Spikes in Acute:Chronic Workload Ratio (ACWR) Associated with a 5–7 Times Greater Injury Rate in English Premier League Football Players: A Comprehensive 3-Year Study

Bowen, L., Gross, A.S., Gimpel, M., Bruce-Low, S., Li, F.-X.

This study aimed to investigate the relationship between global positioning system (GPS)-derived workloads and injury occurrence in English Premier League football players across three seasons. Workload and injury data were collected over consecutive seasons, and cumulative loads were analyzed over various time frames, including 1-weekly, 2-weekly, 3-weekly, and 4-weekly periods. The acute:chronic workload ratio (ACWR) was calculated by dividing the acute workload (1-week workload) by the chronic workload (previous 4-week average acute workload).

The study classified workload ranges using z-scores and calculated the relative risk (RR) for each range between injured and non-injured players. Specific GPS variables such as total distance, low-intensity distance, high-speed running distance, sprint distance, accelerations, and decelerations were analyzed.

The findings revealed that the greatest risk of non-contact injury occurred when the chronic exposure to decelerations was low (<1731) and the ACWR exceeded 2.0, with a relative risk of 6.7. Similarly, the risk of non-contact injury was 5–6 times higher for accelerations and low-intensity distance when chronic workloads were categorized as low and the ACWR was >2.0, compared to ACWRs below this threshold.

Including all chronic workloads, an ACWR >2.0 was associated with a significant but lesser injury risk for the same metrics, including total distance.

Based on these findings, the study recommends that practitioners involved in training planning for performance and injury prevention monitor the ACWR, increase chronic exposure to load, and avoid spikes in workload that approach or exceed 2.0 to reduce the risk of injury.

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