Is my workload appropriate, or is it risking injury?

by | Mar 29, 2016

In a previous blog post, I discussed how pain during exercise can be used as a guide to keep from ‘overdoing it’ and injuring yourself. But what if you don’t have any pain? Well, that’s a great situation to be in, but sadly it is still all too easy to suffer injury from doing too much, too quickly. That is why I am excited about some new research that suggests a simple way to measure your activity level to help avoid overuse injuries!

This new metric is called the “acute:chronic workload ratio”, and it comes to us from the Australian sports scientist, Dr. Tim Gabbett, and his colleagues1-5. The basic idea is to compare your short-term (previous week) workload against your longer-term (previous month) workload. (The previous week’s workload is called the ‘acute’ workload, and the previous month’s workload is called the ‘chronic workload’.) If you’ve been exercising the same amount every week, then this ratio will be 1. If you’ve been ramping up over time, then the ratio will be greater than one, and it will be less than one if you are ramping down.

To see how the ratio works in real life see this example below for a runner:

Acute Workload: 50 miles running the previous week

Chronic Workload: 300 miles running the previous 4 weeks   =   75miles/week average

Acute:Chronic workload ratio


50/75 = 2/3

Is 2/3 a good result? This is a good question and one that Gabbett and colleagues studied. To date, they have studied three sports, which have different physical pressures: cricket fast bowlers2, Australian rules football3, and rugby league4-5. They found that moderate-to-high ratios increased injury risk. They found that high chronic workloads reduced injury risk as long as the acute loads were proportionate. In other words, they found that high exercise levels reduce injury risk as long as the ramp-up to the high level is gradual enough, and the workload is consistently maintained. Therefore, a high chronic workload is a preferable long-term goal for injury prevention as long as it is reached gradually.

The “sweet spot” indicated by the research so far is between 0.8 to 1.3, as shown in the figure below. When the ratio exceeds 1.5, injury risk in increased 2-4 times in the following week. Allowing the ratio to drop too low also increases injury risk compared to staying in the ‘sweet spot’, but the risk is still much less than when the ratio spikes high.

A visual representation of the acute:chronic workload ratio

A visual representation of the acute:chronic workload ratio, adapted from Gabbett et al.

The figure above really highlights how training has to be a gradual progression. The acute:chronic workload ratio can be a useful tool (along with pain monitoring) for athletes and coaches to pace workload progression. I think it can be particularly useful to an athlete if they are considering making changes to their plans, or are going to work with a new coach. If the new coach recommends a training schedule where the new (acute) workload is too great relative to the old (chronic) workload the athlete can express concern and discuss. I am also excited to start using this metric in my practice to better understand whether an athlete’s injury might be related to recent overuse or workload changes.

As always, using these methods does not guarantee injury-free sports performance. . A limitation of this work is that so far it has only been studied in three sports. However, two of the sports, Rugby League and Aussie rules football, include a lot of running and have a lot of similarities with other sports (i.e. soccer, football etc.) Therefore, I expect the results to be replicated in different areas, and in time we should see more sports medicine professionals and coaches making use of this metric.

June 2016 update: see how the acute:chronic workload ratio influences taper in this new blog post!

May 2018 Updated: Hear Andrew talk about the ACWR on video on Facebook.


  1. Gabbett TJ. The training-injury prevention paradox: should athletes be training smarter and harder?. Br J Sports Med. 2016;50(5):273-80.
  2. Hulin BT, Gabbett TJ, Blanch P, Chapman P, Bailey D, Orchard JW. Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers. Br J Sports Med. 2014;48(8):708-12.
  3. Blanch P, Gabbett TJ. Has the athlete trained enough to return to play safely? The acute:chronic workload ratio permits clinicians to quantify a player’s risk of subsequent injury. Br J Sports Med. 2015;
  4. Hulin BT, Gabbett TJ, Caputi P, Lawson DW, Sampson JA. Low chronic workload and the acute:chronic workload ratio are more predictive of injury than between-match recovery time: a two-season prospective cohort study in elite rugby league players. Br J Sports Med. 2016;
  5. Hulin BT, Gabbett TJ, Lawson DW, Caputi P, Sampson JA. The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br J Sports Med. 2016;50(4):231-6.
The female athlete triad a diagnosis that we need to look for in our female athletes

The Female Athlete Triad

Table of Contents Female Specific Research - The Gap Is Narrowing Right to work, right to vote, and in many ...
Read More
No all stress fractures need an expensive boot

Boots For Stress Fractures and What Exercises Help The Most?

Table of Contents Have you noticed how many people are given a boot to treat stress fractures? If you’ve had ...
Read More

Blood Flow Restriction Training

Table of Contents Why should we lift? Living an active life requires certain levels of strength. For example, when we ...
Read More
Tendon Compression an important thing to consider for some tendons

Tendon Compression – Important to Consider For Some Tendons!

Not all tendons and tendon pain should be treated the same. For example, we tend to consider Achilles tendon pain ...
Read More

What Is The Right Running Shoe For Me?!

Modern advances (and claims) have not done much for injury risk! Runners assign a huge level of importance to footwear ...
Read More
Carpal tunnel and neck pain care in huntsville and madison alabama

When is Carpal Tunnel Not Carpal Tunnel

There is often the assumption that numbness in the hand is due to carpal tunnel syndrome. However, oftentimes these symptoms ...
Read More



  1. Susi's Story - From Pain to Boston - […] to loading through a combination of continued technique improvements and building mileage. In a recent blog article, I discussed…
  2. Tapering - […] previously blogged on a new tool called the acute:chronic workload ratio (ACWR) and its use in helping to reduce…
  3. Tendonitis - […] had four weeks of mileage data and I was able to suggest using the acute:chronic workload ratio (see our previous…
  4. Reducing Running Injury Risk - […] Acute Chronic Workload Ratio (ACWR) […]
  5. Stress Fracture – Part 2 – Risk factors, prevention, treatment | PhysioWorks, Sports and Wellness - […] they should be asking about your training history! For more on loading and injury see these blogs (ACWR blog,…
  6. Tendonitis or Tendinopathy - The Truth affects Treatment! - […] We can consider this using tools such as the Acute Chronic Workload Ratio that we have previously blogged about.…
  7. What does my running watch or app tell me? How do you use the data? - […] is called the “Acute Chronic Workload Ratio” (ACWR). You can read more detail about this at my previous blog…

Submit a Comment

Your email address will not be published. Required fields are marked *

google logoPhysioWorks, Sports and Wellness, Inc.PhysioWorks, Sports and Wellness, Inc.
5 Stars - Based on 48 User Reviews

facebook logoPhysioWorks, Sports and Wellness, Inc.PhysioWorks, Sports and Wellness, Inc.
5 Stars - Based on 22 User Reviews

Never miss a blog!

Andrew is a fantastic physical therapist, and I highly recommend him to everyone! I originally saw him for an impinged shoulder about 10 years ago in a traditional PT setting, and although I was very pleased with the results, the Physioworks practice model is a tremendous improvement over traditional PT. Andrew is able to provide more individual attention to his patients and work with them over a longer period of time to get better and more permanent results. Andrew has the gift of encouragement and focuses on educating his patients in the "why" of each exercise.

Sandy Grady Avatar Sandy Grady

I highly recommend PhysioWorks. My condition was not an injury, but rather years of back pain, tension and fatigue, especially associated with pregnancy. I finally decided to try to tackle it, and Andrew was very thorough, knowledgeable, and helpful - giving me useful tips, techniques, and detailed stretches and exercises that quickly helped combat the pain and tension. Very thankful I gave him a try, and I recommend you to do the same!

Ryan-Anna Wolfe Avatar Ryan-Anna Wolfe

Andrew is super great! He keeps up with the latest research and uses it to better treat his patients. I came to him because I was having knee pain that kept me from running like I wanted to. He did a running analysis and identified some problem points. With the exercises her prescribed, I was able to get back to running (and was stronger), and I even completed a half marathon only a couple months after starting PT. Unlike traditional PT, I only had to go a few times over a couple months as opposed to several times per week,... read more

Melissa Wilk Avatar Melissa Wilk

- Want to be treated without surgery or medication? -

Claim your FREE consultation with the PT who has the most

⭐️⭐️⭐️⭐️⭐️ Google reviews in Huntsville Alabama!