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. 2022 May 1;57(5):470-477.
doi: 10.4085/1062-6050-0135.21.

Workload and Noncontact Musculoskeletal Injury in Collegiate Swimmers: A Prospective Cohort Study

Travis R Pollen  1 , David Ebaugh  2 , Meghan Warren  3 , Clare E Milner  1 , Jennifer A Taylor  4 , Sheri P Silfies  5
Affiliations

Workload and Noncontact Musculoskeletal Injury in Collegiate Swimmers: A Prospective Cohort Study

Travis R Pollen et al. J Athl Train. .

Abstract

Context: Swimmers are known for experiencing high training loads and a high incidence of overuse injuries, but few researchers have investigated the relationship between the two at the collegiate level.

Objective: To determine the association between workload and noncontact musculoskeletal injury in collegiate swimmers.

Design: Prospective cohort study.

Setting: College natatorium.

Patients or other participants: A total of 37 National Collegiate Athletic Association Division III swimmers, 26 uninjured (age = 19 years [interquartile range = 3 years], height = 175 ± 11 cm, mass = 70.2 ± 10 kg) and 11 injured (age = 19 years [interquartile range = 3 years], height = 173 ± 9 cm, mass = 69.4 ± 13.5 kg) individuals.

Main outcome measure(s): Logistic regression using generalized estimating equations was conducted to calculate odds ratios (ORs) with 95% CIs for injury relative to high workloads and high acute:chronic workload ratio (ACWRs). Injury rates for several ranges of workloads and ACWRs were also calculated.

Results: A total of 11 participants (29.7%) sustained 12 injuries, with 7 injuries occurring during the participants' winter training trip. Injury was associated with high acute workloads (OR = 27.1; 95% CI = 8.2, 89.8) and high ACWRs (OR = 25.1; 95% CI = 7.7, 81.4) but not high chronic (OR = 2.6; 95% CI = 0.3, 20.0) or overall (OR = 1.00; 95% CI = 0.99, 1.01) workloads. High acute workloads (>37.2 km/wk) and ACWRs (>1.56) increased the injury rate from ≤1% to 15% and 14%, respectively, compared with all lower acute workloads and ACWRs.

Conclusions: Collegiate swimmers tolerated high workloads spread out during the season. However, caution should be used when prescribing high acute workloads and high ACWRs (eg, winter training trip) because of the increased odds of injury.

Keywords: acute workload; chronic workload; training monitoring.

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Figures

Figure 1
Figure 1
A sample participant's acute workload and acute:chronic workload ratio (ACWR) over the season. This participant sustained a noncontact musculoskeletal injury during the winter training trip (week 16), which coincided with both a high acute workload and a high ACWR, as indicated by the dashed gray and black lines, respectively.
Figure 2
Figure 2
Dot-and-box plots of overall workload (km) over the season for student-athletes who did or did not sustain an injury. No association was observed between overall workload and injury.
Figure 3
Figure 3
Distribution of (A) acute workloads, (B) acute:chronic workload ratios (ACWR), and (C) chronic workloads for all 809 athlete-weeks during the season, ordered from smallest to largest. Gray vertical lines denote weeks with no injury; black vertical lines denote weeks in which an injury occurred. Horizontal dashed lines indicate the demarcation lines for high workloads and ACWR. Injuries clustered toward the high acute workloads and ACWRs but not the high chronic workloads.
Figure 4
Figure 4
Compared with lower ranges of (A) acute workloads and (B) acute:chronic workload ratios (ACWRs), injury rates during the season increased by an order of magnitude with acute workloads >37.2 km/wk and ACWRs >1.56 (from ≤1% for all lower ranges to 15% and 14% for the high acute workloads and high ACWRs, respectively).
See this image and copyright information in PMC

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