Load Management

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Introduction

Over the last few decades sport has become a competitive, professionalized industry (1). Athletes have to deal with fuller competition calendars and face increasingly higher pressure to stay competitive (ref). Consequently, athletes of all levels as well as their coaching staff are relentlessly aiming to improve performance. Although there are a multitude of factors that can contribute, the main factor athletes focus on is usually their training methods. (ref) Training and competition load causes a series of homeostatic responses and adaptations in the human body (ref 2-5). The key factor in training theory is to implement this process of biological adaptation to improve fitness and eventually improve performance (ref 4,5) Furthermore, a principal goal in rehabilitation is improving capacity to manage load and this has been discussed in the literature in relation to tendinopathy (Goom, 2013 provides a good summary) and cartilage repair.  There is also good evidence for load management to prevent illness and overtraining in althetes

Poorly managed training loads in conjunction with the full competition calendar may influence the health of athletes (ref 7-9) The balance between external load and tissue capacity plays a significant role in injury (ref 10,11) and although there are various intrinsic and extrinsic factors12,13 involved in injuries, there is evidence to suggest that load management is a key risk factor for injury (14)

The relationship between load and heath is considered as a well-being continuum (16), with load and recovery as mutual counteragents (ref)During rehabilitation processes, initially we might consider reducing load to allow pain to settle and allow gentle specific exercise prescription. Later we will gradually increase load by progressing the exercise prescription appropriate for restoring normal function specific for an individual and their disorder as symptoms allow.

Great summary - Goom T. Balancing training load and tissue capacity. Running Physio, Aug 2015

Terminology

The IOC Consensus statement on load management (ref) defines load as "the sport and non-sport burden (single or multiple physiological, psychological or mechanical stressors) as a stimulus that is applied to a human biological system (including subcellular elements, a single cell, tissues, one or multiple organ systems, or the individual). Load can be applied to the individual human biological system over varying time periods (seconds, minutes, hours to days, weeks, months and years) and with varying magnitude (i.e. duration, frequency and intensity)."

External load refers to any external stimulus applied to the athlete that is measured independently of their internal characteristics (ref 25,26). Internal load refers to the physiological and psychological response in an individual following the application of an external load.