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Workload, Fatigue Management, and Pain - Part 1



Introduction

On any given day at Driveline, I encounter several athletes dealing with various forms of pain or discomfort. My primary job is to guide these athletes on how to manage and resolve their issues while maintaining a rigorous training regimen. The reality is that performance does not equal health. When training to elevate your skills and play at a higher level, you risk encountering periods of pain or even injury. But you can’t play if you’re hurt. The key to a successful training program isn’t just the exercise selection or methodology. It’s about having a strategy to monitor and finely tune the necessary variables to push performance forward while managing workload appropriately to ensure you see the fruits of your labor.


Acute vs. Chronic Workload


Definition

To discuss workload management, we first need to define it. When we talk about workload, we refer to imposed stress, primarily in terms of acute versus chronic workload. An important distinction is that there is no specific span of time when discussing workload spikes in the context of pain and injury. Acute workload is always referenced against the chronic timeframe. Acute could refer to one day in a week, a week within a month, or even one "bad" rep in a day’s work that stresses a tissue beyond its current capabilities.


A Necessary Foundation

Similar to how injury rates are highest at the start of spring training, we often see an increase in problems within the first few weeks of an athlete's stay due to a spike in daily workload. While we educate athletes on preparing for training demands before they arrive, we can only control so many variables. It is these spikes in acute workload that exceed what the athlete has been chronically exposed to that often lead to pain.


The body is a resilient adaptation machine, but it takes time to adapt. This is where training progressions come into play in both the weight room and skill development. Ideally, athletes come prepared to train, but if an athlete is under-trained or lacks exposure to certain stimuli, such as weighted balls or a consistent lifting routine, we need to take time to establish a base workload tolerance.


An effective strategy is to establish a high volume of work at submaximal intensities. From there, the periodization is primarily linear, with volume decreasing slightly as intensity increases over time. Once an athlete is accustomed to handling a solid workload on both sides, we can start balancing as we drive them towards higher outputs. However, pain sometimes becomes an obstacle in this process of improving the body's tolerance to high stress.


Let’s Talk About Pain

Understanding pain is crucial in managing these athletes. Here, I draw from pain science experts David Butler and Lorimer Mosely and their book, Explain Pain.


In the early stages, pain is an alarm system worth paying attention to. Pain is extremely complex, multifactorial, and sometimes downright confusing. In this context, pain can be a warning that the body is experiencing significantly more stress than it has previously and to proceed with caution.

Think of this alarm system as having a threshold that must be crossed before it is set off, with chronic workload establishing that threshold.


Many athletes experience pain when their acute workload exceeds this threshold. It doesn’t necessarily mean they’ve injured themselves, but it may have triggered an inflammatory response in tissue that wasn’t prepared for the stress.


Consider the last time you did something highly active and unusual, like a massive hike after a long winter. Your knee might have been puffy and bothering you for a few days afterward. You didn’t injure your knee, but it’s telling you to back off. The threshold for pain is now more sensitive than before. This threshold is dynamic and can increase to tolerate more stress, but this takes time and repeated exposure to training within the threshold's limits. Chronic pain and subsequent injury occur when athletes or coaches ignore this warning and continue to exceed the threshold day after day.


Physical stress isn’t the only consideration. Stress is stress, and everything counts—from physical to psychosocial to occupational domains. While this may apply less in our setting, it is significant in others. For example, D1 football athletes have double the injury rates during periods of high academic stress. It's essential to respect all variables, from school and work to playing games and relationship troubles, and manage the variables you can control, such as promoting sleep habits, quality nutrition, and modifying training demands appropriately.


Conclusion

I hope this brief dive into workload and pain response provides a more holistic perspective for viewing your athletes. For a deeper dive into any of these topics, I recommend exploring the links throughout the article. In part two, we will discuss the application of these principles in the day-to-day management of our athletes.


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