Do injury rates effect team performance?

Last week I blogged about individual performances in team sports following ACL reconstruction. As you may remember, there were examples of player’s careers thriving after ACL reconstruction, but unfortunately for some athletes, it was the start of a decline in performance and premature end to their careers. This time however, I’m going to turn my attention to total team injury rates and overall team performance.

Before I get in to the nitty gritty, I want to pause for a second and ask a question; Whether you’re directly involved within the sporting environment as a club doctor, physio, High Performance Unit (HPU) manager, strength and conditioning coach or sport scientist, or simply you are a fan of sport in general;

How is your team fairing this year? Are they peaking nicely for the finals? Are they touch and go to make the finals? Or are you languishing at the bottom of the table?

Now I want to ask you another question;

How's your team injury rate been this year? Does your injury rate correlate with your team’s performance? Ie. Low injury rate and sitting high on the table? Or high injury and sitting low on the table?

If so, this may not be a coincidence… For those that enjoy watching the English Premier League (football/soccer), you'd be all well aware of the Cinderella story of the century, Leicester City winning this year’s premiership. For those of you that aren’t aware of the story; Leicester City were promoted to the Premier League from the Championship League for the 2014-15 season. At the end of that season, they barely survived relegation back to the Championship competition, and leading into the 2015-16 season were at 5000/1 odds of winning the title. However, they defied all odds and won this year's title...and bankrupted many book-makers in the process. What was simply unbelievable about their title win, was the fact that they were the 3rd least richest club in the competition, with player transfer fees totaling just over £50m. The 2 richest clubs in the competition, Manchester City and Manchester United, who both cost in excess of £400m to put their team on the park, finished 4th and 5th overall respectively.

What is less known about Leicester City’s success are 2 other factors that are imperative to team success:

Firstly, they had the lowest injury toll all season, with only 18 injuries sustained that prevented a player from playing in a match. Manchester City on the other-hand had 69 injuries that prevented match-play.

Side note: Astoundingly, as I was doing research for this blog, I came across a newspaper column (see link) describing Leicester City's low injury toll as “lucky” and “sheer chance”. I was beside myself. Low injury rates are not “sheer-bloody-chance”. Sure, Leicester City's scheduling was not as rough as the likes of Manchester City or Manchester United's who also competed in the Champions League, but a low injury toll is an absolute credit to the Manager/Coach and the HPU preparing and load managing these players to perfection.

Secondly, as a result of their low injury toll, they used the least amount of players of all the clubs in the Premier League. This meant that the Manager (coach) was able to regularly pick the best starting 11 players week-in-week-out for the 38 game season.

So on the back of Leicester’s incredible result, I went looking for some more research and found a handful of studies that clearly demonstrate that lower injury rates equate to greater team success:

UEFA (soccer)- (1)

• Lower injury burden and high match availability were associated with higher domestic league ranking and success in the UEFA or Europa league.

Australian Track and Field athletes - (2)

• Likelihood of achieving a performance goal was increased by 7x in those that completed >80% of planned training sessions in the 6 months leading up to the event.

• For every modified training week the chance of success reduced by 26%

• Athletes who sustained less than 2 injuries or illnesses per training season, were 3x more likely to achieve their performance goal than those who sustained 2 or more per season.

NBA (basketball) - (3)

• Strong correlation between player games missed and percentage of regular season games won . Ie. The less player games missed per season equates to more team wins per season.

Qatari Football (soccer) - (4)

• Lower injury incidence strongly correlated with overall team ranking, more games won, more goals scored, greater goal difference and total points

English Rugby Union - (5)

• Positive association between injury and team success – ie. less injury equates to team success

So it seems that it was simply not a coincidence that Leicester had great success this year. And it certainly wasn’t “luck” or “sheer chance” that won them the title. Of course team success is very multi-factorial, and can not be 100% contributed to low injury rates, but in my opinion it’s a bloody good place to start!

In closing up this week's blog, I think the important take home message for all involved within sport administration and team coaching is this:

Invest wisely in the people (experienced, evidence-based HPU) who are going to look after your primary asset – The Players.

It is clear from the above literature that lower injury rates, means that the coaching staff have a greater talent pool to choose from. As a result, there will be less team changes, more team cohesion and a better chance of winning.

Seems like a fairly simple formula for success doesn’t it?

I hope you have enjoyed this week's blog as much I did researching it. Feel free to like and share it amongst your colleagues, and leave a comment if you have other examples of teams doing well on the back of low injury rates, or simply have other views on this topic.

Have a great week!

References:

1. Hägglund M, Waldén M, Magnusson H, Kristenson K, Bengtsson H, Ekstrand J. Injuries affect team performance negatively in professional football: an 11-year follow-up of the UEFA Champions League injury study. British journal of sports medicine. 2013 August 1, 2013;47(12):738-42.

2. Raysmith BP, Drew MK. Performance success or failure is influenced by weeks lost to injury and illness in elite Australian track and field athletes: A 5-year prospective study. Journal of Science and Medicine in Sport.

3. Podlog L, Buhler CF, Pollack H, Hopkins PN, Burgess PR. Time trends for injuries and illness, and their relation to performance in the National Basketball Association. Journal of Science and Medicine in Sport. 2015 5//;18(3):278-82.

4. Eirale C, Tol JL, Farooq A, Smiley F, Chalabi H. Low injury rate strongly correlates with team success in Qatari professional football. British journal of sports medicine. 2013 Aug;47(12):807-8. PubMed PMID: 22904292. Pubmed Central PMCID: PMC3717779. Epub 2012/08/21. eng.

5. Williams S, Trewartha G, Kemp SP, Brooks JH, Fuller CW, Taylor AE, et al. Time loss injuries compromise team success in Elite Rugby Union: a 7-year prospective study. British journal of sports medicine. 2016 Jun;50(11):651-6. PubMed PMID: 26552415. Epub 2015/11/11. eng.