Reduce Injury Risk: Mastering the Art of Training Load Modification

Have you ever experienced a niggle or injury that’s set you back a few weeks or months? Just by monitoring and modifying your training load, you can greatly reduce the risk of these setbacks. So, let’s dive into the secrets of tweaking your training load to keep injuries at bay.

Understanding Training Load

Training load is a combination of two components: internal and external workload. The internal load is how your body responds to external stress, like measuring your heart rate or how hard you feel you’re working (rate of perceived exertion). The external load is simply the amount of work you do, such as the total distance covered, number of weights lifted, or repetitions completed (Jones et al., 2016).

No two athletes are the same. Factors like age, injury history, training background, and current physical capacity play a significant role in determining the outcome of the training load on the individual.

Consistency is Your Friend

When it comes to your training load, consistency and progressive overload is the key for injury prevention. Studies have shown that maintaining a relatively stable load, with variations between 5% to 10% increase in load compared to the previous week, keeps your risk of injury below 10%. However, if you suddenly crank up the load by 15% or more, your risk of injury skyrockets to an alarming 21%-49% in the next 7 days (Piggott et al., 2009, Gabbett, 2017) If you want to reduce your risk of injury, stick to the golden rule of gradually increasing your load by less than 10% each week.

The biggest risk to an injury is a sudden spike in training load (Gabbett, 2017 and 2020). When the training load is greater than the athlete’s current capacity, there is a risk of injury. The athlete’s current capacity changes and is impacted by mood, sleep quality, illness and stress, therefore what the athlete can tolerate today may not be tolerable tomorrow. This is why subjective and objective measures like rate of perceived exertion, heart rate and how the athlete recovers after training should be taken into consideration, when programming for the athlete to reduce the risk of injury.

Finding the Sweet Spot

Understanding the relationship between training load and injury risk is like finding the perfect harmony in a symphony. Keep in mind; that under-training can increase your risk of injury, and so too can over-training.

“… to reduce your risk of injury, stick to the golden rule of gradually increasing your load by less than 10% each week.”

Acute Chronic Workload Ratio

By calculating the Acute:Chronic Workload ratio, we can reduce the risk of injury to the athlete. The acute workload is the amount of load completed in 1 week of training, whereas chronic workload is the average workload performed in the previous 4 weeks.

Acute:Chronic Workload Ratio =
A / ((0.25x(W1 + W2 + W3 + A))

A = Acute Workload
W1, W2 and W3 = Workload in the previous 3 weeks
*Workload = Rate of perceived exertion (RPE) x session duration. For example, If I ran or weightlifted at RPE 7 for 100 minutes, my workload for the day is 700 Arbitrary units (AU).

Aim to maintain Acute:Chronic workload ratios between 0.8 and 1.3 for that sweet spot of minimized injury risk. Ratios lower than 0.8 means the training stimulus is low, increasing the risk of injury. Ratios higher than 1.5 means the athlete has too much load for the athlete’s capacity, and lands them in the “danger zone.” So, strive for balance and keep that ratio in check. (Gabbett, 2017)

Practical Tips to reduce our risk of Injury:

  1. Embrace Variation: Incorporate a training program that offers a high degree of variation. Mixing things up can reduce the incidence of injuries.
  2. Plan Ahead: Implement a well-structured and periodized training program with less than 10% increase in load per week. Planning your training cycles intelligently can work wonders in minimizing injury risks.
  3. Pre-season training: Remember, Rome wasn’t built in a day. Athletes who performed less than 18 weeks of pre-season training before their first injury were 9x more likely to sustain a subsequent injury! (Gabbett, 2017) Take your time and allow your body to adapt.
  4. Balance is Key: Avoid the perils of over-training or under-training. Strive for an acute:chronic workload ratio between 0.8 – 1.3 where your training load elicits improvement without pushing you into the danger zone.

References:

  1. Jones, C.M., Griffiths, P.C. and Mellalieu, S.D. (2016) ‘Training load and fatigue marker associations with injury and illness: A systematic review of longitudinal studies’, Sports Medicine, 47(5), pp. 943–974. doi:10.1007/s40279-016-0619-5.
  2. Piggott, B., Newton, M. and Mcguigan, M. (2009) ‘The relationship between training load and incidence of injury and illness over a pre-season at an Australian Football League Club’, Journal of Australian Strength and Conditioning, 17(3).
  3. Gabbett, T. (2017) ‘Infographic: The Training–Injury Prevention Paradox: Should Athletes be training smarter and harder?’, British Journal of Sports Medicine, 52(3), pp. 203–203. doi:10.1136/bjsports-2016-097249.
  4. Gabbett, T.J. (2020) ‘The training-performance puzzle: How can the past inform future training directions?’, Journal of Athletic Training, 55(9), pp. 874–884. doi:10.4085/1062/6050.422.19.

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Area of Interest:

Qualifications

Bachelor of Science (Physiotherapy) - Curtin University, Western Australia

Advanced Clinical Credentials & Specialist Training:

Experience

Isabelle is a physiotherapist who thrives on functional fitness and helping people stay active. Born and raised in Singapore, she completed her Bachelor of Science in Physiotherapy at Curtin University in Australia​. During her time abroad, she gained valuable experience across different settings – from guiding patients through post-surgical rehabilitation to helping individuals manage chronic pain conditions​. Isabelle didn’t just stick to clinical work; she’s also a certified ACE personal trainer and even worked as a group fitness instructor while studying​. This means she’s incredibly skilled at designing and coaching exercise programs for clients of all fitness levels, blending physiotherapy knowledge with practical fitness training.

Back in Australia, Isabelle served as a sports trainer for local teams, where she provided on-field injury management, recovery strategies, and preventive care for athletes​. This hands-on sports medicine experience honed her ability to act quickly and effectively when injuries occur, and to plan rehabilitation that fits an athlete’s specific sport. Her special interests at Activex include functional fitness rehabrunning injuries, and knee injury rehabilitation. Having been an active individual all her life, Isabelle understands how frustrating injuries can be – in fact, overcoming her own sports injuries is what inspired her career in physiotherapy​. She is passionate about “paying it forward” by helping others bounce back and return to the activities they love​. Outside of work, you’ll find Isabelle staying active herself and continually pushing her physical limits through training. Her energetic, empathetic approach ensures that every client is supported, motivated, and confident in their journey to recovery.

Area of Interest:

Qualifications

Bachelor of Science (Honours) in Physiotherapy - Singapore Institute of Technology - Trinity College Dublin

Advanced Clinical Credentials & Specialist Training:

Experience

Nick is a physiotherapist with a deep personal passion for paddle sports. A Singaporean with a joint degree from SIT – Trinity College Dublin (B.Sc. Physiotherapy), Nick started his career at Singapore General Hospital, where he treated patients of all ages with conditions ranging from heart and lung issues to chronic muscle and joint injuries​. He was part of SGH’s specialized outpatient sports and shoulder clinic team, managing both surgical and non-surgical cases of shoulder injuries​. This experience, combined with his own sporting background, makes him our go-to expert for shoulder rehabilitation and upper-limb injuries.

Having spent more than half his life paddling, Nick has competed in canoe-kayak sprints, marathon races, ocean paddling, and dragon boating​. He knows first-hand the physical demands these sports place on the body. Nick leverages this knowledge in his physiotherapy practice, offering specialized rehab for paddling and water-sport injuries. Whether you’re a dragon boat racer with shoulder pain or a kayaker recovering from an injury, Nick understands what you need to get back on the water. He focuses on improving strength, endurance, and technique for a safe return to sport​. Nick is dedicated to keeping people active – his philosophy is that with the right care, everyone can pursue their sporting passions for as long as possible​. Outside of work, Nick continues to race competitively in ocean kayaking and even volunteers as a surf-ski coach for new paddlers. (He’s also a big Star Wars fan – living by Yoda’s motto, “Do or do not, there is no try,” which reflects his encouraging approach to rehab.)

Area of Interest:

Qualifications

Bachelor of Science (Honours) in Physiotherapy - Singapore Institute of Technology - Trinity College Dublin

Advanced Clinical Credentials & Specialist Training:

Experience

Hui Lin is a Singapore-born physiotherapist who specializes in dance and performing arts rehabilitation. A dancer since young, she naturally combined her love for dance with physiotherapy to help performers stay injury-free. She earned her Bachelor of Science (Honours) in Physiotherapy from Singapore Institute of Technology – Trinity College Dublin, and went on to spend four years in major hospitals gaining experience in orthopedics, cardiopulmonary rehab, and sports outpatient therapy​. This well-rounded background means she’s equipped to handle everything from post-surgery rehab to chronic conditions.

As a dance physio, Hui Lin is passionate about injury prevention and rehabilitation for dancers, musicians, and other performing artists. She understands the unique physical demands of dance and uses that insight to tailor her treatments. Her approach combines movement analysis with strength-based rehab – she’ll not only treat your injury but also teach you how to move better and strengthen key areas to prevent future issues​. Hui Lin is also certified in Polestar Pilates for Rehabilitation and in advanced dry needling techniques​, which she often incorporates into her sessions. Outside of work, she’s continually involved in the dance community (even exploring aerial silks and pole dance to deepen her understanding of different art forms)​. Her goal is to equip performers with the knowledge and exercises they need to hone their craft safely and prolong their careers.

Hui Lin is currently involved in physiotherapy coverage for NAFA Dance students.
Recent event coverage includes:
• Reformd Powerlifting Nationals 2024
• High Heels Frenzy 1.0 and 2.0
• The Intersection 2024
• NAFA Crossings 2024

Area of Interest:

Qualifications

Bachelor of Science (Honours) in Physiotherapy - Singapore Institute of Technology - Trinity College Dublin

Advanced Clinical Credentials & Specialist Training:

Experience

TJ is our resident strength sports enthusiast and physiotherapist. Born and raised in Singapore, he holds a Bachelor of Science (Honours) in Physiotherapy from SIT – Trinity College Dublin. After graduation, TJ further sharpened his skills in an acute hospital setting, managing a wide range of patients presenting with neurological conditions to orthopedic injuries. This broad experience taught him to adapt his rehabilitation strategies to patients of all ages and backgrounds.

Outside the clinic, TJ is an avid powerlifter. He firmly believes that strength training can significantly improve a person’s overall health, functionality, and happiness. This philosophy shines through in his physiotherapy practice: he uses his knowledge of powerlifting and biomechanics to help clients understand their injuries and incorporate appropriate strength exercises into their recovery. If you’re a gym-goer with a lifting injury or someone who wants to start strength training safely, TJ will speak your language. He has a keen eye for technique and even enjoys coaching at powerlifting meets, ensuring athletes perform at their best safely. At Activex, TJ focuses on rehabilitating strength sport injuries (like powerlifting, Olympic lifting, CrossFit-related issues) and common problems like lower back pain. When he’s not treating patients or training himself, you might find him hiking outdoors or enjoying a good coffee – always staying active and engaged with the community.

Area of Interest:

Qualifications

Bachelor of Science (Honours) in Physiotherapy - Singapore Institute of Technology - Trinity College Dublin

Advanced Clinical Credentials & Specialist Training:

Experience

Helen is our founder and an Australian-born Musculoskeletal Physiotherapist who now calls Singapore home. Since graduating in 2015 with a Bachelor of Science in Physiotherapy from Curtin University (Western Australia), she has built a reputation as a leading clinician in Singapore, known for her determination to find the cause of problems, not just treat the symptoms. Helen has extensive experience in both hospital and private clinic settings – she has rehabilitated post-surgical patients in an acute hospital and worked with various sports teams. Notably, she has been involved in high-level sports events, including working with Australian soccer and WAFL teams, the Singapore national netball team, Team Fiji during the 2019 Netball Test Series, and providing on-site physio support at Singapore Powerlifting and Weightlifting competitions​. These experiences have fueled her special interest in sports injury rehab and post-operative knee rehabilitation.

Beyond her clinical experience, Helen is skilled in a wide range of techniques – from Dry Needling and Mulligan’s manual therapy to strength and conditioning programming. (Fun fact: she was the best female powerlifter in the 2018 APU Powerlifting State Competition in Australia!) She’s also Polestar Pilates trained and holds an ASCA Level 1 Strength & Conditioning certification​. Helen’s philosophy is to blend hands-on therapy with functional strength training to help patients recover and come back stronger. Her passion and deep understanding of biomechanics allow her to create targeted exercise plans that promote optimal recovery and performance for every patient.