Pain is multifactorial. Even when there is tissue damage present, pain can be up or down regulated by a myriad of factors. Injury itself is multifactorial. There are a huge amount of intrinsic and extrinsic factors that come into play when predisposing an athlete to injury or not.
Injury “prevention” is complex, and to an extent, impossible. We know from work on acute:chronic workload ratios, and work looking at optimal workload thresholds, that we’re not only at risk of injury by doing too much, but also by doing too little (sarcopenia, anyone?).
The statistics involved in determining potential injury risk factors is not so simple as just running associations with individual variables (I used binomial logistic regressions back in the day AND has a biostatistician consulting for me, but if I were to conduct any of this sort of research again I’d definitely be involving a good biostatistician from step 1 – I’m trained as an exercise scientist and I still feel I wouldn’t know where to start, and depending on what data you have, there are very likely better ways to determine potential predisposing factors).
Injury and pain are complex. If you are being told “it happened because of *insert one thing,*” the picture is unfortunately very likely to be too simplistic.
Given how well bodies adapt to all kinds of stress and stimuli, load management plays a huge role – load management also doesn’t just mean training volume or intensity – but that’s probably a post for another day ✨
In general, the rule for pain and injury usually remains; calm it down, build it back up.
Siobhan Milner 