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Abstract
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BACKGROUND: In this clinical commentary, we highlight issues related to conceptual foundations and methods used in the training load-injury research. We focus on sources of degrees of freedom that can favor questionable research practices such as p-hacking and HARKing (Hypothesizing After the Results are Known), which can undermine the trustworthiness of research findings.
CLINICAL QUESTION: Is the methodological rigour of studies in the training load-injury field sufficient to inform training-related decisions in clinical practice?
KEY FINDINGS: The absence of a clear conceptual framework, causal structure, and reliable methods can promote questionable research practices, selective reporting and confirmation bias. The fact that well accepted training principles (e.g. overload progression) are in line with some study findings may simply be a consequence of confirmation bias, resulting from cherry picking and emphasizing results that align with popular beliefs. Identifying evidence-based practical applications, grounded in high-quality research is not currently possible. The strongest recommendation we can make for the clinician is grounded in common sense "do not train too much too soon" - not because it has been confirmed by studies, but because it reflects accepted generic training principles.
CLINICAL APPLICATION: The training load-injury research field has fundamental conceptual and methodological weaknesses. Therefore, making decisions about planning and modifying training programs for injury reduction in clinical practice, based on available studies, is premature. Clinicians should continue to rely on best practice, experience and well-known training principles, and consider the potential influence of contextual factors when planning and monitoring training loads. J Orthop Sports Phys Ther, Epub 1 Aug 2020. doi:10.2519/jospt.2020.9211.
Language: en |