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British Journal of Sports Medicine · 2016

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Martin Schwellnus, Torbjørn Soligard, Juan-Manuel Alonso, Roald Bahr, Ben Clarsen, H Paul Dijkstra, Tim J Gabbett, Michael Gleeson, Martin Hägglund, Mark R Hutchinson, Christa Janse Van Rensburg, Romain Meeusen, John W Orchard, Babette M Pluim, Martin Raftery, Richard Budgett, Lars Engebretsen

How much is too much? (Part 2) IOC consensus statement on load in sport and risk of illness

BMJ. 50(17). 1043-1052.

DOI PMID: 27535991 Open original source
Study type
Expert consensus statement
Review basis
Full text reviewed

The strain on an athlete is not fully captured by training hours. Competition, travel, psychological stress and recovery also enter the picture when considering illness risk. The paper brings together evidence linking these demands to illness and overtraining. In shorter major competitions, the studies discussed reported illness episodes in roughly 6% to 17% of registered athletes. These figures describe different events, not a single pooled risk. The relationship with training volume was also uneven: high loads were associated with more illness in some recreational and subelite groups, but that pattern did not consistently hold among the highest-level athletes.

A demanding schedule does not establish why a particular athlete becomes ill. The paper distinguishes the work completed from the individual's response to it. Similar sessions can feel very different depending on fitness, fatigue and other circumstances. Symptoms also need interpretation: respiratory complaints may reflect infection, allergy or irritation. Many studies relied on reported symptoms rather than laboratory confirmation of an infection.

How Does This Show Up in Real Life?

An athlete returning from travel may face the same planned session as before, but a different combination of sleep disruption, stress and recovery needs. The authors recommend considering those circumstances when planning and monitoring training. They also emphasize individual information, including perceived effort and wellbeing, rather than relying only on team averages or distance covered. This makes a training diary more useful when it records the response to work as well as the work itself. The paper supports scheduled recovery after demanding periods and ongoing attention to illness symptoms. It does not provide a single number that predicts illness reliably, and its recommendations should not be read as a promise that monitoring can prevent every infection or distinguish every cause of fatigue.

Evidence comes from a limited range of sports with varied definitions and measurement methods. Much is observational, making other influences difficult to separate. Training changes, travel and psychological strain often occur together. The authors call for prospective and intervention studies, including follow-up of prevention strategies; the paper does not establish the lasting effectiveness of one universal load-management program.

Why We Cite It

Alpekin can use this source when discussing the practical meaning of a crowded activity schedule. It adds an organizational perspective: event planning and support arrangements can shape the demands placed on an athlete, so responsibility for recovery cannot be understood solely as an individual's ability to follow a routine.

The guidance is most useful as a framework for noticing changing circumstances and responding to them. Treat the associations as informative, with their population limits intact. A well-kept record can support judgment, but it cannot turn a complex health outcome into a certain prediction.

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