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Does a Team’s Average Acute to Chronic Workload Ratio Correlate with Injury Risk? A Study Performed in a Division I NCAA Men’s Soccer Team

David Bakal, MD (Stanford University, Palo Alto, California); Tyler Friedrich; Eugene Y. Roh, MD

Meeting: AAPM&R Annual Assembly 2021

Categories: Musculoskeletal and Sports Medicine (2021)

Session Information

Session Title: Research Spotlight: Musculoskeletal and Sports Medicine

Session Time: None. Available on demand.

Disclosures: David Bakal, MD: No financial relationships or conflicts of interest

Objective: In a division I NCAA men’s soccer team, we assessed the correlation between the team’s average workload, including their acute to chronic workload ratio (ACWR), and the risk of injury.

Design: Injury and workload data were retrospectively evaluated for all players of an NCAA soccer team during one season. Workload data for 5 GPS-derived workload variables (total distance, high-speed distance, accelerations, player load, and average velocity) was used to calculate each player’s daily acute workloads (cumulative workload for each variable during the most recent 3 days), chronic workloads (cumulative workload for each variable during the most recent 28 days minus the acute workload), and uncoupled ACWRs (average daily acute workload divided by average daily chronic workload for each variable). The team’s daily acute workloads, chronic workloads, and ACWRs were calculated for each variable as the mean of each individual’s respective values. A retrospective case-control design was used to compare the team’s workloads and ACWRs on days where ≥1 injury occurred versus days where no injury occurred.Setting : NCAA soccer.Participants : 23 NCAA division I men’s soccer players from a single team.

Interventions:

Interventions: not applicable.

Main Outcome Measures: The presence of a lower limb soft-tissue or bone stress injury to ≥1 player during a training or game.

Results: Trainings/games with injuries had higher acute workloads, lower chronic workloads, and higher ACWRs for all 5 workload variables in univariate analysis. In multivariate analysis, risk factors for injury included a low chronic workload for total distance (OR 7.23, p=0.024) and an ACWR > 1.4 for accelerations (OR 4.34, p=0.029).Conclusions: While prior research has shown that an individual’s ACWR correlates with their risk of injury, this is the first study to show that a team’s average workload and ACWR correlate with injury risk. Future intervention-based studies aimed at using ACWR load management principles may consider tracking the team’s average ACWR.

Level of Evidence: Level III

To cite this abstract in AMA style:

Bakal D, Friedrich T, Roh EY. Does a Team’s Average Acute to Chronic Workload Ratio Correlate with Injury Risk? A Study Performed in a Division I NCAA Men’s Soccer Team [abstract]. PM R. 2021; 13(S1)(suppl 1). https://pmrjabstracts.org/abstract/does-a-teams-average-acute-to-chronic-workload-ratio-correlate-with-injury-risk-a-study-performed-in-a-division-i-ncaa-mens-soccer-team/. Accessed May 11, 2025.
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