Workload management for safe reintegration of injured footballers into full training and game play

Managing athlete workload is widely believed to be an important part of reducing injury risk and elite sports teams invest considerable time and resources into athlete workload monitoring systems. This has led to extensive research into the most effective approaches to workload monitoring in healthy athletes but there has been a notable lack of research exploring workload monitoring in injured athletes. Workload monitoring is likely to be important for injured athletes because their workload will typically undergo large changes from week-to-week, as they attempt to recover from their injury and then return-to-play (RTP) in the shortest time possible. The current thesis is divided into three parts. Part 1 provides an overview of existing cohort studies that have investigated the relationship between athlete workload and injury risk in healthy and injured athletes. This review demonstrates the positive association between high workloads and injury risk in healthy athletes, and highlights how the literature on the workload management of injured athletes is scarce. Part 2 describes an analysis of athlete workload data that was undertaken in 28 injured elite Australian football (soccer) athletes. The analysis explores the time course of athlete workload changes that occur in the 4 weeks before and after returning to play following injuries of different severity. All injuries resulted in a reduction in absolute workload during the pre-RTP period relative to the post-RTP period, however the magnitude and timing of this reduction varied across injury severity groups. Athletes with severe injuries presented with the highest average acute to chronic workload ratios during the pre-RTP period compared to athletes with mild and moderate injuries. Lastly, part 3 discusses the importance of athlete workload monitoring in injured athletes and provides recommendations for future research and clinical practice based on the findings from part 1 and part 2.