The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players

Br J Sports Med. 2016 Feb;50(4):231-6. doi: 10.1136/bjsports-2015-094817. Epub 2015 Oct 28.


Aim: Investigate whether acute workload (1 week total distance) and chronic workload (4-week average acute workload) predict injury in elite rugby league players.

Methods: Data were collected from 53 elite players over two rugby league seasons. The 'acute:chronic workload ratio' was calculated by dividing acute workload by chronic workload. A value of greater than 1 represented an acute workload greater than chronic workload. All workload data were classified into discrete ranges by z-scores.

Results: Compared with all other ratios, a very-high acute:chronic workload ratio (≥2.11) demonstrated the greatest risk of injury in the current week (16.7% injury risk) and subsequent week (11.8% injury risk). High chronic workload (>16 095 m) combined with a very-high 2-week average acute:chronic workload ratio (≥1.54) was associated with the greatest risk of injury (28.6% injury risk). High chronic workload combined with a moderate workload ratio (1.02-1.18) had a smaller risk of injury than low chronic workload combined with several workload ratios (relative risk range from 0.3 to 0.7×/÷1.4 to 4.4; likelihood range=88-94%, likely). Considering acute and chronic workloads in isolation (ie, not as ratios) did not consistently predict injury risk.

Conclusions: Higher workloads can have either positive or negative influences on injury risk in elite rugby league players. Specifically, compared with players who have a low chronic workload, players with a high chronic workload are more resistant to injury with moderate-low through moderate-high (0.85-1.35) acute:chronic workload ratios and less resistant to injury when subjected to 'spikes' in acute workload, that is, very-high acute:chronic workload ratios ∼1.5.

Keywords: Fatigue; Fitness; Injury; Training.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Athletic Injuries / etiology
  • Football / injuries*
  • Humans
  • Male
  • Risk Factors
  • Workload / statistics & numerical data*
  • Young Adult