Too Much, Too Soon

October 15, 2019 | Overuse, Prevention

By Dev K. Mishra, M.D.

President, Sideline Sports Doc

Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Soft tissue injuries are frequently caused by sudden increases in training loads
  • Monitor training load and pain symptoms using a wearable activity tracker or a training journal

Training “too much, too fast, too soon” has been called the “terrible toos” for as long as I can remember, because it’s a great formula to create an injury. But one of the problems with this line of thinking is that it can be very difficult when you’re in the moment to understand whether you are in fact doing something “too much, too fast, or too soon”.

We often don’t know whether an athlete has over trained until they come in to the doctor’s office with an injury. We then work backwards and if we’re lucky we can point to specific training errors as the likely cause of the injury. Is there a way we can monitor training loads going forward to avoid exceeding the thresholds for overtraining? Wearable activity trackers may be the answer.

Let’s begin with the assumption that you’d rather not be injured. Let’s also begin with an assumption that most overtraining injuries can be prevented through an appropriate ramp up in your training load. The challenge then is to figure out the best way to ramp up your training load. You need to push yourself aerobically and through resistance training in order to improve your fitness and performance. The key is to track your increases and monitor your overall health status to avoid an overtraining injury.

A recently published study titled “Does Overexertion Correlate With Increased Injury?” attempted to study this question prospectively with a single NFL team. Using the Catapult GPS tracking system, the players were monitored over two full NFL preseasons and regular seasons.

They found that soft tissue injuries in professional football players were associated with sudden increases in training load over the course of a month. This was especially true during the preseason when player workloads were generally higher. The injured players had on average a 111% increase in workload, and the uninjured players had on average a 73% increase in workload.

This study of elite professional athletes provides some insights that can be useful for the amateur athlete.

First, I’d strongly recommend that you find some way to monitor your workload. If you have a wearable activity tracker such as a smartwatch or other digital activity tracker, use it! If you don’t have one of these then keep track of your activity the old-fashioned way. Keep a journal and write down the details of your activities in terms of time, intensity, reps, load, etc.

Second, be mindful of any symptoms of pain that you may be having. Some amount of muscle and joint discomfort is normal and to be expected as you increase your activity level, but you need to be aware of when an injury is serious enough to require professional attention. Check out The SAFE Method™ from our website for guidance.

Finally, how fast exactly should you ramp up? The “10% rule” has been around forever and is a reasonable way to start. Under this guideline you would increase your running mileage or training load by 10% per week. This will be too fast for some, and too slow for others, so I would want you to pay attention to my advice above to monitor your symptoms of pain.






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