Injury Incidences related to Acute-to-Chronic Workload Ratios in Taekwondo: A Prospective Study with a 3-Year Follow-Up.

Context: Although the relationship between workload and injury incidence has recently gained attention, data on the acute-to-chronic workload ratio (ACWR) and injury incidence in Taekwondo remain unavailable.

Objective: To report the injury incidence related to the categorized ACWR, calculated using the rolling average (RA) and exponentially weighted moving average (EWMA) methods, for musculoskeletal injuries in Taekwondo.

Design: Descriptive epidemiologic study.

Setting: Data were prospectively collected through Taekwondo training facilities and competition venues.

Patients or other participants: A total of 110 collegiate Taekwondo players (58 females; 54 males) were studied over three consecutive seasons in 2020, 2021, and 2022.

Main outcome measures(s): The traumatic and gradual onset of musculoskeletal injury (rate, body location, type, mechanism, and severity) and workloads (duration of training and competitions) were recorded. ACWRs for each injury were calculated using the RA and EWMA and categorized as either high (> 1.5), relatively high (1.3 - 1.5), moderate (0.8 - 1.3), or low (<0.8).

Results: Of the 841 injuries (training: 16 per 1,000 hours; competition: 548 per 1,000 hours), the ankle (n=86/501, 17% in traumatic) and thigh (n=106/340, 31% in gradual onset) were the most predominantly injured body locations. Contusion (n=201/501, 40% in traumatic) and muscle cramps/spasm (n=201/501, 75% in gradual onset) were the most frequent injury types. Although the most predominant mechanism was overuse (n=331/841, 40%), 32% of the injuries (n=230/721) took > 28 days to recover from injury. The greatest number of traumatic (RA: n=224/501, 45%; EWMA: n=259/501; 52%) and gradual onset (RA: n=118/340, 35%; EWMA: n=165/340; 49%) injuries were recorded under the moderate ACWR.

Conclusions: The moderate ACWR range (0.8 - 1.3), which was considered as the "sweet spot" in team sports, was calculated to be the "danger zone" in Taekwondo. The high injury risk related workload could be used for planning training schedules.