Article
Injury Risk Score Overview
Benjamin T. House, Andy J. Galpin, Dan Garner, Vince Kreipke, and Thomas R. Wood

What Is the Injury Risk Score?

Musculoskeletal injuries are a part of life and are surprisingly difficult to predict [1-3]. The level of risk depends on a variety of factors, including: sport or exercise type, training volume + intensity, previous injury history, strength, mobility, biomechanics, body composition, recoverability, psychological stress levels, and sleep quantity/quality [1, 4]. Injuries are hard to predict; however, multiple blood biomarkers have been shown to elevate injury susceptibility, and the Injury Risk Score combines all of these values into one integrated value. A yellow or red on this score indicates an increased risk of injury from blood-based markers.

Keywords: Injury, Inflammation, Pain

Associated Biomarkers

Female Biomarkers Male Biomarkers
hsCRP hsCRP
Creatine Kinase Creatine Kinase
LDH LDH
PTH PTH
Vitamin D Vitamin D
Ferritin Ferritin
IGF-1 IGF-1
Total Testosterone Total Testosterone

Experienced Physiological Effects:

  • Low energy
  • Fatigue
  • Reduced motivation

Physiology Deep Dive:

Elevated levels of inflammation have been related to an increased risk of injury [5-7]. Higher systemic inflammation can promote muscle atrophy, reduce healing times, increase bone breakdown, and elevate pain signaling [8-11]. Chronically high amounts of muscle damage have also been associated with increased injury risk, potentially due to overwhelming the body’s ability to recover [6, 12, 13]. Decreased levels of iron and vitamin D also appear to elevate the risk of musculoskeletal injuries [14-22]. Clinically low vitamin D is well known to increase bone demineralization, reduce bone mineral density, and is directly related to increased stress fracture risk [23, 24]. Low vitamin D has also been related to impaired muscle regeneration, increased muscular oxidative stress, and attenuated growth pathways potentially elongating the recovery cycle [25, 26]. The relationship between iron deficiency and increased injury risk may be related to low energy availability, which is also known to increase injury risk (ping back to LEA white paper). Along these same lines, reductions in testosterone have also been predictive of increased injury risk [12]. Thus, the injury risk score melds all these biomarkers together into a composite value in order to provide an integrated window into potential injury susceptibility.

Constraint Zones:

Green:

Blood markers associated with injury risk are not elevated. This does not necessarily mean that overall risk of injury is low. However, all blood-based biomarkers associated with injury risk are currently clear. Load monitoring may still be advantageous.

Yellow:

An increased risk of injury from blood biomarkers is probable. This does not mean that someone will get injured. However, it is in the athlete’s best interest to work to improve these biomarkers. Load and recovery monitoring may be advantageous.

References

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