A Guide to the Training and Injury Paradox

Hey everyone, Dr. E here. Let's talk about one of the biggest myths that still hangs around in rehab and performance: the idea that high training loads are the enemy. We've been taught to protect, to offload, and to fear the heavy weights or high mileage. But what if I told you that approach might actually be increasing injury risk? The evidence is clear that under-training and massive spikes in workload are the real culprits. It’s time we shift our paradigm from just protecting our athletes to building them into resilient, robust humans who can handle the demands of their sport. I've put together a quick, evidence-based infographic that breaks down this "Training-Injury Prevention Paradox" into a simple model you can start using with your athletes and clients today. Check it out below!

Modern Manual Therapy's Guide to the Training/Injury Prevention Paradox

Modern Manual Therapy's Guide to the

Training/Injury Prevention Paradox

Hey PTs, let's flip the script on injury prevention! It's a "wicked problem" - complex and ever-changing, with no single magic bullet. For too long, we've been told that more training automatically equals more injuries. It’s time to ditch that outdated, linear thinking. The real culprits? Under-training and sudden spikes in load. Let’s build resilient, robust athletes, not wrap them in bubble wrap.

The Old Way is WRONG

The simplistic idea that high training loads are inherently dangerous is flawed. It leads to under-prepared athletes who are more susceptible to injury when competition demands inevitably spike.

The Paradox Explained

Athletes who are consistently exposed to high chronic training loads build resilience and are actually LESS LIKELY to get injured. Injuries happen when the acute load (what they did this week) drastically outweighs what their body is prepared for (their chronic load).

The Key Metric: ACWR

The Acute:Chronic Workload Ratio is your clinical game-changer. It's a simple calculation that quantifies training load progression.

ACWR = Acute Load (1 week) / Chronic Load (4-week avg)

Sweet Spot (0.8 - 1.3): Optimal adaptation, peak performance, and lowest injury risk.

Caution Zone (<0.8): Under-training. Increases injury risk when load spikes.

DANGER ZONE (>1.5): "Too much, too soon." Significant spike in injury risk.

The Evidence is Mounting

It Works for Team Sports

A 2022 systematic review by Griffin et al. confirms the ACWR model is a valid and powerful tool for predicting injury risk across a wide range of team sports.

The Tech Edge: Wearables

Research on collegiate runners (Shull & Shull, 2023) shows that data from wearable sensors provides an objective, precise way to track external loads, taking the guesswork out of monitoring.

A "Wicked Problem" Paradigm

Windt & Gabbett (2024) urge us to view injury prevention as a 'wicked problem'—requiring adaptable, context-sensitive strategies, not a single 'ultimate solution'.

Your Clinical Game Plan

Build Robustness

Our goal is to build capacity, not just protect. Use progressive overload intelligently to make your athletes more resilient to the demands of their sport.

Monitor, Don't Guess

Track training loads. Session RPE x Duration is a simple, validated method for internal load. Combine it with objective data from wearables when you can.

Educate Everyone

This is a simple, powerful model to share with athletes, parents, and coaches. It empowers them to understand the "why" behind your programming.

Bridge Rehab to Performance

The ACWR is the perfect tool for return-to-sport. It provides an objective guide to safely ramp up an athlete's training load post-injury, reducing the risk of re-injury.

Earn CEUs & Take Dr. E's Flagship Course Online!

Unlimited Access. Lifetime Updates.

Learn my full Eval, Reset, and Stabilize system and how to easily assess and treat most conditions from head to toe!

Seminario en línea sobre terapia manual moderna: el enfoque ecléctico para la evaluación y el tratamiento de la calidad de la audición y la calidad de la voz

5.0

My easy to learn system will get you fast results! Get unlimited access and earn CEUs.

The course will cover:

The principles of Eval, Reset, and Stabilize
Movement Screen and Repeated Motions based evaluation
Neurodynamic testing median, radial, ulnar nerves and sciatic and femoral nerves
Instrument Assisted Soft Tissue Massage (IASTM) with the EDGE Tool
Neurodynamic treatment
Functional mobilization of the hip, knee, and ankle
Home exercises, repeated motions based resets and using the EDGE Mobility Bands
An emphasis on patient education and self treatment

Note: this course is fully online and is digital only like all our media. Upon purchase you will immediately receive instructions on how to watch and get your handouts to follow along.

Retail Price:

$ 399.99

Your Price:

$ 199.99

You Save:

$ 200.00

Contact Dr. E

Move, Strengthen, Recover, Learn at EDGE Mobility System