Can we predict non-contact injury by assessing workload?

‘Internal workload’ is believed to be an important risk factor for injury in elite football players. A recent study from the BJSM has attempted to investigate the association between workload and non-contact injuries in the UEFA Champions League and whether it is possible to predict non-contact injuries.1

The acute:chronic workload ratio (a measure of a change in a player’s training and match volume) has been used in other sporting codes as a measure of training load. It has also been identified as a possible tool that could be used to predict injury. This measure is also widely used, and discussed in football, but there is limited evidence relating to its efficacy. Workload is generally measured using session RPE (s-RPE). This measure is calculated for a training session by asking the player to report their rating of perceived exertion (RPE) for a given session or match and multiplying this by the duration of activity. The values for each session are added together to have a figure for each week (acute workload). This is then compared with the sum of the s-RPE over several weeks (chronic workload). In this way the acute:chronic workload ratio can be calculated.

In this study the RPE was collected 30 minutes after every session for all players in five elite European teams. Players were asked to rate the intensity of their session using the question “How was your workout”. Chronic workloads were calculated as rolling averages over two, three and four weeks. The acute:chronic workload was then calculated (1:2, 1:3 and 1:4 weeks).

Acute:chronic ratios measured over 1:3 and 1:4 weeks demonstrated an association with non-contact injuries in the subsequent week. Unfortunately, a high workload ratio as a stand-alone maker, was not useful at predicting subsequent injury.

To learn more about the prevention of injury complete the ‘injury prevention’ module in the FIFA Diploma in Football Medicine.

1. McCall A, Dupont D & Ekstrand J. Internal workload and non-contact injury: a one-season study of five teams from the UEFA Elite Club Injury Study. Br J Sports Med Published Online First: 06 April 2018. doi: 10.1136/bjsports-2017-098473.


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Dr Shahnawaz GaziAhmed Bayuomy Ibrahim Abo ElattaBangouraGreg Mirtdrlabelle Recent comment authors
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Not really a surprise (unfortunately).

Greg Mirt
Greg Mirt

More or less true.


La charge de travail chez un sportif de haut niveau doit être rationalisé
Lorsque la charge est très élevée de façon très désordonnée au cours des entraînements cela se répercute pendant les compétitions
Comme les tendinopathies les contracture musculaires l élongation voir même les déchirures musculaires
Voilà ce que la charge peux entainer comme dégâts dans les atteintes musculaires sans contact sans oublier LE SURENTRAINEMENT et ces consequences

Ahmed Bayuomy Ibrahim Abo Elatta
Ahmed Bayuomy Ibrahim Abo Elatta

highly subjective

Dr Shahnawaz Gazi
Dr Shahnawaz Gazi

Well we all say we can quantify the training load, but let me ask one question that can we rely on the subjective feedback given by the players, are they honest or they are trying to impress Coach for that matter.