Effectiveness of Load Management Interventions In Question

In a group of elite youth soccer players, specific load management interventions weren’t found to offer any significant health protections, according to a new study.

While the acute:chronic workload ratio (ACWR) is often used to manage training load in sports and reduce injury risk, the youth soccer players who received the training in this study didn’t experience any reduction in health issues compared to the controls.

In the study, “Does load management using the acute: chronic workload ratio prevent health problems? A cluster randomized trial of 482 elite youth footballers of both sexes,” published in the January 2021 issue of the British Journal of Sports Medicine, 34 elite soccer teams, 16 females and 18 males, were cluster-randomized to an intervention group (18 teams) and a control group (16 teams).

The intervention group received all training based on published ACWR load management principles using a commercially available athlete management system for a full 10-month season. Teams in the control group were trained per usual methodology.

The researchers measured the prevalence of health problems in both groups monthly using the Oslo Sports Trauma Research Center Questionnaire on Health Problems.

According to the data they collected, the between-group difference in health problem prevalence was 1.8%-points (-4.1 to 7.7%-points; p = 0.55) with no reduction in the likelihood of reporting a health problem in the intervention group compared to the control group. The relative risk for the intervention group was 1.01 (95% CI 0.91 to 1.12); p = 0.84).

“We observed no between-group difference, suggesting that this specific load management intervention was not successful in preventing health problems in elite youth footballers,” the researchers wrote.

They added, “When planning this study, choosing the exact mode of intervention represented a major challenge. We were guided by the literature at the time, as well as the recommendations from the group that developed the ACWR approach. Also, we considered what was commonly used in the field and therefore had the most practical relevance.

“Since then, there has been increased scrutiny of the ACWR concept, with several papers highlighting methodological challenges and some authors questions the validity of the entire concept. Despite many studies showing an association, no study has yet managed to predict health problems based on ACWR, indicating that a meaningful and pronounced relationship between ACWR and health problems is unlikely.

“In elite football, sports medicine and performance practitioners meticulously and continuously assess each player’s training load together with numerous other factors, such as history of previous injuries, injuries, player age, wellness, non-sporting load, communication with player, screening and strength test and the importance of next match. This is done to inform subjective decisions that aim to increase performance and reduce risk of health problems. Providing coaches with a one-size-fits-all metric does not seem to add much value to this process. We believe that, given the results of this study and the current state of knowledge in the field, load management remains just as much an art as a science.”