Load Management
The concept of load management is the single most important concept to understand in your training.
It will entirely dictate whether or not you see results and whether or not you get injured.
We will cover:
What is load management?
Everything adapts
The failure of exercise technique to predict injury
Different types of load
External load
Internal load
Capacity
Summarized bullet points
What is load management?
There are two basic premises to this concept:
Matching the amount of exercise to what your body can currently handle
Gradually building up what your body can handle over time
For any stimulus that you impose upon your body (such as running or deadlifting, for example), there are three different doses of this stimulus that are possible:
A dose that is too low and will not cause any stress to the body. No adaptation is made and injury risk is as low as can possibly be.
A dose that is just right and provides an optimal amount of stress to the body. Adaptations are made (such as muscle growth, increased strength, increased endurance, etc.) with injury risk remaining low.
A dose that is too high and provides excess stress. Adaptations may be made, but injury risk increases as well. If the stimulus exceeds the capacity by too much, then the tissue fails and injury occurs.
This can happen from a single too-heavy lift, or from doing too much exercise over many weeks.
Take the deadlift, for example.
Picking up a broom is essentially a deadlift. However, nobody is going to increase their deadlift strength from doing this.
Deadlifting to an effort level of ~7-8/10 at a frequency of 1-2 times per week is very likely to build muscle and increase strength. Moreover, there is very little risk of injury at this dosage.
Deadlifting at maximum intensity 2-3x/week may still build muscle and strength, but the risk of injury becomes a ticking time bomb.
Two key points need to be made before we move on:
It is not just excessive load compared to your capacity that causes injury. Insufficient load (e.g. not providing enough stimulus) also increases risk of injury. This is part of why non-athletic, sedentary individuals experience musculoskeletal pain at higher rates than active populations do.
No single exercise is inherently bad for you; only the wrong dose of an exercise is bad for you.
Everything adapts
An underlying principle as to why this works is that your body is constantly adapting.
This includes beneficial adaptations and harmful adaptations.
Everyone intuitively knows this about muscles, but the same concept applies to all other tissues of the body.
For instance, Wolff’s law describes how bone adapts to loading. [18]
To keep it simple, here are the two key points:
Progressive loading (e.g. training) increases bone mineral density (bone strength)
In the absence of loading (e.g. sedentary behavior), the body will proactively decrease bone mineral density and allocate those resources elsewhere.
As another example, it was long thought that the intervertebral discs of your spine are inanimate structures that do nothing but wear and tear.
However, we now have strong data to show that they do adapt to loading. [19]
For instance, strength training causes the discs to absorb more water, which improves their ability to cushion impact.
Similarly, runners have significantly greater intervertebral disc height as compared to non-runners.
Davis’s Law states that soft tissue such as tendons, ligaments, and fascia all can increase in strength as they are loaded; similar to muscle. [20]
Similar to Wolff’s law, Davis’s law states that in the absence of loading, these tissues will weaken over time.
Point is: your body is constantly modifying itself.
The body you have now is not the body you’ll have a year from now.
The question is whether beneficial or harmful changes will be made over that year.
The failure of exercise technique to predict pain or injury
When many people think about training “safely,” the first thing they think about is what technique are they using during exercise.
However, the research suggests that exercise technique really doesn’t influence injury risk to any meaningful degree.
There’s no universal definition of what constitutes “good technique” for all exercises, but there are some common claims made that we can address.
For example:
Whether your spine is neutral or “bent” during lifting has been shown to have no relationship to the development of lower back pain [9]
For instance: teaching “safe lifting technique” to employees of a business does not decrease the prevalence of lower back pain developed from the workplace[17]
Whether your knees cave in during running or squatting has not been shown to reliably predict injury to the ACL[7][8]
This comes back to the idea that your body adapts to whatever you consistently do.
If you typically lift with a slightly bent spine, and the amount of lifting you do is appropriate for your capacity, then your body will adapt to that lifting technique however it needs to.
Different types of load
Generally speaking, there are two different kinds of “load” that influence the total stimulus that is placed on your body:
External load
Internal load
External load is what you are consciously imposing on your body.
This includes what exercise you do, how much you do, and how often.
There are a number of ways you might measure this:
Heart rate
Perceived energy and effort (how you feel)
etc.
The important point here is this:
The higher your internal load, the less external load you can handle.
In other words, internal load influences your capacity for exercise at any given moment. They are related but not the same — more on that shortly.
External load
There’s a wide variety of different kinds of training you can perform, and they will all differ in how much stress they impose on the body.
The simplest and most practical way to quantify how stressful they are is through looking at the time needed for full recovery (on average).
Researchers Gabbett and Oetter recently published a review that included recovery times for different types of training.[1]
Their data differentiates recovery time between recovery needed for a specific tissue vs recovery needed for the system overall (e.g. whole body).
To sum their findings:
Sprinting and max-effort anaerobic training require the greatest amount of recovery time; needing up to 72 hours if they are true max intensity
Sprinting = max effort running of ~60 seconds or less
Maximum anaerobic training = any max effort bout of training lasting ~1-4 minutes
Most forms of resistance training require at least 48 hours for the tissues trained to recover
Isometric exercises differ and require substantially less recovery time (~4-8 hours)
Running recovery times vary depending on the nature of the run
short to middle distance runs done to a truly easy intensity can be fully recovered from within ~4-8 hours
Long distance or moderate effort runs may require somewhere between 24-48 hours to reach full recovery
High effort running done (that would not otherwise be characterized as sprinting or max-effort anaerobic) are more likely to need ~48 hours for full recovery
Non-impact aerobic activity can usually be recovered from within ~4-8 hours or so
Easy to moderate effort
Example exercises:
Cycling
AirDyne
SkiErg
Rower
etc.
Now, these recovery timelines don’t mean you can’t do any training until they have run their course.
For instance, a short-to-moderate distance run that’s done at an easy pace can absolutely be done the day before or after a session of sprinting.
These timelines mostly refer to when a given tissue or body structure can be loaded intensely again.
In other words, if you trained your legs hard today, wait at least 48 hours before training them hard again — whether that’s lifting or high-intensity running.
Moreover, the timeframes provided here are not absolute; and there are many variables that will influence them.
To illustrate this, let’s cover a few examples of these variables.
There is some degree of innate variability with regard to how quickly one person recovers from an activity vs another.
This is the primary way in which age influences what appropriate training looks like.
As we get older, it isn’t the case that some exercises become dangerous and others become more safe. Rather, the recovery process moves a little more slowly.
The volume of training you do of any of the aforementioned training types will, of course, influence how much recovery time you need.
The recovery time needed from 6 hard sets of squats will be much greater than doing 2.
Furthermore, your ability to recover from exercise is itself something you can build up.
This ability to recover can be built up in two ways.
First, the process of recovery is itself an aerobic process. Thus, the greater your aerobic fitness, the greater your ability to recover.
Second, you can gradually increase the volume and intensity of your training as your body gets used to the routine.
In other words, whenever you start a new block of training, the week’s worth of training is new compared to what you were doing before. The movements that take primary focus, the order of exercises, the session structure, etc.
If you keep a lid on how much you do and how hard you do it in the first week and slowly build up, your body will have developed a better ability to recover from this specific training routine; allowing you to train harder without more recovery needed.
With all that said, you may question what is the point of those timelines if they are so subject to change.
To that I would say: they serve as your starting point. You start your training program out following them and then modify as is best fit for you over time.
Progressing the external load
So far, we’ve covered how to structure a training week.
The other, and equally crucial, point to get right is how you progress that stimulus over time.
Think back to the three dose levels: too little, just right, or too much. What counts as each level changes as you get stronger and fitter.
In other words, what dose constitutes “just right” will progress as you progress.
Properly increasing this dose over time is what will dictate whether or not you make progress or get injured. Put simply, the reason you’d ever incur an injury is because the rate of progression of the stimulus exceeds the rate of progression of your capacity
For instance, the strongest predictor of running injuries is not what your running technique is.
Rather, it is if your volume increases more than it should for a given session.
Specifically, if a single run exceeds a distance of 10% or more of your longest run within the last 30 days, your risk of injury increases dramatically.[3]
A recently developed concept to quantify what constitutes a high risk rate of progression is the acute to chronic workload ratio (ACWR).[2]
This takes the average training load over the past 7 days and compares it to the average training load over the past 28 days (Average acute / average chronic).
If this ratio exceeds 1.5, risk of injury increases ~17-20% in most populations studied.
Maintaining the ratio between 0.8 and 1.3 has been shown to minimize injury risk by keeping the training load tolerable while progressively increasing capacity over time (how much load you can handle).
Maintaining a ratio less than this isn’t safer, because your capacity for a stimulus may decrease as a result.
Remember: the body is constantly adapting.
This doesn’t just mean good adaptations; it also includes adapting to an absence of stimulus by re-allocating resources from your muscles, bones, tendons, ligaments, etc. to other functions of the body.
To define this further is difficult without knowing the specific training regimen that you are following.
For now, the relevant point is this: both insufficient and excessive stimuli can increase your risk of injury.
Excessive stimuli increases your risk of injury due to exceeding your capacity.
Insufficient stimuli increases your risk of injury due to your capacity decreasing and any stimulus becomes higher risk as a result.
Internal load
Internal load is how stressed your body is at baseline while resting.
This could include an active process of recovery from a previous training, and it also includes all of the non-training related stressors your body is experiencing.
Some of these include:
Psychological stress from work, relationships, anxiety, etc.[10]
Low Energy Availability (LEA) [11]
Insufficient fueling for a given bout of training; much deeper topic and can be very problematic
And more
What may be the most important contributor to your internal load is the state of your metabolic health.
This includes things like:
High blood sugar (diabetes or pre-diabetes)
High cholesterol[15]
Obesity
High blood pressure (hypertension)
And more
All of these are incredibly strong risk factors for injuries & conditions such as:
Rotator cuff pathology[13]
Degenerative disc disease[14]
Osteoarthritis[12]
Fractures[16]
And the list goes on…
In fact, if I had to name one thing as the biggest risk factor for musculoskeletal pain or injury, it would be metabolic health.
Think of it this way:
In states of poor metabolic health, your body’s ability to recover is crippled and age-related degeneration occurs at a much faster rate.
Conversely, in states of good metabolic health, your body’s ability to recover is maximized and age-related degeneration is slowed.
Think of it like planting a tree in sand versus rich soil — the tree grows much better in good soil.
Improving your fitness is actually one of the best ways to improve your metabolic health.
But poor metabolic health still raises your internal load in the meantime.
Capacity
Capacity is simple: it’s how much total load your body can handle.
Practically speaking, it’s really how much external load you can tolerate; as that portion is more immediately in your control than internal load.
Your internal load will dictate much of what your capacity is. The higher internal load is, the lower your capacity for external load.
The other component to capacity is simply what your fitness level is and how prepared for a given activity you are.
As an obvious example of how fitness affects capacity, say we have two people attempting to deadlift 225 pounds.
The first person has never deadlifted before, and the second person has recently deadlifted 315 pounds before.
This 225 pound lift will obviously be a very different stimulus to these two people.
As a more practical example, say you are moving and need to get everything moved into your new place within a day or two.
A person who has high strength and endurance will be able to accomplish this task with much lower risk of injury than a person who doesn’t train.
Your preparedness for a specific task also matters.
When a movement is new to you, your body isn’t prepared for it — even if you’re generally very fit.
For instance, pickleball has developed a reputation for being quite injurious.
However, most people will play pickleball for the first time, decide to play 3 hours of it in one go, and then wonder why their knees are aching.
The more sensible approach would be to start with a lower dose and slowly build up as you become more used to the activity.
Because of this, some experts argue that overuse injuries should really be called “underprepared” injuries.
Because whether or not something is overuse is entirely dependent on a person’s capacity.
If you were to build up your capacity over time (e.g. through training), what was once overuse to you might now be a lower level stimulus; therefore making you safer in the activity.
To summarize:
Exercise technique does not seem to matter much for pain or injury; load management does
External load: exercise
Internal load: how stressed or healthy your body is
External load + internal load = total load
Capacity = how much total load you can handle without injury
The goal: provide a sufficient total load relative to your capacity
Why: makes you adapt in a beneficial & healthy way
Too little or too much total load both increase risk of pain
Too much total load: tolerance or recoverability of a given tissue is exceeded
Too little: capacity decreases and becomes easier to exceed
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