title: Training load--injury paradox: is greater preseason participation associated with lower in-season injury risk in elite rugby league players?
abstract: OBJECTIVE
  To determine whether players who completed a greater number of planned preseason training sessions were more or less likely to be injured during the competitive season.
  
  
  METHODS
  A cohort of 30 elite rugby league players was prospectively studied during their 17-week preseason and 26-round competitive season. Injuries were recorded using a match time loss definition. Preseason participation was quantified as the number of 'full' training sessions that players completed, excluding modified, rehabilitation or missed sessions. In-season training load variables, collected using global positioning system (GPS) data, included distance covered (m), high-speed distance covered (m) and the percentage of distance covered at high speeds (%). Multilevel logistic regression models were used to determine injury likelihood in the current and subsequent week, with random intercepts for each player. Odds ratios (OR) were used as effect size measures to determine the changes in injury likelihood with (1) a 10-session increase in preseason training participation or (2) standardised changes in training load variables.
  
  
  RESULTS
  Controlling for training load in a given week, completing 10 additional preseason sessions was associated with a 17% reduction in the odds of injury in the subsequent week (OR=0.83, 95% CI=0.70 to 0.99). Increased preseason participation was associated with a lower percentage of games missed due to injury (r=-0.40, p<0.05), with 10 preseason sessions predicting a 5% reduction in the percentage of games missed.
  
  
  CONCLUSIONS
  Maximising participation in preseason training may protect elite rugby league players against in-season injury.
authors.affiliation: Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada.|Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.|Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Johann
authors.initials: J
authors.lastname: Windt
authors.affiliation: School of Human Movement Studies, The University of Queensland, Brisbane, Queensland, Australia.|School of Exercise Science, Australian Catholic University, Brisbane, Queensland, Australia.
authors.forename: Tim J
authors.initials: TJ
authors.lastname: Gabbett
authors.affiliation: High Performance Unit, Manly Sea Eagles, Sydney, New South Wales, Australia.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ferris
authors.affiliation: Experimental Medicine Program, University of British Columbia, Vancouver, British Columbia, Canada.|Centre for Hip Health and Mobility, University of British Columbia, Vancouver, British Columbia, Canada.|Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
authors.forename: Karim M
authors.initials: KM
authors.lastname: Khan
mesh_terms: D000328:Adult; D001265:Athletic Injuries / Q000453:epidemiology*; D005538:Football / Q000293:injuries*; D006801:Humans; D016015:Logistic Models; D008297:Male; D064797:Physical Conditioning, Human / Q000379:methods*; D011446:Prospective Studies; D055815:Young Adult
keywords: Athlete; Rugby; Sporting injuries; Training load