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To explore the association between in-season training-load (TL) measures and injury risk in professional rugby union players.
This was a 1-season prospective cohort study of 173 professional rugby union players from 4 English Premiership teams. TL (duration × session-RPE) and time-loss injuries were recorded for all players for all pitch- and gym-based sessions. Generalized estimating equations were used to model the association between in-season TL measures and injury in the subsequent week.
Injury risk increased linearly with 1-wk loads and week-to-week changes in loads, with a 2-SD increase in these variables (1245 AU and 1069 AU, respectively) associated with odds ratios of 1.68 (95% CI 1.05–2.68) and 1.58 (95% CI 0.98–2.54). When compared with the reference group (<3684 AU), a significant nonlinear effect was evident for 4-wk cumulative loads, with a likely beneficial reduction in injury risk associated with intermediate loads of 5932–8651 AU (OR 0.55, 95% CI 0.22–1.38) (this range equates to around 4 wk of average in-season TL) and a likely harmful effect evident for higher loads of >8651 AU (OR 1.39, 95% CI 0.98–1.98).
Players had an increased risk of injury if they had high 1-wk cumulative loads (1245 AU) or large week-to-week changes in TL (1069 AU). In addition, a U-shaped relationship was observed for 4-wk cumulative loads, with an apparent increase in risk associated with higher loads (>8651 AU). These measures should therefore be monitored to inform injury-risk-reduction strategies.
Cross, Williams, Trewartha, and Stokes are with the Dept for Health, University of Bath, Bath, UK. Kemp is with Rugby Football Union, Twickenham, UK.