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 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 epidemiology study. Setting: Data were prospectively collected through Taekwondo training facilities and competition venues. Patients or Other Participants: A total of 110 collegiate Taekwondo players (56 female, 54 male) were studied over 3 consecutive seasons in 2020, 2021, and 2022. Main Outcome Measure(s): The traumatic and gradualonset 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 1000 hours; competition, 548 per 1000 hours), the ankle (n = 86 of 501, 17% of traumatic injuries) and thigh (n = 106 of 340, 31% of gradual-onset) were the most predominantly injured body locations. Contusion (n = 201 of 501, 40% of traumatic) and muscle cramps/spasm (n = 256 of 340, 75% of gradual-onset injuries) were the most frequent injury types. Although the most predominant mechanism was overuse (n = 331 of 841, 40%), 32% of the injuries (n = 230 of 721) took >28 days for recovery. The greatest number of traumatic (RA: n = 224 of 501, 45%; EWMA: n = 259 of 501, 52%) and gradual-onset (RA: n = 118 of 340, 35%; EWMA: n = 165 of 340, 49%) injuries were recorded under the moderate ACWR range. Conclusions: The moderate ACWR range (0.8-1.3), which is considered 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.