This is so important to understand because while sports performance training is often touted as injury prevention training, the multivariate nature of injuries stretches far beyond our control as trainers/coaches.
In our 20 years of working with athletes, we've had next to no active athletes experience a non-contact injury. I believe that to be due in part to our training because our goal is to disrupt patterns that lead to injury. However, as a trainer, you can only do so much. We don't have control over many factors that increase injury risk. It doesn't mean we stop training to prevent injury, it just means we educate ourselves by gaining knowledge about this type of science and the athletes we train.
Injury risk is rarely the result of one isolated factor. Bittencourt et al. challenged the traditional approach of reducing injury prediction down to individual risk factors and argued that sports injuries are better understood as complex, emergent phenomena. In their words, the multifactorial nature of sports injuries comes not from âthe linear interaction between isolated and predictive factors,â but from the interaction among a âweb of determinants.â That web may include biomechanical, physiological, psychological, behavioral, training, technical, and contextual factors.
This is helpful because it changes how we interpret risk. A strength deficit, range of motion limitation, fatigue state, poor tissue capacity, technical fault, psychological hesitation, prior injury history, or spike in workload may not fully explain injury risk by itself. But each can influence the systemâs ability to tolerate, dissipate, adapt to, or recover from load. Said another way, these factors often have one thing in common: they can reduce tolerance to load when they interact with the right context, exposure, and timing. That is why the authors argue we need to move from simply identifying risk factors to recognizing risk patterns.
For return to performance, this matters. We are not just clearing a tissue, a test, or a number. We are trying to understand whether the athlete, operator, or crew member can repeatedly express readiness under the actual demands of the environment they are returning to.