Spikes in acute:chronic workload ratio (ACWR) associated with a 5-7 times greater injury rate in English Premier League football players: A comprehensive 3-year study

Research output: Contribution to journalArticlepeer-review


Colleges, School and Institutes

External organisations

  • Sports Medicine and Science
  • Southampton Football Club
  • Performance Support


Objectives: We examined the relation between global positioning system (GPS)-derived workloads and injury in English Premier League football players (n=33) over three seasons. Methods: Workload and injury data were collected over three consecutive seasons. Cumulative (1-weekly, 2-weekly, 3-weekly and 4-weekly) loads in addition to acute:chronic workload ratios (ACWR) (acute workload (1-week workload)) divided by chronic workload (previous 4-week average acute workload) were classified into discrete ranges by z-scores. Relative risk (RR) for each range was then calculated between injured and non-injured players using specific GPS variables: total distance, low-intensity distance, high-speed running distance, sprint distance, accelerations and decelerations. Results: The greatest non-contact injury risk was when the chronic exposure to decelerations was low (<1731) and the ACWR was >2.0 (RR=6.7). Non-contact injury risk was also 5-6 times higher for accelerations and low-intensity distance when the chronic workloads were categorised as low and the ACWR was >2.0 (RR=5.4-6.6), compared with ACWRs below this. When all chronic workloads were included, an ACWR >2.0 was associated with a significant but lesser injury risk for the same metrics, plus total distance (RR=3.7-3.9). Conclusions: We recommend that practitioners involved in planning training for performance and injury prevention monitor the ACWR, increase chronic exposure to load and avoid spikes that approach or exceed 2.0.


Original languageEnglish
JournalBritish Journal of Sports Medicine
Publication statusPublished - 21 Feb 2019


  • football, GPS, injury, Premier League, workloads