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Training-performance relationship
In a British Journal of Sports Medicine blog, Dr John Orchard 1 proposed hypothetical relationships between training (both under-training and over-training), injury, fitness and performance. He speculated that both inadequate and excessive training loads would result in increased injuries, reduced fitness and poor team performance (see figure 1 ). The relationship between training load, injury, fitness and performance is critical to sports medicine/physiotherapy and sport science practitioners. In this paper I use the term 'practitioners' to refer to the wide gamut of health professionals and also sport scientists who work with athletes/teams (ie, strength and conditioning coaches, certified personal trainers, etc). Our field-sports performance and sports injury prevention is a multidisciplinary one and this paper is relevant to the field broadly.
Injuries impair team performance, but any injuries that could potentially be considered 'training load-related' are commonly viewed as 'preventable', and therefore the domain of the sport science and medicine team. Sport science (including strength and conditioning) and sports medicine (including doctors and physiotherapists) practitioners share a common goal of keeping players injury free. Sport science and strength and conditioning staff aim to develop resilience through exposing players to physically intense training to prepare players for the physical demands of competition, including the most demanding passages of play.
On the other hand, doctors and physiotherapists are often viewed as the staff responsible for 'managing players away from injury'. A stereotype is the physiotherapist or doctor advocating to reduce training loads so that fewer players will succumb to 'load-related' (eg, overuse) injuries. However, how many of the decisions governing players and their individual training loads are based on empirical evidence or the practitioners' 'expert' intuition (ie, 'gut feel')?
Banister et al 2 proposed that the performance of an athlete in response to training can be estimated from the difference between a negative function ('fatigue') and a positive function ('fitness'). The ideal training stimulus 'sweet spot' is the one that maximises net performance potential by having an appropriate training load while limiting the negative consequences of training (ie, injury, illness, fatigue and overtraining). 3
Several studies have investigated the influence of training volume, intensity and frequency on athletic performance, with performance generally improved with increases in training load. 4-10 In individual sports (eg, swimming and...