VICE Sports Q&A: Sports Scientist Tim Gabbett On How To Prevent Injuries

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Injury prevention is the future of sports data analytics, we're often told. Whoever figures it out will be rich.

Tim Gabbett, an Australian sports scientist, has been working in injury prevention and performance maximization for 20 years, and has published over 150 peer-reviewed articles on these subjects. He recently co-authored a paper in the British Journal of Sports Medicine titled, "High training workloads alone do not cause sports injuries: how you get there is the real issue."

With all of the big promises being made around injury prevention, VICE Sports wanted to ask someone who has worked in the field about what really helps athletes—and what doesn't.

Gabbett was kind enough to get up early in Australia and talk to us about his latest article, the best ways to maximize performance and reduce the risk of injury, how much players are to blame for their own injuries, and why Jurgen Klopp got all his players injured.

This interview has been lightly edited and condensed for clarity.

VICE Sports: When I read your recent paper, I thought, this is exactly the opposite of what we're always told to do, which is: train hard, keep your energy up, then you rest for the big game. Do I have that right?

Gabbett: You're partly right. We do need to rest up before a big game. Part of the message there is making sure you go into a game fresh and having adequate recovery before big competitions. We call them unloading periods. We might unload for a couple of days, or depending on the sport, we might unload for a couple of weeks leading into big events. But the idea with an unloading phase is we get a thing called "supercompensation." So your performance actually decreases a little in that unloading phase, you feel like you've lost your ability to compete, to run, your coordination goes out the window. For a couple of days, you feel like you can't walk. But then you bounce out of that. That supercompensation is, when you bounce out of it, you're actually at a higher fitness level than when you went into that taper or that unloading period.

For a long time, there's been a lot of evidence to say high loads is related with injury. So we've always assumed that there's this ceiling of load and too much load is a bad thing. And it just got me thinking that not all load can be bad. We need load to develop resilience. We need load to get fit. We need load to compete at the very highest level. Otherwise, the other extreme is we go into competitions under-prepared and then we get injured.

It made me think a little more about what we're doing when we're applying this load. If we can apply it safely and we progress that increasing load safely, what actually happens is, by doing that, it promotes greater capacity and it also promotes injury resilience or robustness against injury, so it actually protects you against injury.

This seems really counterintuitive to me: That the harder work protects you from injury, as opposed to exposing you to more risk.

I think we have to be careful when we say "the harder you work." Because there's probably a smart and a dumb way to do it. So if I throw all my eggs up against a wall and hope some of them don't break, it's not a smart way to see if eggs don't break. It's the same with training. If you just throw excessive loads at a wide range of people, we know that same absolute load will elicit different results and different responses in every individual. So if I give you 4km to run, and I run 4km, based on our fitness, based on our training history, based on our injury history, it will elicit different responses. If you're really fit [editor's note: I thought I was] you'll handle that 4km a lot better than I will. We still have to be individualized in our approach and we still have to stick with some really solid guidelines on training prescriptions and things like progression.

Let's talk about your recent study. What exactly did you look at, and what did you find regarding the best predictors of injury?

First, we've looked at a number of sports in Australia. Some are high-intensity sports. Australian football is, I guess, similar to rugby and soccer. A lot of running but there are also collisions. We've looked at rugby over here. We've also looked at cricket. It's a very unnatural type of activity and places huge loads on players. We've measured different types of load for those three sports, because they all have different types of demands. What we found was that if we could get the chronic load of players up to a high level, and when I talk about chronic load we're talking about a rolling four-week average load, when we get the chronic load up high, it actually protects against injury. So the higher the chronic load—that's analogous to fitness for us—the lower the risk of injury.

But if your acute load—so what you've done in the last week—is really high, that's when you increase your risk of injury. Then we look at a ratio of the acute load, what you've done in the last week, compared to what you've been prepared for over the last four weeks. We call that the acute-chronic workload ratio. When that ratio is really high, it indicates that you've spiked your workload relative to what you've been prepared for. That's the whole concept of loading. Load is not the problem. It's what you've been prepared for that's the issue. When we spike acute loads over chronic load, that's when we run into trouble with injury risk.

We know there are lots of intrinsic and extrinsic factors. Age is a risk factor. Previous injury history is a risk factor. But what we're starting to see now is that one of the biggest risk factors that for a long time has been under-investigated, it's been one of those things that hasn't been considered in a lot of risk factor models, is training and match load.

We see it if we look at the NBA. Teams are playing 82 games in a season and that only considers match load. We also have to consider there's training that goes on around that. There's travel and a lot of other things that can contribute to the stress in players. Now, we're starting to get some really good data to inform teams so they can minimize risk for their players.

If a professional team asks you for the most cost effective ways you can manage injury risk in players, what's the answer?

Probably the most simple and cheapest way to manage injury risk is to monitor load. Just about every team monitors load in some capacity, whether it's minutes played or session RPE [rated perceived exertion scale] and a lot of teams are using GPS, accelerometers, wearable devices, so just about every team is collecting data. The trick is then knowing what to do with the data. If I was to give a team one single bit of advice, it would be to make sure they calculate the acute-chronic workload ratio. It will be able to inform injury risk, but also tell you about how your player is traveling in terms of freshness and fatigue.

What kind of advice would you give a parent or coach at the youth level about monitoring load?

I think the important thing to consider with youth is, they're not mini-adults. We need to train them a little bit differently from adults. But we need to instill the importance of training and learning how to win a session in these young athletes. An important part of when they're developing at 13, 14, 15 years old is just that discipline of rocking out the training, going through their routine, and preparing well, but also when it's time to switch on to train, they need to learn how to win that training session, because they can't even consider winning a competition if they first haven't learned to win a session.

I feel like all of this load monitoring, knowing when athletes have had enough, is something an experienced coach picks up on, too, right?

Absolutely. You hit it on the head. It's experience. I know through working with an experienced coach over here that he doesn't use a lot of data, hard data, but I get the feeling he's computing things in his brain all the time about players. He's calculating things all the time. He's looking at a player, looking at his body language, oh he looks a bit off today. Certain players are a bit cheekier today, bouncing around, he can see they've got a lot of energy and are ready to play. The experienced coaches know.

One of the big tips I'd suggest for coaches is don't get overly reliant just on numbers. You still have to coach the athlete, you still have to coach the player rather than the numbers, so don't get overly reliant on numbers and forget that there's a person in there and you've got to work at what makes them tick.

What kind of common mistakes do you see?

We see it all the time on the back of losses. Typically, when you lose a game, the coach will come in on Monday and say, well we're obviously not fit enough, so we're gonna get fit. They either hadn't trained hard enough before, or even if they are training hard, they just flog the players in a training session. So training is seen as a punishment, fitness is seen as a punishment, rather than something that is done to actually improve your performance. By doing that, you're increasing injury risk because you spike loads.

You also see it when a new manager comes into a team—and we see it in the Premier League all the time—where a manager gets sacked in the season, a new manager comes in, and in an attempt to either implement their playing or their control over the team, training loads increase. They obviously need to be fit to play the game, but by increasing training loads, it results in a spike in load and inevitably what we see is this large increase in soft tissue injuries.

There are teams in the Premier League at the moment that have gone through that new manager phase and the spike in training intensity resulted in a spike in injury rates.

Do these teams happen to rhyme with Blibberpool?

That's funny because I've been on the phone a few times to different clubs over there and, it's interesting talking to those guys. They actually do a very good job, but they've got some challenges, that's for sure.

Well, you knew exactly who I'm talking about, but in that example, you can understand why the manager wants to come in and assert his authority, but also assert training intensity because of the style that team plays. It's a very pressing style, you have to be really fit to play it. So, you know, how do you get fit? You have to train hard. So if he doesn't increase loads then they can't play that style and therefore they're not going to win games and probably get injured anyways. If he does, then he runs the risk of getting injured as well. So it's a little bit of damned if you do, damned if you don't.

How much responsibility is on the players to stay fit?

A lot of the time, when players get injured, the manager or the staff bears the brunt of it, and you never hear about the player's role in it, but of course the player has a responsibility in keeping themselves injury free as well. They can do a lot of work away from training that doesn't involve a lot of physical effort. They can do their pre-hab type work, they can do their strengthening type work to handle training loads when they get thrown at them. So a big part of making sure players are able to cope with the demands of training and match play comes back to the player.

Then you also need to consider what they do in their down time. Are they professional athletes, or are they athletes that are just paid to play their sport? There's a difference there because you see a lot of professional athletes that aren't that professional in their preparation. They play well, and then they don't recover very well in between games, and over time that can contribute to injury risk as well. So a big part of it comes back to how well an athlete prepares themselves to come into training and ready to do their work.

I can see it from both points of view: the coach needs to understand loading, but the athlete needs to take responsibility as well for how healthy they are in their sport and how successful they want to be in their sport.