Over recent years there has been increasing concern that some children are being exposed to increasing levels of injury risk because they are playing too much sport. The issue is particularly pertinent for children who are identified as having sporting talent and who may be participating in intensive sporting competitions over a short period of time. Similar concerns have been raised in the broader context of potential links between fatigue, training volumes and injury rates across different sports and athlete groups, including endurance sport.

Given this background, a paper in the 2012 May issue of the British Journal of Sports Medicine caught my attention. The USA Cup soccer tournament attracts boys and girls aged from 12-19 years, with some playing up to seven games over five days. Over two separate tournaments and for each competitor who was treated at the central medical facility for injury or a medical condition, Waibel et al recorded the number of tournament match hours played, the occurrence of any injuries during specific games and the games missed due to injury. They concluded that the scheduling of games in this competition did not significantly increase the need for medical treatment later in the competition, as has also been previously reported by Rosenbaum and colleagues in a 2009 issue of Injury Prevention.

This type of study is important because, as previously noted by Rosenbaum et al., more research is needed into better understanding how to schedule the density of games in a multi-day tournament so as to avoid physical overload that can lead to injury. Both the Waibel et al and Rosenbaum et al. studies are based on relatively small samples but they do give some reassurance that our young people are unlikely to be being placed at excessive risk of injury during intensive soccer tournaments over successive days.

However, there is still much work to be done in this area. A lack of good quality, large-scale epidemiological studies directly linking fatigue to injury risk in sport and the generally poor quality fatigue measurement tools used in the published studies need to be addressed. Optimizing training loads for performance and other benefits is already being adopted by professional sport. It is now time for us to also translate similar strategies to community sport, whilst also ensuring that injury risk is kept to a minimum.

Additional reading

Finch CF, Williamson A, O’Brien B. An overview of the epidemiological evidence linking injury risk to fatigue in sport. Identification of research needs and opportunities. In FE Marino (2011). Regulation of fatigue in exercise. Nova Science Publishers Ltd. 2011:155-176.

Caroline Finch is an injury prevention researcher from the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP) within the Monash Injury Research Institute, Monash University, Australia. She specialises in implementation and dissemination science applications for sports injury prevention. She is the Senior Associate Editor for Implementation & Dissemination for the British Journal of Sports Medicine and a member of the Editorial Board of Injury Prevention; both journals are published by the BMJ Group. Caroline can be followed on Twitter @CarolineFinch