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Methods matter: exploring the ‘too much, too soon’ theory, part 1: causal questions in sports injury research
British Journal of Sports Medicine ( IF 18.4 ) Pub Date : 2020-03-05 , DOI: 10.1136/bjsports-2018-100245
Rasmus Oestergaard Nielsen 1, 2 , Michael Lejbach Bertelsen 3 , Merete Møller 4 , Adam Hulme 5 , Mohammad Ali Mansournia 6, 7 , Marti Casals 8, 9 , Erik Thorlund Parner 10
Affiliation  

Background It is widely accepted that athletes sustain sports injury if they train ‘too much, too soon’. However, not all athletes are built the same; some can tolerate more training than others. It is for this reason that prescribing the same training programme to all athletes to reduce injury risk is not optimal from a coaching perspective. Rather, athletes require individualised training plans. In acknowledgement of athlete diversity, it is therefore essential to ask the right causal research question in studies examining sports injury aetiology. Purpose In this first part of a British Journal of Sports Medicine educational series, we present four different causal research questions related to the ‘too much, too soon’ theory and critically discuss their relevance to sports injury prevention. Content If it is true that there is no ‘one size fits all’ training programme, then we need to consider by how much training can vary depending on individual athlete characteristics. To provide an evidence-base for subgroup-specific recommendations, a stronger emphasis on the following questions is needed: (1) How much training is ‘too much’ before athletes with different characteristics sustain sports-related injury? and (2) Does the risk of sports injury differ among athletes with a certain characteristic (eg, high experience) compared with athletes with other characteristics (eg, low experience) depending on how much training they perform? Conclusion We recommend that sports injury researchers aiming to examine the ‘too much, too soon’ theory should carefully consider how they, assisted by coaches, athletes and clinicians, pose their causal research question. In the light of the limitations of population-based prevention that intends to provide all athletes with the same advice, we argue that a stronger emphasis on research questions targeting subgroups of athletes is needed. In doing so, researchers may assist athletes, clinicians and coaches to understand what training advice/programme works best, for whom and under what circumstances.

中文翻译:

方法很重要:探索“太多,太早”理论,第 1 部分:运动损伤研究中的因果问题

背景 人们普遍认为,如果运动员训练“太多、太快”,就会遭受运动损伤。然而,并不是所有的运动员都是一样的。有些人比其他人可以忍受更多的训练。正是出于这个原因,从教练的角度来看,为所有运动员制定相同的训练计划以降低受伤风险并不是最佳选择。相反,运动员需要个性化的训练计划。为了承认运动员的多样性,因此在检查运动损伤病因学的研究中提出正确的因果研究问题至关重要。目的 在英国运动医学杂志教育系列的第一部分中,我们提出了与“太多、太早”理论相关的四个不同的因果研究问题,并批判性地讨论了它们与运动损伤预防的相关性。内容 如果确实没有“一刀切”的训练计划,那么我们需要考虑根据运动员的个人特点,训练可以有多少变化。为了为特定亚组的建议提供证据基础,需要更加强调以下问题:(1)在不同特征的运动员遭受运动相关损伤之前,多少训练是“过度”?(2) 与具有其他特征(例如,低经验)的运动员相比,具有特定特征(例如,经验丰富)的运动员的运动损伤风险是否因他们进行的训练量而异?结论 我们建议旨在研究“太多,太早”理论的运动损伤研究人员应该仔细考虑他们如何在教练、运动员和临床医生的协助下,提出他们的因果研究问题。鉴于旨在为所有运动员提供相同建议的基于人群的预防的局限性,我们认为需要更加强调针对运动员亚群的研究问题。在此过程中,研究人员可以协助运动员、临床医生和教练员了解什么训练建议/计划最有效,适合谁以及在什么情况下。
更新日期:2020-03-05
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