3:00 or 3:30 rest. However, this begins to change the physiological effect of the workout, as the rests become very long between intervals, and the pace is faster than a 10K effort, at the current altitude.

1. Finally, you can break the intervals into shorter bouts to increase total rest so that you can run faster paces. A possible permutation of this workout would be 6x4x400 @ 75 with 60 seconds’ rest between reps, and the original 2:30 rest between sets. This modification approximates the results of a sea level workout, allows for sea level paces to be run, and keeps the recovery short enough to continually stimulate the proper energy system. The repetitions are also short enough that the altitude will not affect you as much as it would in longer repetitions.

Other Factors

When you train at altitude, there are a few other things you should know about to stay as healthy as possible.

Iron Supplements

Athletes training at altitude should take iron supplements, as iron is a necessary component of red blood cell production. There are two different types of supplemental iron that can be taken: liquid and pill form. The liquid form is superior because it has a much higher absorption rate, relatively, than pill form. However, it is also more likely to upset your stomach. The recommendation would be to try the liquid form, and if you can’t handle it, take the pill form instead.

Many manufacturers recommend that their iron supplements be taken with food. This will reduce the likelihood of stomach upset, but will also severely impede absorption. To maximize the already low absorption rates, do not take iron within an hour before or after eating, and only pair it with a high vitamin C liquid. Avoid calcium in this period, because it especially impedes iron absorption.

Take iron for a few weeks before the start of altitude training, to build up the ferratin stores that are used when creating new red blood cells. If ferratin stores are too low to create new red blood cells, spending a few weeks at altitude will not have the hoped-for beneficial effects.

Sleep

While living and training at altitude, it is important to get more sleep, for two reasons. The first is that sleep quality can be worse while at altitude, so spending more time in bed to get the same number of REM cycles and quality becomes necessary. The second is that altitude is an additional stressor on the body, which requires extra recovery.

Dehydration

Most altitude locations have very low humidity. When this is combined with the higher respiration rate at altitude, there is a greater loss of water through expiration and sweating. In order to replace this, it is necessary to drink extra water frequently, and in larger volumes than usual, the whole time you are at altitude.

Temperature Changes

Because of the elevation, temperature changes are much greater at higher elevations, compared to lower elevations. Keep this in mind when you plan to spend more than a few hours outside. If you are planning on increasing elevation, be prepared for a decrease of anywhere from 3-6 degrees Fahrenheit, depending on conditions, per 1,000 feet of elevation gain. Dress in layers that you can add or remove as necessary.

Altitude Sickness

Altitude sickness is a reaction to increasing altitude too quickly. It usually occurs above 10,000 feet; however, it can occur at any point. The symptoms include a headache, nausea, loss of appetite, shortness of breath, fast heart rate, and fatigue. The only remedy is to reduce your elevation, or take supplemental oxygen. You can preempt altitude sickness by taking iron ahead of time, hydrating properly and adequately, and increasing your altitude a little at a time.

How High to Live

For short stints at altitude, the best elevation seems to be between 7,000 and 8,000 feet. One study suggested that, during a short stint, only athletes that lived and trained in this range had measurable increases in Vo2 max, as well as improvements in 3,000-meter race performances.

Any elevation above 3,000 feet is considered altitude, with increasing physiological response as altitude increases, up to about 9,000 or 10,000 feet. The comfort and convenience of a lower elevation might also balance out the extra physiological effects but increased emotional stress of a higher altitude location. Especially with your first trip to altitude, making it an easy and comfortable experience outweighs trying to get as high as possible, or trying for some optimal altitude.

The Optimal Length of Stay at Altitude

There is a clear increase in red blood cells after just one week at altitude, but the increases are exponential for each additional week. This is especially true in the three- to four-week range.

Any time spent at altitude will result in some improvement in red blood cell production, but a stay of three to four weeks will result in the best ratio of red blood cell production, compared to time spent at altitude.

References

Chapman, Robert & Wilber, Randy. “Altitude Training for Sea Level Performance: Best Practices and Timing for Championships.” Handout for 2011 IAAF Athletic Championships, Daegu, South Korea.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Because nothing in life is perfect, daily stressors inevitably will inhibit our ability to train optimally. I knew I couldn’t manage the external stressors that my athletes experienced, but I decided I could create something that would account for their level of readiness on any given day.

The Stress Scale for Athletes dramatically changed the way I train athletes. The scale allows me to apply the appropriate training load for a session based on an athlete’s readiness that day despite any stresses they’re dealing with outside the gym. I’ve used it for the past eight months, and it has served us surprisingly well with significant results.

The information I present is a culmination of existing concepts, including the Prilepin’s Chart, the rate of perceived exertion (RPE) scale, and fatigue management concepts I’ve put together based on “in the trenches” empirical data. I’ve recorded hundreds, if not thousands, of different numbers in my ten notebooks that I carry with me daily. I hope this information helps you well in your training and coaching.

Recognizing the Stress Problem

We all experience stress. Stress manifests itself in many ways, both acutely and chronically. Furthermore, all stressors are not created equal—to an extent. However, both types of stress have a large effect on our training and the ability to recover from each training session.

A training session consisting of 4×10 volume squats puts significant stress on the body and will cause fatigue in most of us. Emotional pain is a stressor as well, for example a break up with a significant other. One physical, one physiological, both cause systemic stress on the body that will inhibit optimal subsequent training sessions.

When thinking about stress, it’s useful to start with the General Adaptation Syndrome. Very small amounts of stress won’t provoke a very robust adaptive response, while more stress increases adaptation. Too much stress—to the point where we can’t cope physically or psychologically— decreases the rate of adaptation.

Keep in mind that, while our bodies don’t differentiate types of stress to a great degree, the specific adaptations to various stressors (lifting weights, a car crash, and tight work deadlines, for example) will differ. Also, the body’s general response to any stressor is very similar regardless of the specific stressor we encounter.

This means that all the stressors in life pool together and dip into the same reservoir of “adaptive reserves” available for recovering from those stressors. This allows us to adapt so we’ll be better equipped to handle them next time. With strength training, this means bigger and stronger muscles, more resilient tendons and connective tissue, and bones that can handle heavier loading.

Our bodies need a certain amount of stress to function normally. If we remove all the stressors from our lives, our bodies begin to deteriorate. For example, if we were to win the lottery and spend a year lying on the couch watching reality TV, facing no stressors that challenge us physically or mentally, we’d be much weaker and in much worse health than we are now with some baseline level of physical and psychological stress.

Past that baseline level, additional stress causes beneficial adaptation with diminishing returns and eventually negative returns. The first input of any stress causes the largest beneficial adaptation. More stress will have an additive effect, though each additional unit of stress doesn’t add as much benefit as the first. Once the total amount of physical and psychological stress exceeds the threshold of what our adaptive reserves can handle, any additional stress will cause negative effects.

My Challenge as a Coach

It’s nearly impossible to monitor an athlete’s stress levels since we have little control over the external things that happen to them outside the weight room. In most cases, we see our athletes no more than 8-10 hours a week. There are 168 hours in the week. That leaves athletes with at least 158 hours experiencing other external and internal stressors.

As coaches, our job is to ensure our athletes feel good, are ready to perform, and can sustain a healthy lifestyle that is conducive to sport success. Because we cannot control everything that happens outside the gym, we must create training programs that will most benefit our athletes no matter what’s going on in their lives.

My professional athletes are always ready to go because they’ve dedicated their entire lives to training. They take the necessary steps to put themselves in the best position to succeed. I don’t train many professional athletes at a time, however, because of their busy schedules.

Like most coaches, the bulk of my athletes consist of high school and collegiate athletes, ranging from 14-22 years old. Thisis where things get tricky. We all know what amazing things happen during those years: partying, late nights, relationships, breakups, school work, and the daily stress of home life. These may seem small to us now, but we all remember how much they influenced us at that age and how we felt on a daily basis.

One week my athletes came in, and the weights were moving. They were hitting numbers 25-30lbs over what we prescribed for the day. The problem with this happened during the following weeks of training. They did not even come close to the numbers they were supposed to hit based on their performances the previous week. As always, I asked them how they felt, what they ate, how they slept, and how their weekends were. The answers always changed. “I didn’t sleep well” or “I had a rough weekend” or “I didn’t have time to eat.”

This was when I knew I couldn’t keep prescribing the same thing week after week with minor tweaks here and there. I needed a holistic training program overhaul.

Concrete Steps Toward a Solution: Stress Scale for Athletes

Since I couldn’t manage the external stressors my athletes experienced, I created a method to account for their level of readiness on any given day. Below are outlines of two tables you may have seen before.

As the reps increase, the perceived intensity of each load decreases. Obviously a 5RM should be at a lower percentage than a 1-2RM, which is why 5 reps @ RPE 5 would be about 60-65% and a single rep @ RPE 5 would be around 80%. Volume work around 80% of your 1RM could fall anywhere between 3-6 reps, so an 80% single would be no problem, thus an RPE 5 on the RPE Scale.

At this point, I had Prilepin’s Chart and an RPE table with estimated percentages that closely resembled Prilepin’s Chart. I now needed to account for how the athletes felt, how much volume they could handle, and how much they could recover from each training session.

When looking at the Stress Scale for Athletes, keep in mind these key definitions:

• Training Effect (TE)—the training objective and desired effect for the day.
• Percentage of 1RM—based on Prilepin’s Chart, the objective of each percentage.
• RPE—a number value based on effort and associated with a given percentage of your 1RM.
• Fatigue Management Levels (FML)—how fatigued you are, based on your RPE.
• Minimum Effective Dose (MED)—the minimum amount of volume to get the desired outcome and training effect for that training session, based on Prilepin’s Chart.
• Maximum Recoverable Volume (MRV)—the most amount of volume an athlete can handle during a particular training session to recover and progress in the subsequent training session. This concept was brought to me by Dr. Mike Israetel of Renaissance Periodization and has been extremely useful in training my athletes.

How to Start with Your Athletes

Here’s how to use the Stress Scale with your athletes. Start by asking them how each set felt, starting with warm-ups up to their working sets. Use the chart to compare and contrast your data. From here, you can modify the training plan based on how your athletes feel that day. I left room for flexibility because everyone is going to perceive certain training loads differently. This allows more flexibility in your coaching program as well.

Based on all of the information in the table, here is an example of how I would use the Stress Scale with my athletes.

Example of the Stress Scale for Athletes

1RM Squat = 315

Work for the Day = Squat 3×5 @ RPE 7 | 70-75% = 240

• Bar x 10
• 135 x 10 @ RPE 4 | 50% x 10
• 185 x 5-8 @ RPE 5 | 60% x 8
• 225 x 5 @ RPE 7.5-8 | 70% x 5
• 240 is the target range for the day but 70% (225) felt like an 8 RPE according to the Stress Scale; 70% should be an RPE 6-7 at the most. This would put your fatigue level at 3 vs. 1-2 according to the Stress Scale.

You now have two options:

1. Option A. Cut back to 225 @ RPE 7 (70%) and hit your MED—15 reps.

2. Option B. Go up to 240 @ RPE 8 but cut back your volume to 6-14 reps total (MED for that range).

• FML represents how fatigued the athlete is for that particular day or possibly week. It’s not perfect, but it is a very strong representation of the athlete’s output for that training session. Overall intensity does not always create the most stress. Overall volume can cause significant stress for an athlete as well.

Observations and Results

I’ve been using the Stress Scale for eight months. During this time, my athletes have hit numerous PRs. More importantly, they’re always working within the appropriate ranges for the day as opposed to trying to hit percentages or numbers based on what they did last week. They’ve progressed week to week without overexerting themselves, which protects against getting hurt.

The Stress Scale also allows the athletes to take ownership of their bodies and how they feel. Our job as coaches is not only to lay out a plan and guide our athletes, but to teach them how to take care of their bodies, how to train properly, and how to live a healthy lifestyle. The Stress Scale helps give ownership and accountability to my athletes.

Final Thoughts

Training athletes is about health, progression, and longevity. There is a time and place for heavy metal, ammonia caps, and yelling. However, the day in and day out grind will not always provide these energy levels. We need a way to improve our athletes every single time they step foot in the facility. I hope this becomes a useful tool that you can use in training yourself and your athletes.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Exercise program design is an applied solution for the inherently complex task of strategically manipulating the biological expression of the human life form. The degree of complexity and depth to human physiology is one of the most daunting puzzles facing scientists. Long story short, we as coaches and sports scientists are trying to understand and manipulate a system that the best and brightest minds of all time couldn’t and cannot fully grasp.

This is really hard stuff, and it is my belief that the best we can do is create inaccurate models that are rooted in basic science and simple rules that maximize utility and reproducible numerical results. It is also my belief that the only way you can actually design a comprehensible and comprehensive training system is to design it around biomechanics rather than physiological principles. You will ultimately affect appropriate physiological pathways as a by-product of training the relevant and appropriate domains within a biomechanics model.

If you can work your way through this article and grasp the central tenets of the fundamental principles here, I think you’ll see that this is perhaps the most useful model currently in existence for designing fitness programs.

A New Training Model – Designing with Biology

Biology, as a single coherent discipline, is said to have begun in the 19th century. Biology traces its roots to ancient times, and is heavily influenced by medicine, botany, and zoology; however, we can say that it is still relatively young compared to things like mathematics. Exercise science falls under the umbrella of biology, and is essentially in its infancy from the timeline perspective of scientific inquiry.

Whenever there is a young scientific realm, one of the first things that needs to be done is a taxonomy of the phenomena within that domain. The most famous scientific taxonomy is the one constructed for life forms (Systema Naturae) that was put together by Carolus Linnaeus. You can effectively classify any form of life on the planet by going through the hierarchical arrangement of Linnaeus’ taxonomy.

In my mind, the world of exercise is not very different from the world of life. Life on planet Earth is incredibly diverse, with what seems to be an infinite number of variations on each type of creature, plant, or fungi. Some forms of life are so bizarre that it is hard to believe they exist. From our perspective, many animals don’t seem to make any sense at all; however, each living thing on this planet makes perfect sense in the environmental niche that it has come to occupy and take advantage of.

In the world of exercise, there are so many ways that humans choose to move that it seems to defy all possible logic. Some methods of physical exertion look ridiculous—bordering on comedic, dangerous, or misguided—yet they exist, and will probably continue to exist for a long time. Those of us who work in the world of exercise and gravitate towards a scientific perspective are often mortified by what we perceive to be stupid approaches to training, but this is likely due to the perspective we take from the lens we have been taught to view things through.

Fear not for your sanity though, my empirically minded brethren, for I would like to present to you a model you can use to classify and categorize all forms of exercise, along with a model you can use to grade the degree to which the movement you are witnessing represents optimal. To accomplish such a feat, I believe that you must take a biomechanics path rather than a physiological path.

The biomechanics model I present here is based on the idea that biomechanics is divided into two primary domains: kinematics and kinetics. Kinematics describes the quality of the shapes that life can assume and move through, and kinetics provides quantitative information on movement. In my model, I divide kinematics into three sections: pattern, stance, and plane. I also divide kinetics into three sections: load, velocity, and duration. It is my belief that you can arrive at any exercise you could fathom by describing it via the six levels of this biomechanics hierarchy.

Getting Started with Key Movement Patterns

The topic of movement patterns has a large amount of ambiguity, and you should feel free to come up with different patterns than what I have here. Ian King was one of the first to begin thinking along the lines of creating an exercise taxonomy, and many of us gravitate back towards his list of primary resistance training patterns whenever we think about designing a training plan for athletes.

Great coaches like Boyle and Verstegen were wise to begin thinking of designing training days based on concepts such as linear and multidirectional movement directions/patterns. However, it’s time to upgrade and expand these models, and make them more objective. Having said that, here are the patterns that I use in this section of the Exercise Taxonomy.

When I talk about stance, I mean the arrangement of the feet relative to each other and relative to the center of mass of the axial skeleton. I divide stance into three realms: bilateral symmetrical, asymmetrical front/back, and asymmetrical lateral.

Bilateral symmetrical stances are common in life and sport, and involve the two feet being next to each other and bearing equal weight from the skeleton above. The bilateral symmetrical stance is often a ready position in sports (pre-snap linebackers, pre-pitch baseball players, free throw position in basketball, etc.), and is the position from which certain athletic movements take place, such as two-foot vertical jumping. In the world of exercise, the bilateral symmetrical stance is essentially the place we find ourselves in when performing nearly every weight room movement imaginable.

The asymmetrical front/back stance can most easily be thought of as a lunge position; however, in this model it would be any instance where one foot is in front of the other foot. The asymmetrical front/back staggered position of feet is ubiquitous within athletics, as it is the only way to run. It is how we create first steps, jab steps in basketball, and shots in wrestling, to name a few.

The asymmetrical lateral staggered stance is where one foot remains under the center of mass of the axial skeleton, and the other foot is kicked out to the side like a kickstand and resides outside the axial skeleton. In the world of exercise, the lateral lunge is the easiest way to think of the presentation of this stance. Kettlebell lifting is also an exercise where this stance is used with some frequency, as movements like the Turkish Get-Up and the windmill both feature this foot arrangement throughout or in part of the movement. The asymmetrical lateral stance displays itself in sport mostly in movements featuring change of direction, such as cutting, but also in throwing motions, and is seemingly the only way to ice skate.

The Essence of the Planes of Motion

You will probably be introduced to the three anatomical cardinal planes of motion in one of the first three chapters of any anatomy textbook. Rather than belaboring the identification and definitions of these planes that we should all know, I would like to share what I perceive as the essence of each plane for humans.

The sagittal plane is your anti-gravity plane. Mastering the sagittal plane allows you to avoid falling on your face or your back. The frontal plane is the plane you have to regulate to ultimately create forward propulsion. Optimal forward propulsion occurs when a center of mass shifts side to side (truly in a sigmoidal pathway), but stays within the boundaries of the base of support (inside the feet). Those who display aberrant frontal plane mechanics stagger back and forth like they’re drunk, and lose energy that should be contributing towards moving forward. The transverse plane allows us to coil and uncoil for high rate of force development striking and throwing maneuvers.

Do what you will with this paragraph, because it is speculative; however, I do not see enough people asking appropriate questions, such as what the purpose of the cardinal planes of movement are from an overarching perspective, so I’m putting the discussion forward. My statements here regarding the purposes and essences of these planes guide me through the way that I coach exercises that I believe target a specific plane of motion. My confirmation that an exercise targeted a specific plane is the individual I am coaching reporting that they feel a muscle corresponding to an appropriate plane.

When attempting to train the sagittal plane, the affected muscles should be flexors and extensors. When targeting the frontal plane, individuals should feel adductors and abductors, and when going after the transverse plane, rotator muscles should be working. The specifics of knowing that an activity represents competency within a specific plane of motion will be covered in Part 2 of this article series.

Kinetic Zones and Individualizing Training

As we move into the kinetics side of the discussion, I would like to start out by saying that I have created my own arbitrary differentiations for what will constitute different levels of load, velocity, and duration. With all three of the kinetics variables, I try to keep things simple and divide them into three zones. If you want to create your own system with more levels or fewer levels that’s on you, and that’s fine.

I divide load into activities that use high load, moderate load, and low load. I divide velocity into high velocity, moderate velocity, and low velocity. I divide duration into long duration, moderate duration, and short duration. To provide some level of numerical bumpers to these three levels of load, velocity, and duration, the following may be useful to people.

So now that I have introduced you to all the factors at play, let’s discuss how a coach would go about utilizing this information. I would start with the kinematics information. First, what movement pattern are you trying to train? Once you have identified the pattern, what stance are you going to put the athlete in? Now that you have a pattern and a stance, what plane of motion do you want them to move in?

Now we shift our attention to the kinetics variables. How much load do you want to provide? What velocity do you want the load moved at? How long would you like this movement to take place for? Once you have provided an answer for all of these questions, you choose your tool (e.g., barbell, medicine ball, etc.) and you arrive at an exercise.

For the most part, the first thing you want to do with athletes at the beginning of a session is to “warm them up.” How would I use the model being presented here? As a very simple example, I’ll choose the locomotion pattern in the asymmetrical front/back staggered stance performed in the sagittal plane, performed with low load, low velocity, and moderate duration. What is that? Jogging the length of a football field.

Maybe you are a coach who bases things on FMS principles, and you’re of the belief that you can improve the mobility and/or stability of an athlete with a prescribed activity. You choose knee dominant, bilateral symmetrical stance, sagittal plane, low load, low velocity, and moderate duration, and you come up with an activity like a squat to stand. I could list countless examples, but warm-up is generally a time of low-load, low-velocity, and short- to moderate-duration activities that can try to either mimic the activities you want to train or attempt to improve the overall movement capabilities of the individual you are coaching.

As training sessions move beyond warm-ups, I would likely next do activities with low load, high velocity, and short duration (aka, speed, agility, plyometrics, or medicine ball throwing), and I would arrive at the activity by defining it from a kinematics perspective. Change of direction with a lateral asymmetrical stance in the frontal plane in this circumstance would be a 5-10-5. Throwing from a bilateral symmetrical stance in the transverse plane would be rotational med ball throws facing towards a wall. Triple extension from an asymmetrical front/back stance in the sagittal plane would be a split squat jump.

The Weight Room – Loading Smarter

Following low-load, high-velocity, short-duration activities, it is very likely that I would next proceed to the weight room with the athlete. The first weight room activities would most likely be lifts with high load, high velocity, and short duration. The most obvious example that fits into this category is Olympic lifts. Cleans and snatches, and their derivatives, are generally triple extension, bilateral symmetrical stance, sagittal activities. Split jerks would feature a transition into an asymmetrical front/back staggered stance.

Outside of Olympic lifts, it becomes difficult to think of activities that fall into this kinetics category; however, the sport of Strongman may provide some alternatives. Stone loading and tire flipping provide alternative triple extension, bilateral symmetrical, sagittal plane activities that require very little coaching. Tire flipping also features the transition into the asymmetrical front/back stance similar to split jerks.

An activity that lives in this kinetics category and also features a transverse plane element is the circus dumbbell clean and press. To be able to clean the dumbbell, the athlete needs to bring the bell up to only one shoulder, which requires rotation to accomplish the task. Outside of the circus dumbbell, which many strength and conditioning coaches likely are not versed in performing or coaching, it is difficult to think of other activities in this kinetic realm that feature moving in any other plane but sagittal.

After performing high-load, high-velocity, short-duration lifts, the most likely next kinetics realm that we would move to would be high-load, low-velocity, short- to moderate-duration activities. Classic examples of movements in this category would be deadlifts, squats, presses, rows, and pull-ups. Most of the activities in this realm are going to be bilateral symmetrical, sagittal plane activities, as these seem to be the stance and plane that lend themselves most to developing strength.

Generally speaking, most coaches attempt to put an activity from the major lifting categories somewhere in their weekly training programs. At some point, athletes will perform a hip-dominant, knee-dominant, horizontal push/pull, and vertical push/pull activity from this kinetics domain at least once a week in their program.

The next component of training in a standard model would be assistance lifts. This could have some movement pattern bleed over from the previous category, but could also feature movements from categories such as locomotion (loaded carries and sled work), and throwing (Turkish Get-Ups and windmills—I consider these to be the same pattern), along with core exercises focusing on the pelvis (Nordics) and ribs (planks). These activities would generally be classified as moderate load, moderate velocity, and moderate duration from a kinetics perspective.

The activities coming from hip dominant, knee dominant, horizontal push/pull, and vertical push/pull would often be unilateral choices once we’ve reached this component of training. Prior to creating this training/programming matrix, I really struggled with knowing where to put the kettlebell grind lifts. I simply did not have a bucket to know where those kinds of things belonged, other than putting them in as assistance activities after the main lift.

Now I understand that a Turkish get-up for three reps each hand fits into the previously mentioned kinetics domain, and is a throwing activity performed from an asymmetrical lateral stance focusing on the transverse plane. I also understand that farmer’s walk for 100 feet is moderate- to high-load locomotion at moderate to slow velocity for moderate duration with an asymmetrical front/back stance in the sagittal plane. This ability to describe these activities has led me to think about where they would fit into a program much more accurately.

The last piece of a very simple training day would be some kind of conditioning exercise. Conditioning in this case is low-load, low-velocity, long-duration kinetic activity. I usually try to think of cyclic activities for this kinetic domain. Common weight room conditioning activities include jogging, stationary bikes, Jacob’s Ladder, VersaClimber, slide board, and rowers.

Jogging is asymmetrical front/back stance sagittal locomotion. A spin bike is locomotion (this is questionable—you’re free to disagree) from an asymmetrical front/back stance in a sagittal direction, but if you use an arm and leg bike, that would add transverse plane to the equation because the movements of the arms would rotate the trunk. Jacob’s Ladder is also locomotion in an asymmetrical front/back stance in the sagittal plane, and is a great option for individuals who need impact removed from their training.

The VersaClimber is locomotion in an asymmetrical front/back stance, but is a frontal plane dominant movement, as individuals move like upright salamanders while using this piece of equipment. The slide board is change of direction in a lateral asymmetrical stance with the movement taking place in the frontal plane. Rowers feature a combination of knee-dominant and horizontal pulling (hard to categorize), and are bilateral symmetrical stance sagittal tools.

To help the reader conceptualize the whole puzzle, here are three tables that visually demonstrate the taxonomy concept for specific exercises.

The easiest example that I can think of involving grossly imbalanced movers and a high degree of injury is CrossFit. When analyzing the types of movements done in CrossFit, almost all take place in a bilateral symmetrical stance, and move in the sagittal plane. CrossFitters warm up in this stance and plane, they lift in this stance and plane, and they even condition in this stance and plane (burpees, wall-balls, rowers, high-rep Olympic lifts, etc.). Other stances and planes of movement are largely neglected. With CrossFit, you also see times when the athletes are forced to do unpredictable, random events at competitions. You’ll see an inability to cope with certain new events, as well as high rates of injuries in those new events (swimming and peg board are two classic examples).

It is my opinion that different stances and planes are distinct biomechanic realms with limited carryover to other stances and planes of movement. The accurate assessment of strength, speed, and fitness in specific stances and planes featuring various patterns executed with different loading schemes, velocity presentations, and durations will become a critical task for coaches moving into the future of the sports performance coaching.

Parting Thoughts on Biomechanics and Program Design

Every sport features levels of dominance in terms of what stances athletes assume, what planes they move through, what patterns they execute, what kinds of loads they encounter, what sorts of velocities they need to be able to produce, and what kinds of durations they need to continue to move through. Targeting those kinematic and kinetic realms is a great way to provide fairly specific stimuli in the training process.

Beyond specificity of training, athletes also seem to benefit from the performance of training movements that target antagonist tissues to their sports moves, as this is believed to have injury prevention elements. We should begin to try to quantify the number of movements that athletes perform in specific kinematic and kinetic realms.

Such an endeavor, using the taxonomy and tables that I have provided here, would be an enormous undertaking, and would require computer systems to accurately model out how much movement an athlete actually performs in a specific pattern, stance, and plane at specific loads, velocities, and durations. If we could see the total quantity of movement in these biomechanical domains, we may get a glimpse into the likelihood of injury potential for an individual, and possibly see that there is a movement rate-limiting factor preventing further progress towards sport-specific goals.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Coaching is expensive. It consumes your personal time and bank account. We get paid in personal satisfaction, passion, happiness, competitiveness, and growth. However, our bank statements only reflect withdrawals for expenses and tiny amounts of monetary deposits for work. If you break down a coach’s stipend and divide it by the amount of hours spent on work, it most likely averages to pennies on the hour. Coaching is a labor of love. Increasingly, budgets are being reduced, particularly in sports like track and field.

If this situation describes you, you have to be creative with spending. Speed Hurdles are not cheap. A new set of six can cost as much as $40. Adjustable ones are even more costly. We tried using small cones or disc cones, but they didn’t have the same benefit as actual wickets. The solution: build your own wickets. This article serves as a practical guide in creating wickets in a frugal and simple manner. It outlines how we created 20 wickets for less than $2.00 apiece. You can change the dimensions to create wickets for whatever purpose is desired.

The next article, Part 2, discusses how we use the wickets, with special emphasis on the different spacing according to the skill levels of your athletes and the time of season. In the meantime, grab the spare change in your savings jar and build your first wicket!

Total Materials

1. Five 10-foot-long PVC pipes, half-inch width (5x$2.18 each pipe = $10.90).
2. Forty 90-degree half-inch elbows (40×22 cents per elbow = $8.80).
3. 40 half-inch PVC insert fitting Ts (40×48 cents apiece = $19.20).

Materials for Each Wicket

• One 14-inch length PVC pipe
• Two 6-inch lengths PVC pipe
• Two PVC T fittings
• Two 90-degree PVC elbows

Construction

1. Cut one 14-inch piece of PVC pipe to use as the crossbar (top) of each wicket. Next, cut 19 more equal pieces, using the first length as a model. This accounts for 280 inches of the 10 PVC pipes, leaving 420 inches.
2. Cut one 6-inch pipe segment to serve as a guide for the posts (sides) of each wicket. Then cut 39 more equal pieces. This uses another 240 inches of the PVC pipe. That leaves 80 inches of unused PVC pipe, which you may be able to use elsewhere.
3. Use two elbows, one at each end of the 14-inch crossbars, to join the crossbars with the 6-inch posts and form the top and sides of the wickets.
4. Insert a T at the bottom of each post to serve as the base of the wicket.

After building the first set, we created 40 more wickets so we could have three different settings to accommodate all skill levels within our program. It added slightly to the overall cost but the added benefits are invaluable.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

Analytics have become a religion in sports. And why not? Coaches are looking for every possible way to squeeze more skill out of their athletes, and a data-driven approach makes sense.

But most developing athletes need something much simpler: more sleep.

It shouldn’t come as a surprise. Still, it’s rarely recognized as the low hanging, performance enhancing fruit that it is. I suspect that’s because it isn’t well understood.

Sleep, Memory, and Skill Development

Sleep prior to a big event is the most important, right? Not necessarily. It’s actually sleep after a lesson, practice, or big game that impacts skill development. If you don’t sleep the night after training, you’ll never learn. It doesn’t matter if you sleep well the following nights. Getting seven to eight hours of sleep allows the brain to process events from the day, and commit it to knowledge.

When we sleep, we repeatedly go through 90-to-120-minute cycles. Within those cycles, there are two main types of sleep: deep and rapid-eye-movement (REM). Deep sleep comes first. During this process, the brain consolidates memories and rebuilds energy stores. As the night goes on, the balance shifts, with REM dominating the final cycles. You’ve probably heard most of the dreams we remember occur during REM.

Solidifying knowledge requires both types of sleep. Phase one, which happens during deep sleep, is basically a rehearsal: Your brain files away the facts and practices the moves it learned that day. Phase two is integration. This is where those facts and lessons are combined with existing knowledge. This happens during REM.

There is an excellent study conducted at MIT that demonstrated how sleep helps build long-term memories in mice. Spoiler alert: Researchers were able to determine that the mice were replaying new experiences in their brains as they slept.

Sleep and Recovery

Many benefits of getting enough sleep—clearer thinking, more consistent metabolism—are well established and widely understood. Most coaches should also be aware of the connection between sleep and growth hormone secretion.

But the effects of sleep deprivation are less understood and more worrisome.

Clinically, we know that sleep deprivation leads to depression, high blood pressure, weight gain, heart disease, and possibly mortality. But here’s what track and field coaches need to know about sleep deprivation:

Numerous studies have shown that reaction time nearly triples when a person misses an entire night of sleep. Regularly it’s at about a quarter of a second. Didn’t sleep last night? Ok. It’ll increase to 800 to 900 milliseconds.

Losing that half a second on the track is, well, costly.

And here’s another doozy: After just one week of sleeping five hours or less each night, a man’s testosterone levels drop as if he’s aged about 11 years. You’re aware testosterone is critical to male sexual behavior and reproduction, but it also plays a critical role in recovery — think muscle mass and strength, bone density, and even decision-making abilities.

Techniques for Better Sleep

“Get a good night’s rest. We’ve got a big day tomorrow.” You’ve said this before, so you’re already prescribing sleep. Excellent.

But how many of your athletes can’t quite shut their minds off when it’s time to rest? They’re too excited, too anxious for the big meet. If you’re coaching developing athletes, it’s probably a big number.

One simple technique we prescribe our athletes (in addition to neurofeedback) is a combination of breathing exercises, heart rate monitoring, and sleep tracking. It sounds complicated. It’s actually very simple. So simple, we’ve turned it into a free app—SenseSleep.

Basically, your brain should be produced relaxed brain waves when it’s time to go to bed. This can be difficult to do when you’re mind is racing with thoughts about tomorrow. Research has shown that controlled breathing exercises can help the brain enter a more relaxed, sleepy state.

Here’s how it works:

Record your heart rate — If your heart is beating too quickly, your brain and body are probably too active to fall asleep—obviously. It’s a simple indicator in your autonomic system, and it’s a measurement you can watch improve in real time.

Begin breathing exercises — SenseSleep will guide you through simple breathing exercises designed to lower your heart rate, calm your brainwaves, and prepare your body for rest.

Rate your sleep — The next time you open SenseSleep, you’ll rate your night’s sleep on a scale of 1 through 5. This allows you to track improvement over time and learn what techniques work best for you.

Thanks For Reading

If you’d like to learn more about self-regulation techniques like biofeedback and neurofeedback, feel free to follow me on Twitter @LeslieSherlin or my Facebook page. For more information about SenseLabs be sure to check out our Twitter (@sense_labs), like our Facebook page, or visit our website SenseLabs.

Please share so others may benefit.

If you’re involved in sports that require speed, power, and strength, then you’ve likely come across creatine before. The supplement gained prominence in the early 1990s as a method of enhancing strength, and since then research has continued to explore its use as a sports performance aid.

In this article, I’ll give an overview of the research underpinning creatine’s use as a training aid, but also focus on some of the more novel findings regarding creatine. This includes its use as an agent to prevent disuse atrophy in injured athletes, as a cognitive enhancer, and as a potentially important agent in the recovery from concussion. Given these important new findings, we can no longer just consider creatine from the perspective of muscle, but instead view it as a supplement that can optimize performance across a number of different realms.

What Is Creatine?

Creatine is a naturally occurring, nitrogen-containing molecule that tends to be found in animal flesh. Creatine’s main role in humans is as part of the ATP-PC energy system—the method by which we produce energy rapidly during high-intensity exercise, such as in sprinting or lifting heavy weights. Our body utilizes adenosine triphosphate (ATP)—the “energy currency” of the cell—to power muscle contraction; here, the breaking of a bond between one of the phosphate molecules and adenosine creates the energy required for contraction.

This leads to a buildup of adenosine diphosphate (ADP), which the body can’t utilize for energy quite as readily. Instead, it needs to add an additional phosphate molecule to ADP, recycling it back to ATP. This reaction requires an additional phosphate molecule to be found from somewhere, and the most readily available source is from phosphocreatine, one of the major ways creatine is stored in the body.

Creatine Supplementation for Performance

Given that we need energy to train, and given that the majority of speed, strength, and power adaptations come from high-intensity exercise, a logical step was for researchers to take a closer look at whether creatine supplementation could increase muscular levels of creatine. If it could, then in theory we would have greater amounts of phosphocreatine available, and so could both sustain high-intensity exercise for longer and also recover from it quicker.

An early study from 1992 was one of the first to test this hypothesis. In this case, the researchers recruited 17 males and females of differing ages (ranging from 20-62 years old), and differing levels of fitness. It was found that 5g of creatine (the amount found in just over 1kg of steak) resulted in a decent increase in blood plasma levels of creatine, and that supplementation of 5g four to six times per day for at least two days led to a substantial increase in creatine levels within the muscle.

Subsequent research indicated that, following a loading phase comprised of six days of consuming 20g of creatine per day, the increased creatine levels could be maintained with an intake of just 2g per day. A daily dose of 3g per day, with no loading phase, was found to be similarly effective at increasing and maintaining creatine levels, such that, today, most athletes skip the loading phase and just consume creatine at a set dose.

But do increased creatine stores lead to enhanced performance? Well, the short answer is yes—this has been exceptionally well-researched over the years, such that we can now be very confident that creatine supplementation can enhance performance in exercise tasks lasting less than 30 seconds (where the ATP-PC system plays a large role), strength, and strength endurance, as well as potentially aiding in improvements in body composition. There is also some evidence that creatine supplementation may enhance aerobic endurance performance, potentially due to an increased ability to train at higher workloads.

Creatine Supplementation for Recovery

Alongside its clear and replicated performance benefits, there is also the potential that creatine can act to support recovery from exercise, which a number of different studies have explored. Such a positive effect of creatine supplementation has been shown for recovery from sprint-based exercise, resistance training, endurance exercise and competition, and eccentric loading protocols. In particular, it appears to enhance the repeated bout effect, whereby we experience less soreness following prior eccentric loading.

Although not all studies show such a positive effect, none show a negative effect, and so creatine supplementation may be a worthwhile consideration as a recovery agent. Furthermore, chronic ingestion of creatine enhances muscle glycogen resynthesis following prolonged exercise, illustrating that it might be a useful method of enhancing recovery between repeated bouts of endurance exercise, such as those seen in heats and finals at major championships, or in team sports that compete on a weekly basis.

Creatine Supplementation and Injury

Creatine has also shown promise as an agent that may enhance the post-injury rehabilitation process. This can be especially true when immobilization has to occur, for example when a cast is worn. In a 2009 study published in the Journal of Strength and Conditioning Research, researchers recruited seven male subjects and had their arm placed in a plaster cast for seven days on two different occasions. On one occasion they received a placebo, and on another they consumed 20g of creatine per day for the duration of immobilization.

The researchers found that creatine supplementation maintained lean muscle mass to a greater extent than placebo following immobilization, which in turn was associated with better maintenance of strength and strength endurance. These results have since been replicated—although an effect is not always found—and, given that increasing the strength of an injured body part post-injury is a crucial part of the return-to-play process, it’s easy to understand how a better maintenance of muscle mass and strength during the early injury immobilization phase may be worthwhile.

Creatine Supplementation and the Brain

Given what I’ve reviewed so far, it’s clear that creatine has a multitude of positive physiological effects on performance across a variety of different domains, from strength to sprints to endurance training. But its positive effects don’t just end there. While the majority (~95%) of the creatine in our bodies is found in our muscles, a smaller proportion can be found in the brain, where, as in muscle, it has a role to play in the production of energy.

This gives creatine the potential to be a useful neurocognitive enhancer. A great example of this is creatine’s use in the management of Parkinson’s disease. It is believed that Parkinson’s develops through mitochondrial dysfunction, indicating that there is a breakdown in the optimal production of energy in the brain. Because creatine can help offset this metabolic dysfunction, it may well be useful here, and is in fact undergoing testing in clinical trials. Such cognitive effects have also been shown in non-diseased subjects, including the elderly and those who may consume lower-than-normal dietary levels of creatine, such as vegetarians.

Perhaps one of the more exciting neurocognitive uses of creatine, from a performance perspective, is that it appears to mitigate some of the negative effects of insufficient sleep. This could be important when it comes to sports that have a higher neurocognitive demand, characterized by the need to make many decisions in a short period of time, as in many team sports.

This was shown in a neat 2011 study, published in the Journal of the International Society of Sports Nutrition. Here, researchers put 10 elite rugby players through a rugby passing skill test on 10 different occasions. Half of the times the subjects undertook the passing test, they had slept for between seven and nine hours the previous night; the other times, they had slept for between three and five hours. Ninety minutes before the start of each trial, they took a placebo, creatine (either in a dose of 50 or 100 mg/kg), or caffeine (in a dose of 1 or 5 mg/kg).

The results indicated, unsurprisingly, that sleep deprivation negatively affected skill execution, but that the use of either creatine or caffeine reduced this negative effect. Regarding the creatine, subjects taking the higher dose (100 mg/kg, equivalent to 8g creatine in an 80kg individual) performed slightly better than those taking the 50 mg/kg dose. As such, while we all understand the importance of getting a good night’s sleep, for times when this hasn’t happened—perhaps due to travel, or pre-competition nerves—creatine represents a potentially useful avenue to at least rescue some of the expected performance loss.

While it is obvious to state that exercise depletes energy stores, and that this is a cause of fatigue, we are starting to understand that there is in fact a two-way interaction between the brain and body when it comes to determining how fatigued an individual is during exercise. (The excellent book Endure by Alex Hutchinson explores this particularly well.) Briefly, it is thought that fatigue—defined as the inability to maintain a certain workload—occurs, in part, through the brain’s interpretation of a multitude of signals, including those measuring energy stores. There is the possibility here that additional muscular creatine, derived through supplementation, could act to “trick” the brain into thinking there is more energy available, allowing the athlete to exercise for longer.

Additionally, physical exercise also causes cognitive fatigue and, given that creatine supplementation can enhance cognitive function, it may also improve cognitive function towards the end of prolonged training and competition events, enhancing decision-making under fatigue. This could be especially important in team sport tournaments that have the possibility of extra time or overtime, and even penalty shootouts; here, the enhanced skill levels of the players with less cognitive fatigue (augmented by creatine supplementation) might be the difference between winning and losing.

Creatine and Concussion

So far, we have looked at how creatine supplementation may be able to enhance performance, but the most recent aspect of creatine research has been exploring how it might act as a neuroprotective agent when it comes to recovering from concussions. Following a concussive injury, research has shown that creatine concentrations in the brain decrease, and this, in turn, causes changes in metabolism within the brain cells, lengthening recovery time. Additionally, there is the potential that creatine can act as an antioxidant within the brain, supporting the recovery from concussive events.

The use of creatine as a neuroprotector has been tested experimentally, both in animal models and, more recently, in humans. The results from the animal models were positive: supplementation with creatine prior to the concussive event was associated with up to 50% less damage to the brain cells, which was mediated by creatine’s protective effects on the mitochondria. In the human studies, children who were suffering from a concussion were infused with ~0.4 grams of creatine per kilogram of bodyweight (a substantial creatine dose) every day for six months. They tended to showed improvements in memory, communication, and behavior, and had shorter hospital stays, when compared to the placebo group.

While these early results are promising, clearly there needs to be a greater amount of research carried out in this field before we can make more concrete statements. However, even based on the preliminary work undertaken so far, it does appear that creatine supplementation can enhance the recovery from concussive injuries—and certainly doesn’t seem to be negative. Based on the animal studies, there may be an additional protective advantage from creatine supplementation prior to the concussion happening, which is perhaps an added consideration for those athletes competing in contact sports.

Tentative Creatine Supplementation Recommendations

When it comes to the form of creatine to be used, there are many different types out there. The “original” form is creatine monohydrate; the research base suggests that this form is both safe for long-term use and also effective. As a small caveat here, given the fairly recent advent of creatine supplementation, the majority of studies are carried out over short time periods. As such, there are actually very few studies examining the effects of long-term (i.e., years) creatine supplementation, although data does suggest that continuous use for five years is not associated with any negative consequences in healthy individuals. Based on this, it seems sensible to suggest that those consuming creatine should have periods of time where they don’t utilize supplemental creatine. I tended to have eight continuous weeks per year in the off-season where I didn’t consume any supplemental creatine.

There is much less research on the alternative forms of creatine, so it’s difficult to ascertain their long-term safety and effectiveness. However, from the research that I have seen, they appear to offer no real advantages over creatine monohydrate. Therefore, given that this form is the cheapest, it seems the most sensible route for consumption.

A further consideration is that there is likely individual variation in the response to creatine supplementation. For many people, creatine will be readily available from diet. In people who consume meat on a daily basis, about half of their daily creatine requirements (2-3g) could be coming from dietary sources, with a pound of uncooked meat generally providing somewhere between 1 and 2 grams of creatine. As a result, many people likely need to supplement with less creatine than they might think.

A study from 2017 further explored this individual variation. Here, the researchers recruited 15 children (aged 10-12 years old), 31 adults (18-45 years old, of which just under half were vegetarian), and 18 elderly subjects (aged between 62 and 84 years). The subjects were given a placebo for seven days, and then switched to creatine (at 0.5 grams per kilogram of body mass) for seven days. At baseline, the adult vegetarians had the lowest levels of dietary creatine intake, which is unsurprising given that creatine is found in animal flesh. The adult omnivores had the highest intakes, with the children and elderly adults having similar intakes.

Creatine supplementation increased the muscle creatine content of both the children and the elderly subjects, and also the vegetarian adults, but was found to have a less-robust effect in adult omnivores. This demonstrates that the impact of creatine supplementation can vary as a function of regular diet, with those who consume the least creatine through dietary sources responding the best. There were no differences between the male and female subjects in this study, suggesting that sex has no impact on the responsiveness to supplementation.

Based on all the above, what advice could we give to people considering creatine supplementation? First, creatine has been shown to be effective at enhancing both performance in, and longer term training adaptations from, high-intensity exercise, including sprint and resistance training. Therefore, for athletes involved in sports that require high levels of performance in these traits, creatine represents a potential avenue for performance enhancement. There is less evidence that it may support aerobic endurance performance, although, again, as far as I am aware there are no studies demonstrating a negative effect of creatine supplementation. Given that athletes of all sports should be utilizing some resistance training, there is the potential for creatine to be effective.

The two methods commonly utilized when supplementing with creatine are either a loading method, which usually involves doses of around 25g per day for about a week, followed by a maintenance phase of 3-5g per day, or just ingestion of the maintenance dose (3-5g per day). Anecdotally, I always preferred just dosing with a smaller amount, but for extended periods of time.

Alongside creatine’s impact on training, it also has beneficial effects on post-exercise recovery, and potentially as a neurocognitive enhancer. As such, creatine is now present in many pre- and post-exercise ready-made mixes, which athletes might wish to consider. The combination of creatine and caffeine pre-competition (or even during competition, if the competitive bout is prolonged) may enhance the decision-making ability, and offset feelings of fatigue. Similarly, following a maximal exercise bout, such as during competition, supplementation with creatine may boost recovery.

The optimal dose for both these scenarios is dependent on the athlete’s current intake of creatine, both through diet and supplementation. If the athlete is already consuming supplemental creatine at the maintenance dose of 3-5g per day, then doses above this are unlikely to offer any additional effect. However, if they are not currently consuming creatine (many athletes reduce creatine intake prior to competition), then larger doses of 10-20g might be appropriate.

When it comes to recovery from injuries, creatine supplementation has been shown to mitigate the losses of muscle mass and strength following disuse. As such, if an athlete suffers an injury, creatine supplementation might be a worthwhile intervention. The dose used in many studies was 20g per day, although if the athlete is already consuming creatine such a loading phase may not be required.

Finally, athletes in contact sports, particularly those that may predispose to head trauma and concussion, might be interested in the neuroprotective aspect of creatine supplementation. Some studies suggest that supplementation prior to a head injury is required to reap the full benefits, pointing to an advantage to keeping creatine stores topped up throughout the competitive season in these players. However, post-injury supplementation has also been shown to be effective, often using doses of 15-20g per day. To my knowledge, no study has compared the impact of pre-injury supplementation with that of post-injury supplementation, so it’s unclear which, if either, is more effective.

How I Used Creatine

I started using creatine in 2005, just after I won the European Junior Championships and was looking to take my training to the next level. In my first year, I utilized a loading phase of 5 x 5g doses per day for seven days. I personally didn’t like this—I found that I had gastrointestinal distress, and my muscles also felt very “full,” although this is completely anecdotal. The following years, I hit on a schedule that worked for me:

• Training Phase: During my training phases, I would consume 5g of creatine, usually post-workout, roughly on a six-weeks-on, two-weeks-off cycle.
• Pre-Competition Phase: In the run-up to competition, I would stop taking creatine perhaps four to five days before a race. I did this initially on the advice of a successful training partner, although I’m not sure this is necessary. Anyway, creatine stores are typically well-maintained for a few days after stopping supplementation and, given that training intensity was low, I can’t imagine they degraded too much.
• Immediately Pre-Race: As part of my pre-race stimulant drink, which I would take roughly 60 minutes prior to racing, I would consume around 3g of creatine.
• Immediately Post-Race: Here, I would consume a slightly larger bolus dose of creatine, usually around 10g, in order to “top up” my stores and enhance recovery
• Off-Season: I stopped consuming creatine for six to eight weeks during my off-season, just as a way of periodizing my approach.

Recommendations for Creatine Supplementation

 In summary, creatine appears to be an effective nutritional aid to support not just performance, but also recovery—from both exercise and injury. As more recent research shows, creatine may also impact the brain, as both a neurocognitive enhancer and a neuroprotective agent.

Supplementing with creatine, most commonly in the form of creatine monohydrate, can increase both muscular and brain stores of creatine, which allow it to exert its benefits. Because creatine is found in the diet through consumption of animal flesh, those that consume large amounts of meat on a regular basis may not respond as well to creatine supplementation as those who don’t consume much creatine through dietary sources, such as vegetarians, children, and the elderly.

A loading phase of ~20-25g per day for seven days can rapidly increase creatine stores, which should then be followed by a maintenance dose of 3-5g per day. Alternatively, athletes may wish to just follow the maintenance protocol, which will increase creatine stores, albeit at a slower rate.

Finally, creatine supplementation appears safe for healthy individuals, as long-term continuous intakes of up to five years have shown no negative side effects. However, I would always recommend having periods within the year where the athletes periodizes their intake as per their need.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

When training and rehabilitating athletes, the sports science professional has two crucial but apparently paradoxical responsibilities: He or she is simultaneously charged with minimizing risk of injury (or re-injury) and maximizing performance. However, to maximize performance, high workloads are required, and high workloads are often associated with increased injury rates.

Therein lies the “training–injury prevention paradox.”¹ How can the practitioner help improve the athlete’s performance if the more the athlete trains, the more likely they are to sustain an injury? Is there a way to enhance performance without increasing injury risk? To solve this paradox, Australian applied sports scientist Tim Gabbett recently developed the Acute:Chronic Workload Ratio Model.¹

Types of Workloads

Before delving into the model, an understanding of workloads is essential. In general, a workload is any training or competition stimulus an athlete undergoes. There are two different types of workloads: external and internal.² External workloads correspond to the amount of work an athlete performs (e.g., distance, speed, duration, or total pitches thrown). Internal workloads denote the athlete’s physiological or psychological response to an imposed external workload (e.g., blood lactate, heart rate, or rating of perceived exertion).

Because different athletes respond to the same external workload with different internal workloads, both types provide useful data.³ Often, internal and external workloads are multiplied to create a “combination workload.” The most common combination workload has been termed “exertional minutes” and is the product of training duration and session rating of perceived exertion.¹ For example, suppose an athlete’s rating of perceived exertion for a 90-minute training session is 8 out of 10. This would correspond to a workload of 720 arbitrary units.

Effects of Workloads on Injury Risk and Performance

When an athlete takes on a workload in training or competition, two performance-altering processes occur: fitness and fatigue.^4,5 Naturally, fitness enhances the athlete’s performance. In conjunction, the athlete develops physical qualities that protect against injury (e.g., strength, power, and repeated-sprint ability).^6,7 Furthermore, the more injury-free the athlete remains, the better they perform.

Conversely, Dr. Gabbett explains that fatigue causes the athlete’s performance to suffer.¹ Fatigue also subjects the athlete to increased injury risk, which would further impair performance. The nature of the workload determines the degree to which fitness or fatigue dominates the athlete’s response to the imposed workload.¹

For example, high workloads lead to high fitness, but they can also lead to high fatigue and, consequently, increased injury incidence. This relationship is well-documented across a variety of sports (e.g., rugby, Australian football, and baseball), levels of play (e.g., youth, sub-elite, and professional), and workload types (e.g., external, internal, and combination).^8-14 The studies have consistently shown that as all types of workloads increase, injury incidence also increases. Moreover, reducing training duration and intensity tends to reduce injury rates.⁹

Based on this research, the simple solution to the injury problem would seem to be a sweeping reduction in workloads. In fact, in an effort to reduce injuries, some sports medicine practitioners do lobby for reduced workloads.¹⁵ However, reducing workloads may actually have the contradictory consequence of hampering the fitness response, a necessary component for injury reduction as well as performance.¹

The 10% Rule

According to Dr. Gabbett, the problem with high workloads lies not in the absolute workloads themselves, but rather in an athlete’s relative preparedness for them.¹ From this perspective, the so-called “10% rule” is another proposed solution to the training-injury prevention paradox. The rule states that an athlete should not increase their week-to-week workloads by more than 10%.^16,17

The 10% rule is most commonly applied to running, but prospective data on rugby players and Australian footballers also supports the recommendation.^1,18 For example, a 15% or more increase in weekly workload put ruggers at upwards of a two to five times increased likelihood of injury compared to a 10% or lower increase.¹ Nonetheless, despite this prospective data, in a large-scale randomized controlled trial of 486 runners, there was no difference in injury incidence between those following the 10% rule and a standard training program.¹⁶

The Acute:Chronic Workload Ratio

While the 10% rule may be a field-expedient heuristic in some cases, Dr. Gabbett’s Acute:Chronic Workload Ratio Model endeavors to characterize athletes’ preparedness more completely. Dr. Gabbett asserts that an athlete’s preparedness is dictated by their chronic workload.¹ Chronic workload is the workload an athlete is accustomed to on a medium-term basis. It’s typically calculated as a rolling average of the preceding four weeks. This time frame may be more indicative of the athlete’s current level of fitness than the previous week alone (as with the 10% rule).

Meanwhile, the acute workload is that which the athlete faces presently, typically over the most recent week. The quotient of the acute and chronic workloads represents the acute:chronic workload ratio. Values of the acute:chronic workload ratio much larger than 1.0 can be interpreted as workload “spikes.”

The acute:chronic workload ratio may represent the ultimate solution to the training–injury prevention paradox. Dr. Gabbett posits that an athlete accustomed to a high chronic workload will respond to a high acute workload with increased fitness, performance, and resilience to injury.¹ On the other hand, an athlete who is not accustomed to a high chronic workload will respond to a high acute workload with fatigue, impaired performance, and increased injury. Emerging data supports Dr. Gabbett’s claims about the relationship between acute:chronic workload ratio and injury.

The Workload ‘Sweet Spot’

An explosion of recent work in a range of sports (e.g., cricket, soccer, rugby, Australian football, basketball) has shown increased injury incidence is in fact associated with spikes in the acute:chronic workload ratio.^19-23 Across sports, the “danger zone” for increased injury appears to be acute:chronic workload ratios over 1.5. Meanwhile, the acute:chronic workload ratio “sweet spot,” which minimizes injury risk, lies in the 0.8-1.3 range.¹

Thus, the ultimate solution to the paradox appears to be consistent application of workloads within the sweet spot range. In this way, athletes can progress to high chronic workloads gradually, with minimal load-related injuries along the way. In turn, the high chronic workloads will enhance fitness and performance, further protecting against injury.²⁰

The Acute:Chronic Workload Ratio in Practice

In practice, monitoring an athlete’s acute:chronic workload ratio can be fairly straightforward. Take swimming, for example. The only essential piece of information needed is the swimmer’s daily yardage (an external workload), which the coach or swimmer can supply. From there, rolling averages of the previous seven days (acute workload) and 28 days (chronic workload) can be calculated and divided to yield the acute:chronic workload ratio. Workload data from one swimmer’s 29-week competitive season is shown below.

While much of the depicted acute:chronic workload ratio lies in the 1.0 ± 0.3 range, there are three clear regions with large workload spikes (beginning at Days 34, 124, and 136). Fortunately, this athlete did not sustain an injury secondary to these spikes. It’s important to note in this example that the yardage data doesn’t capture the swimmer’s internal response to the daily workloads. It could be that the upticks in workload were characterized by mostly low-intensity yardage, which may not be as much cause for concern from a fatigue and injury standpoint. To obtain information of this nature, the athlete’s heart rate or session rating of perceived exertion would also have to be monitored.

Dr. Gabbett’s Acute:Chronic Workload Ratio Model has implications that span the entire season. During pre-season screening, it flags athletes who are at risk based on low off-season chronic workloads.²⁴ During the competitive season, the model improves our ability to manage workloads, which could reduce injury incidence and enhance performance. For an athlete with an injury, the model assists sports medicine practitioners in return-to-play decision-making.²⁵ By gradually increasing the athlete’s workloads to pre-injury levels, it prepares them to return to play while avoiding re-injury.²⁶

As Always, More Research Is Needed

While a lot of high-quality research has already been conducted in this area, there remains much to learn about acute:chronic workload ratios. Investigators have often selected one- and four-week acute and chronic workload windows, respectively. However, more work is needed to determine the merits of shorter and longer time frames for both acute and chronic workloads.¹

In addition, over the past year, the best method for calculating the acute:chronic workload ratio has also been hotly contested. A potential limitation of the rolling average method is that it doesn’t account for the diminishing effects of training over time. For example, a workload imposed three weeks ago gets the same weight in the rolling average chronic workload as one from the previous week. For this reason, some authors favor an exponentially weighted moving average, which weights more recent workloads more heavily than older ones.^27,28

To illustrate the difference between the two methods for calculating the acute:chronic workload ratio, we can take the same swimmer’s data from above and apply the exponentially weighted moving average. The two methods yield similar but slightly different results for the acute:chronic workload ratio. As shown below, using the exponentially weighted moving average method, the magnitude of each of the three workload spikes from the rolling average method drops substantially. More research is needed to determine which method is best for predicting injury.

Building on the Acute:Chronic Workload Ratio

Given what we already know about the acute:chronic workload ratio, it represents an exciting evolution in our understanding of the relationships between training, performance, and injury risk. Based on the available evidence, workload monitoring appears to be a crucial component of injury risk assessment. Yet workload spikes certainly aren’t the only risk factors for athletic injury.

What the Acute:Chronic Workload Ratio Model doesn’t account for are the myriad intrinsic risk factors that can predispose an athlete to injury, such as age, sex, previous injury, biomechanics, and cardiovascular fitness.³⁰ To more fully describe an athlete’s injury risk, a multifactorial injury prediction model would be needed, including intrinsic risk factors as well as workloads.

As it just so happens, Dr. Gabbett has been involved in a more comprehensive modeling effort with the recent “Workload–Injury Etiology Model.”² This new model advances the idea that the athlete’s predisposition for injury is not static. Instead, his or her intrinsic risk factors are constantly being modified by fitness and fatigue adaptations to previously imposed workloads. In this way, this model highlights the importance of repeated player testing (e.g., of strength, power, conditioning) throughout the season, not just in the pre-season.

Training and competition workloads don’t exist in a vacuum, either. The above-described workloads also don’t account for all the potential stressors in an athlete’s life. Additional stressors like nutrition, sleep, interpersonal relationships, academic demands, and travel can all impact an athlete’s workload response.³¹ To characterize an athlete’s status more completely, practitioners should also consider collecting ongoing objective or subjective measurements of stress, recovery, well-being, and readiness.³² Options here include daily assessments of grip strength, resting heart rate, heart rate variability, and self-reported wellness questionnaires.

The sports science professional should closely observe athletes for physiological and psychological signs and symptoms of fatigue and under-recovery using the above objective or subjective measures, especially in the presence of intrinsic risk factors and workload spikes. A heads-up to the rest of the team staff about the data and its potential implications for injury may be warranted, along with strategies for temporarily reducing workloads and promoting recovery. Indeed, this type of multipronged approach to monitoring may prove to be exactly what we need to train more without getting hurt.

Since you’re here…
…we have a small favor to ask. More people are reading SimpliFaster than ever, and each week we bring you compelling content from coaches, sport scientists, and physiotherapists who are devoted to building better athletes. Please take a moment to share the articles on social media, engage the authors with questions and comments below, and link to articles when appropriate if you have a blog or participate on forums of related topics. — SF

References

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