Description:
Understanding factors that motivate young athletes to continue participation in sport can help key stakeholders cultivate an environment that fosters long-term participation. This investigation sought to determine the performance and participation factors that influenced continued participation in junior cricket. Administration-level data were collected each annual season across a seven-year period by a community-level junior cricket association in Australia and analysed to identify the performance and participation-based predictors of player retention. All players were males aged <16 years. Players were categorised according to whether they remained in (or departed from) the association at the end of each playing season. A multivariate logistic regression model with a stepwise variable selection was employed to identify significant independent predictors of player retention. The number of innings batted and overs bowled were significant participation-related contributors to junior cricket player retention. Performance factors such as the number of wickets taken and the number of runs scored also significantly influenced player retention. Finally, team age group, the number of previous seasons played and age were also significant factors in player retention. This demonstrates that sufficient opportunity for children to participate in the game and expression of skills competence are key factors for retention in cricket.
Description:
Background Team ball sports such as soccer, basketball and volleyball have high participation levels worldwide. Musculoskeletal injuries are common in team ball sports and are associated with significant treatment costs, participation loss and long-term negative side effects. The results of recent randomized controlled trials provide support for the protective effect of injury-prevention exercise programmes (IPEPs) in team ball sports, but also highlight that achieving adequate compliance can be challenging. A key process in enhancing the ultimate impact of team ball sport IPEPs is identifying the specific implementation components that influence the adoption, execution and maintenance of these interventions. Despite this, no systematic review focussing on the specific implementation components of team ball sport IPEPs has been conducted. Objectives Our objective was to assess the reporting of specific implementation components in the published literature on team ball sport IPEPs using the Reach Efficacy Adoption Implementation Maintenance (RE-AIM) framework. Methods Six electronic databases were systematically searched from inception to December 2012 for papers reporting team ball sport IPEP trials. All eligible papers were independently evaluated by two raters before reaching consensus on the reporting of individual RE-AIM items, using the RE-AIM Model Dimension Items Checklist (RE-AIM MDIC). Results A total of 60 papers, reporting 52 unique intervention trials, met eligibility criteria. Before consensus, the level of agreement across all trials between reviewers using the RE-AIM MDIC ranged from 81 to 91 %. The RE-AIM MDIC dimension of 'efficacy' had the highest level of reporting, with the five individual items in this dimension reported in 19-100 % of eligible trials (mean 58 %). The RE-AIM MDIC dimension 'maintenance-setting level' had the lowest level of reporting, with none of the four individual items in this dimension reported. For other dimensions, the mean level of reporting and range across items were 'reach' 34 % (12-60 %); 'adoption-setting level' 1 % (0-2 %); 'adoption-delivery agent level' 7 % (4-10 %); 'implementation' 36 % (13-63 %) and 'maintenance individual level' 1 % (0-4 %). Conclusion Information on the specific implementation components of team ball sport IPEPs in published studies is scarce. In particular, major reporting gaps exist regarding the adoption and maintenance of these programmes. The RE-AIM MDIC can be successfully applied to reviewing literature in this context.
Description:
Objective: Scientific knowledge about symptoms of common mental disorders in elite sports is scarce. Consequently, the objectives of the study were to (i) establish the 12-month incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, adverse alcohol use, eating disorders) among Dutch elite athletes and (ii) explore their potential association with several stressors (being injured, recent life events, career dissatisfaction).Methods: A prospective cohort study with a 12-month follow-up period was conducted. The study used validated questionnaires to assess symptoms of common mental disorders (thus not clinically diagnosed) as well as several stressors; an electronic questionnaire was set up and repeatedly distributed.Results: A total of 203 elite athletes gave their written informed consent to participate in the study, from which 143 completed the 12-month follow-up period (follow-up rate of 70%). Incidence of symptoms of CMD ranged from 6% for adverse alcohol use to 57% for symptoms of anxiety/depression. Over the follow-up period, around 17% of the participants reported two simultaneous symptoms of CMD, and around 19% reported three simultaneous symptoms of CMD. Inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant.Conclusions: Substantial 12-month incidence rates of symptoms of CMD (self-reported and not clinically diagnosed) were found among Dutch elite athletes (especially for anxiety/depression), appearing similar to the ones found among athletes from other sports disciplines and the Dutch general population. Also, inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve awareness and psychological resilience of athletes, which would likely improve their performance and quality-of-life.
Description:
Objective: Scientific knowledge about symptoms of common mental disorders in elite sports is scarce. Consequently, the objectives of the study were to (i) establish the 12-month incidence of symptoms of common mental disorders (CMD; distress, anxiety/depression, sleep disturbance, adverse alcohol use, eating disorders) among Dutch elite athletes and (ii) explore their potential association with several stressors (being injured, recent life events, career dissatisfaction).Methods: A prospective cohort study with a 12-month follow-up period was conducted. The study used validated questionnaires to assess symptoms of common mental disorders (thus not clinically diagnosed) as well as several stressors; an electronic questionnaire was set up and repeatedly distributed.Results: A total of 203 elite athletes gave their written informed consent to participate in the study, from which 143 completed the 12-month follow-up period (follow-up rate of 70%). Incidence of symptoms of CMD ranged from 6% for adverse alcohol use to 57% for symptoms of anxiety/depression. Over the follow-up period, around 17% of the participants reported two simultaneous symptoms of CMD, and around 19% reported three simultaneous symptoms of CMD. Inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant.Conclusions: Substantial 12-month incidence rates of symptoms of CMD (self-reported and not clinically diagnosed) were found among Dutch elite athletes (especially for anxiety/depression), appearing similar to the ones found among athletes from other sports disciplines and the Dutch general population. Also, inferences between some stressors and symptoms of CMD were found but none of the associations were statistically significant. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve awareness and psychological resilience of athletes, which would likely improve their performance and quality-of-life.
Description:
There is evidence that eye protection, mouth guards, helmets, and face guards are effective in reducing the risk of facial injury; however, such safety practices are not adopted universally by all athletes playing high risk sports. Underlying beliefs about risk perception, comfort, ineffectiveness, utility, and a lack of awareness or enforcement have been identified as reasons people may not adopt preventive measures. There are several high-risk sports that have not mandated or do not enforce use of protective equipment. Valid evidence can assist with addressing the resistance caused by prevailing beliefs and could be essential in influencing rule changes.
Description:
Musculoskeletal injuries during military and sport-related training are common, costly, and potentially debilitating. There is a need to develop and implement evidence-based injury prevention strategies to reduce the burden of musculoskeletal injury. The lack of attention to implementation issues is a major factor limiting the ability to successfully reduce musculoskeletal injury rates using evidence-based injury prevention programs. This article proposes 7 steps that can be used to facilitate successful design and implementation of evidence-based injury prevention programs within the logical constraints of a real-world setting by identifying implementation barriers and associated solutions.
Description:
BACKGROUND: Despite a rapidly growing body of research, a systematic evidence compilation of the risk and protective factors for middle- and long-distance running-related injury (RRI) was lacking. OBJECTIVES: Our objective was to compile the evidence about modifiable and non-modifiable training-related and behavioral risk and protective factors for middle- and long-distance RRI. METHODS: We searched five databases (PubMed, CINAHL, MEDLINE, SPORTDiscus, and PsycINFO) for the dates 1 January 1970 to 31 December 2015, inclusive, for original peer-reviewed articles. The eligible designs were cross-sectional, case-control, longitudinal observational studies, and randomized controlled trials involving runners competing at distances from >/=800 m to
Description:
BACKGROUND: Despite a rapidly growing body of research, a systematic evidence compilation of the risk and protective factors for middle- and long-distance running-related injury (RRI) was lacking. OBJECTIVES: Our objective was to compile the evidence about modifiable and non-modifiable training-related and behavioral risk and protective factors for middle- and long-distance RRI. METHODS: We searched five databases (PubMed, CINAHL, MEDLINE, SPORTDiscus, and PsycINFO) for the dates 1 January 1970 to 31 December 2015, inclusive, for original peer-reviewed articles. The eligible designs were cross-sectional, case-control, longitudinal observational studies, and randomized controlled trials involving runners competing at distances from >/=800 m to
Description:
Since the initial reporting of salivary hormone measurements in marathon runners in the early 1980s, the practice of utilizing salivary testosterone (T) and cortisol (C) to reflect acute and rhythmic changes to their systemic counterparts has gained considerable momentum. However, substantial variability exists between studies with respect to methodological protocols, laboratory techniques, and interpretation of study findings. These differences can directly influence the salivary hormone values, thus hampering interpretation, limiting cross-study comparison, and constraining the generalizability of individual study findings. This article examines the current body of literature before proposing a sequence of practical guidelines to minimize sample variability in salivary hormone research. The guidelines are grouped into 3 major categories that limit comparison between studies; A) study design, B) sample acquisition and biological variation, and C) technical and analytical error. To achieve this, the present article critically appraises research employing salivary T and C measurements, identifies potential sources of error before proposing appropriate methodological considerations for researchers and practitioners wishing to obtain T and C measurement from saliva. BASI AA, 1980, JOURNAL OF LABORATORY AND CLINICAL MEDICINE, V96, P544
Description:
BACKGROUND. Hamstring strain injuries (HSI) are among the most common injuries in field-based team sports with a high-speed running component. The implementation of the Nordic hamstring exercise (NHE) is a well-documented method of improving eccentric hamstring strength to mitigate the risk of HSI occurrence. Sprint training is specific to the injury mechanism and is thought to activate the hamstrings through maximal eccentric contractions. The purpose of this study was to compare the effects of sprint training and the NHE on eccentric hamstring strength and sprint performance. METHODS. Twenty-eight participants (mean +/- SD age=16.21 +/- 1.34 years; height=1.75m +/- 0.10m; body mass=68.5kg +/- 12.1kg) completed an eccentric hamstring strength assessment and 40m sprint to assess acceleration and maximum speed. Participants were randomly allocated to either a NHE training or sprint training group. Two sessions per week for four-weeks of training was performed with baseline testing procedures repeated in the week following the intervention. Perceptions of soreness were recorded following the warm-up in each training session. RESULTS. Both the NHE (effect size=0.39, P<0.05) and sprint training (effect size=0.29, P<0.05) groups displayed significant gains in eccentric hamstring strength. The NHE group reported trivial improvements in sprint performance, whilst the sprint training group experienced a moderate improvement, specifically in maximum speed (ES=0.83 Moderate). Sprint training also produced greater perceptions of soreness than the NHE following a four-week training intervention, specifically before the start of the last session (P<0.05). CONCLUSIONS. These findings indicate that sprint training had a beneficial effect for both eccentric hamstring strength and sprint performance, whilst also producing greater soreness than the NHE following the final training session. It was concluded that a four-week block of maximum speed training may have both an injury prevention and performance enhancement benefit.
Description:
BACKGROUND. Hamstring strain injuries (HSI) are among the most common injuries in field-based team sports with a high-speed running component. The implementation of the Nordic hamstring exercise (NHE) is a well-documented method of improving eccentric hamstring strength to mitigate the risk of HSI occurrence. Sprint training is specific to the injury mechanism and is thought to activate the hamstrings through maximal eccentric contractions. The purpose of this study was to compare the effects of sprint training and the NHE on eccentric hamstring strength and sprint performance. METHODS. Twenty-eight participants (mean +/- SD age=16.21 +/- 1.34 years; height=1.75m +/- 0.10m; body mass=68.5kg +/- 12.1kg) completed an eccentric hamstring strength assessment and 40m sprint to assess acceleration and maximum speed. Participants were randomly allocated to either a NHE training or sprint training group. Two sessions per week for four-weeks of training was performed with baseline testing procedures repeated in the week following the intervention. Perceptions of soreness were recorded following the warm-up in each training session. RESULTS. Both the NHE (effect size=0.39, P<0.05) and sprint training (effect size=0.29, P<0.05) groups displayed significant gains in eccentric hamstring strength. The NHE group reported trivial improvements in sprint performance, whilst the sprint training group experienced a moderate improvement, specifically in maximum speed (ES=0.83 Moderate). Sprint training also produced greater perceptions of soreness than the NHE following a four-week training intervention, specifically before the start of the last session (P<0.05). CONCLUSIONS. These findings indicate that sprint training had a beneficial effect for both eccentric hamstring strength and sprint performance, whilst also producing greater soreness than the NHE following the final training session. It was concluded that a four-week block of maximum speed training may have both an injury prevention and performance enhancement benefit.
Description:
‘Serious leisure’ cycling has developed as a reinterpretation of the traditional form of the sport. This short term, informal, unstructured and unconventional conceptualisation represents a challenge to participant numbers in the mainstream sport. The purpose of this study was twofold: (i) to ascertain the cultural, subcultural and ecological factors of participation in this new conceptualised form enabling clubs, associations and governments to a deeper understanding about participants practices and (ii) as an ongoing validation to previous qualitative work (see O’Connor and Brown, 2005). This study reports on the development and psychometric properties (principal components analysis, confirmatory factor analysis) of the Cyclists’ Motivation Instrument. Four hundred and twenty two cyclists (371 males, 51 females) who were registered members of the state competitive cycling body completed a fifty-one item instrument. Five factors were identified: social, embodiment, self-presentation, exploring environments and physical health outcomes and these accounted for 47.2% of the variance. Factor alpha coefficients ranged from .63 to .88, overall scale reliability was .92, suggesting moderate to high reliability for each of the factors and the overall scale.
Description:
‘Serious leisure’ cycling has developed as a reinterpretation of the traditional form of the sport. This short term, informal, unstructured and unconventional conceptualisation represents a challenge to participant numbers in the mainstream sport. The purpose of this study was twofold: (i) to ascertain the cultural, subcultural and ecological factors of participation in this new conceptualised form enabling clubs, associations and governments to a deeper understanding about participants practices and (ii) as an ongoing validation to previous qualitative work (see O’Connor and Brown, 2005). This study reports on the development and psychometric properties (principal components analysis, confirmatory factor analysis) of the Cyclists’ Motivation Instrument. Four hundred and twenty two cyclists (371 males, 51 females) who were registered members of the state competitive cycling body completed a fifty-one item instrument. Five factors were identified: social, embodiment, self-presentation, exploring environments and physical health outcomes and these accounted for 47.2% of the variance. Factor alpha coefficients ranged from .63 to .88, overall scale reliability was .92, suggesting moderate to high reliability for each of the factors and the overall scale.
Description:
Alteration in body composition, physical function, and substrate metabolism occur with advancing age. These changes can be attenuated by exercise. This study evaluated whether master athletes (MA [n = 20]) would have improved exercise capabilities, anthropometry, and hormone profiles when compared with age-matched sedentary counterparts (S [n = 28]). The MA group was predominantly aerobically trained with some resistance exercise incorporated in their routine. The VO(2max), peak power output, and salivary testosterone was significantly higher (p < 0.05) in the MA group, while diastolic blood pressure, systolic blood pressure, and body fat percentage were lower (p < 0.05). Cortisol, fat free mass, (FFM) and total body mass were not significantly different between groups. Salivary testosterone correlated positively with VO(2max) (r(2) = .320), suggesting that increased aerobic capacity is linked with higher concentrations of testosterone. These results suggest that life-long exercise is associated with favorable body composition and attenuation of the age related decline in testosterone.
Description:
The present study examined the agreement between peak power output during a standard Wingate anaerobic test (WAnT) and a six second 'all-out' test on a Wattbike Pro. Nine males (40.7 +/- 19.4 yrs, 1.76 +/- 0.03 cm, 82.11 +/- 8.9 kg) underwent three testing protocols on separate days. The protocols consisted 30 second WAnT (WAnT30), a modified WAnT over 6 seconds (WAnT6) and a 6 second peak power test (PPT6). PPT6 was correlated with WAnT30 (r = 0.9; p < 0.001) with a mean bias of 105 W. PPT6 correlated with WAnT6 (r = 0.95; p < 0.001) with a mean bias of 74 W. WAnT6 correlated with WAnT30 (r = 0.99; p < 0.001) with a mean bias of 31 W. There was no difference in time to peak power between any trial. PPT6 resulted in significantly greater power outputs than in WAnT30 and WAnT6 (p < 0.001). We conclude that PPT6 and WAnT6 are valid measures of peak power output compared with WAnT30. This identifies that PPT6 and WAnT6 as short duration 'all-out' tests that have practical applications for researchers and coaches who wish to assess peak power output without the fatiguing effects associated with a standard WAnT.
Description:
Background Concussion is common in the sporting arena and is often challenging to diagnose. The development of wearable head impact measurement systems has enabled measurement of head kinematics in contact sports. Objectives The objective of this systematic review was to determine the characteristics of head kinematics measured by an accelerometer system among male athletes diagnosed with concussion. Methods A systematic search was conducted in July 2015. Inclusion criteria were English-language studies published after 1990 with a study population of male athletes, in any sport, where objectively measured biomechanical forces were reported in the setting of a concussive event. The random effects meta-analysis model was used to combine estimates of biomechanical force measurements in concussed athletes. Results Thirteen studies met the inclusion criteria, the majority of which were conducted with high school and college football teams in the US. Included studies measured a combination of linear and rotational acceleration. The meta-analysed mean peak linear head acceleration associated with a concussive episode was 98.68 g (95 % CI 82.36-115.00) and mean peak rotational head acceleration was 5776.60 rads/s 2 (95 % CI 4583.53-6969.67). The estimates of the biomechanical forces were consistent across studies, with I 2 values of 0 % for both metaanalyses. Conclusions Head impact monitoring through accelerometery has been shown to be useful with regard to characterising the kinematic load to the head associated with concussion. Future research with improved clinical outcome measures and head kinematic data may improve accuracy when evaluating concussion, and may assist with both interpretation of biomechanical data and the development and utilisation of implementation strategies for the technology.
Description:
Introduction Sport injury prevention studies vary in the way compliance with an intervention is defined, measured and adjusted for. Objective The objective of this systematic review was to assess the extent to which sport injury prevention randomised controlled trials (RCTs) have defined, measured and adjusted results for compliance with an injury prevention intervention. Methods An electronic search was performed in MEDLINE, PubMed, the Cochrane Center of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database) and SPORTDiscus. English RCTs, quasi-RCTs and cluster-RCTs were considered eligible. Trials that involved physically active individuals or examined the effects of an intervention aimed at the prevention of sport-or physical activity-related injuries were included. Results Of the total of 100 studies included, 71.6 % mentioned compliance or a related term, 68.8 % provided details on compliance measurement and 51.4 % provided compliance data. Only 19.3 % analysed the effect of compliance rates on study outcomes. While studies used heterogeneous methods, pooled effects could not be presented. Conclusions Studies that account for compliance demonstrated that compliance significant affects study outcomes. The way compliance is dealt with in preventions studies is subject to a large degree of heterogeneity. Valid and reliable tools to measure and report compliance are needed and should be matched to a uniform definition of compliance.
Description:
Introduction Sport injury prevention studies vary in the way compliance with an intervention is defined, measured and adjusted for. Objective The objective of this systematic review was to assess the extent to which sport injury prevention randomised controlled trials (RCTs) have defined, measured and adjusted results for compliance with an injury prevention intervention. Methods An electronic search was performed in MEDLINE, PubMed, the Cochrane Center of Controlled Trials, CINAHL (Cumulative Index to Nursing and Allied Health Literature), PEDro (Physiotherapy Evidence Database) and SPORTDiscus. English RCTs, quasi-RCTs and cluster-RCTs were considered eligible. Trials that involved physically active individuals or examined the effects of an intervention aimed at the prevention of sport-or physical activity-related injuries were included. Results Of the total of 100 studies included, 71.6 % mentioned compliance or a related term, 68.8 % provided details on compliance measurement and 51.4 % provided compliance data. Only 19.3 % analysed the effect of compliance rates on study outcomes. While studies used heterogeneous methods, pooled effects could not be presented. Conclusions Studies that account for compliance demonstrated that compliance significant affects study outcomes. The way compliance is dealt with in preventions studies is subject to a large degree of heterogeneity. Valid and reliable tools to measure and report compliance are needed and should be matched to a uniform definition of compliance.
Description:
BACKGROUND: It is known that some people can, and do, sustain >1 injury over a playing season. However, there is currently little high-quality epidemiological evidence about the risk of, and relationships between, multiple and subsequent injuries. PURPOSE: To describe the subsequent injuries sustained by Australian Football League (AFL) players over 1 season, including their most common injury diagnoses. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Within-player linked injury data on all date-ordered match-loss injuries sustained by AFL players during 1 full season were obtained. The total number of injuries per player was determined, and in those with >1 injury, the Subsequent Injury Classification (SIC) model was used to code all subsequent injuries based on their Orchard Sports Injury Classification System (OSICS) codes and the dates of injury. RESULTS: There were 860 newly recorded injuries in 543 players; 247 players (45.5%) sustained >/=1 subsequent injuries after an earlier injury, with 317 subsequent injuries (36.9% of all injuries) recorded overall. A subsequent injury generally occurred to a different body region and was therefore superficially unrelated to an index injury. However, 32.2% of all subsequent injuries were related to a previous injury in the same season. Hamstring injuries were the most common subsequent injury. The mean time between injuries decreased with an increasing number of subsequent injuries. CONCLUSION: When relationships between injuries are taken into account, there is a high level of subsequent (and multiple) injuries leading to missed games in an elite athlete group.
Description:
BACKGROUND: To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. OBJECTIVE: The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. DATA SOURCES: A systematic search of three online databases for articles published before 2016. STUDY SELECTION: Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. DATA EXTRACTION: Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. RESULTS: Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. CONCLUSIONS: Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions.
Description:
BACKGROUND: To identify and prioritise targets for injury prevention efforts, injury incidence studies are widely reported. The accuracy and consistency in calculation and reporting of injury incidence is crucial. Many individuals experience more than one injury but multiple injuries are not consistently reported in sport injury incidence studies. OBJECTIVE: The aim of this systematic review was to evaluate current practice of how multiple injuries within individuals have been defined and reported in prospective, long-term, injury studies in team ball sports. DATA SOURCES: A systematic search of three online databases for articles published before 2016. STUDY SELECTION: Publications were included if (1) they collected prospective data on musculoskeletal injuries in individual participants; (2) the study duration was >1 consecutive calendar year/season; and (3) individuals were the unit of analysis. DATA EXTRACTION: Key study features were summarised, including definitions of injury, how multiple individual injuries were reported and results relating to multiple injuries. RESULTS: Of the 71 publications included, half did not specifically indicate multiple individual injuries; those that did were largely limited to reporting recurrent injuries. Eight studies reported the number/proportion of athletes with more than one injury, and 11 studies presented the mean/number of injuries per athlete. CONCLUSIONS: Despite it being relatively common to collect data on individuals across more than one season, the reporting of multiple injuries within individuals is much more limited. Ultimately, better addressing of multiple injuries will improve the accuracy of injury incidence studies and enable more precise targeting and monitoring of the effectiveness of preventive interventions.
Description:
Background Clinically it is understood that rapid increases in training loads expose an athlete to an increased risk of injury; however, there are no systematic reviews to qualify this statement. Objective The aim of this systematic review was to determine training and competition loads, and the relationship between injury, illness and soreness. Methods The MEDLINE, SPORTDiscus, CINAHL and EMBASE databases were searched using a predefined search strategy. Studies were included if they analysed the relationship between training or competition loads and injury or illness, and were published prior to October 2015. Participants were athletes of any age or level of competition. The quality of the studies included in the review was evaluated using the Newcastle-Ottawa Scale (NOS). The level of evidence was defined as strong, 'consistent findings among multiple high-quality randomised controlled trials (RCTs)'; moderate, 'consistent findings among multiple low-quality RCTs and/or non-randomised controlled trials (CCTs) and/or one high-quality RCT'; limited, 'one low-quality RCT and/or CCTs, conflicting evidence'; conflicting, 'inconsistent findings among multiple trials (RCTs and/or CCTs)'; or no evidence, 'no RCTs or CCTs'. Results A total of 799 studies were identified; 23 studies met the inclusion criteria, and a further 12 studies that were not identified in the search but met the inclusion criteria were subsequently added to the review. The largest number of studies evaluated the relationship between injuries and training load in rugby league players (n = 9) followed by cricket (n = 5), football (n = 3), Australian Football (n = 3), rugby union (n = 2), volleyball (n = 2), baseball (n = 2), water polo (n = 1), rowing (n = 1), basketball (n = 1), swimming (n = 1), middle-distance runners (n = 1) and various sports combined (n = 1). Moderate evidence for a significant relationship was observed between training loads and injury incidence in the majority of studies (n = 27, 93 %). In addition, moderate evidence exists for a significant relationship between training loads and illness incidence (n = 6, 75 %). Training loads were reported to have a protective effect against injury (n = 9, 31 %) and illness (n = 1, 13 %). The median (range) NOS score for injury and illness was 8 (5-9) and 6 (5-9), respectively. Limitations A limitation of this systematic review was the a priori search strategy. Twelve further studies were included that were not identified in the search strategy, thus potentially introducing bias. The quality assessment was completed by only one author. Conclusions The results of this systematic review highlight that there is emerging moderate evidence for the relationship between the training load applied to an athlete and the occurrence of injury and illness. Implications The training load applied to an athlete appears to be related to their risk of injury and/or illness. Sports science and medicine professionals working with athletes should monitor this load and avoid acute spikes in loads. It is recommended that internal load as the product of the rate of perceived exertion (10-point modified Borg) and duration be used when determining injury risk in team-based sports. External loads measured as throw counts should also be monitored and collected across a season to determine injury risk in throwing populations. Global positioning system-derived distances should be utilised in team sports, and injury monitoring should occur for at least 4 weeks after spikes in loads.