Central West Health & Rehabilitation
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Image - Expert and novice Lifting Jun 28th, 2014


Video - Incorrect Vs Correct Lifting Jun 28th, 2014

External Assistance for Injury Management Systems Jun 27th, 2014
Western Australia is fortunate to have an insurance premium-related incentive scheme where a company’s insurance premium is graded according to claim experience. However, smaller enterprises often have difficulty making use of the benefits.

How are insurances premiums calculated?

graphicNational Occupational Health and Safety (OHS) intervention programmes are often difficult to implement in smaller enterprises. Despite it being generally accepted that small enterprises with less than 50 employees have higher exposure to occupational hazards than larger organisations, smaller enterprises often have limited resources to prioritise risks and to improve the working environment, and they often have difficulties in complying with legislation.

The Western Australian workers’ compensation system requires every employer to:

1) Have workers’ compensation cover for all workers (penalties apply for avoidance).

2) Have a documented Injury Management System outlining the steps taken when a worker is injured and contact details of person responsible for the Injury Management System.

3) Establish and implement a Return to Work Program as soon as practicable after:

- the treating doctor indicates in writing the need for a Return to Work Program; or

- the worker’s treating doctor signs a medical certificate to the effect that the worker has partial capacity for work or has total capacity for work but is unable to return to their pre-injury position for some reason.

Small enterprises constitute a major challenge for efforts to improve occupational injury management as they, on one hand, have extensive needs, and on the other hand, are difficult to reach. At particular stages in a businesses development there is legitimate grounds, both personal and financial, for sourcing an external service provider to assist with the injury management and injury management system development.

Costs of Going it Alone:

1) Time to Research a System $$/hour

2) Time to design a system $$/hour

3) Time for Template Design $$/hour

4) Costs of employing Injury Management Co-ordinator $$/hour

Central West Health and Rehabilitation offer a ‘low cost’ Injury Management Service specifically designed for Small Businesses not yet ready to employ specific Injury Management Staff.

The role of client motivation in Return to Work Jun 26th, 2014

To reach the desired return to work outcome, the Rehabilitation Counsellor is required to identify social, economic, and environmental factors that may adversely affect a client’s motivation toward rehabilitation. Motivation has been recognised as an essential component in managing medical issues, adjusting to physical disability, cognitive impairment, returning to work, and improving psychosocial functioning.

It is too simplistic to say people are motivated or not; rather people are motivated by different things and this can be influenced. Motivation refers to the underlying internal and external influences on behaviour that determine whether a person will achieve the desired rehabilitation goals. 

The current article focuses on understanding the concept of motivation, reasons for its presence or absence, and why motivation is important to the workplace rehabilitation process. The authors also explore significant influencing factors that may be utilised to increase motivation and promote more successful return to work outcomes.

Immediately after the onset of work disability/injury, the return to work aspect of rehabilitation may not be a priority; however as the rehabilitation and return to work process develops, priorities change and motivations to reach personal goals are highlighted. Motivation does not become a focus at any one point in the rehabilitation process, but rather should be maintained throughout the return to work process. Positive and lasting results most likely occur when a client becomes motivated, actively engaged, and invested in change in all aspects of their life.

Factors that Influence Motivation

  1. Internal motivation- the willingness, readiness, and desire to change to achieve the desired outcome

  2. Key stakeholders- It is important that all stakeholders have the potential to gain from the worker successfully returning to work to ensure each stakeholder has an interest in motivating the client to strive for the return to work outcome

  3. Social supports- strong network of good relationships.

  4. External regulation- Pressure from third party payers in many settings dictates a short-term and limited funding approach to change, which makes motivation more critical. It also makes motivation more difficult to establish as clients have less control.

  5. Perceived costs and benefits- the client might be more willing to participate in the rehabilitation process if they are able to see the benefits and payoffs in the future. Possible costs within a workplace rehabilitation plan include the required effort to participate fully, as well as the associated tiredness or pain.

  6. Hope and individual beliefs surrounding working identity- People have increased motivation to return to work if their job is meaningful and they have a sense of belonging and being appreciated.

GP and patient predictions of sick-days duration Jun 25th, 2014


In general practice, sick-listing (give days off work) is a frequent and cost-generating measure often experienced as problematic for the doctor. One reason is that sick-listing involves assessment of how the symptoms reduce the patient’s ability to work, requiring physicians to rely on the patient’s own description of the job and his/her capacity to do it. From the patient’s point of view, the sick note is important if his/her self-perceived ability to work is low. Without the note the patient must keep on working, and patients often worry that working may affect their health negatively. Thus, consultations involving sick-listing assessment involve several difficult considerations on the part of both the physician andthe patient.

In this study the correspondence between the patients’ and the GPs’ perception of the duration of sick-listing was not high. Furthermore, the correspondence between the patients’ and GPs’ respective predictions of sick-listing duration, made at the first consultation, and the respective actual duration was rather low. 


Many other factors besides the employee's medical conditions– e.g. organizational, work-environmental, and social. These factors might be hard to take into consideration at the first consultation, and might not become evident until after several visits. Early in the process, medical factors might be more important for both the physician and the patient, and only a brief consultation may be made regarding workplace factors. This seems to be a relevant approach; however, being sick-listed might in itself influence the patient ’ s motivation and confidence in returning to work. It is important to address issues related to occupation and the workplace early in the consultation to support the process of returning to work efficiently. This can be assisted by the Injury Management Co-ordinator attending initital medical appointments, or providing your employees a preferred medical provider

In the present study, the overall correspondence between the GPs ’ prediction of the interval until return to work and the actual duration of sick-listing was not high on the whole. It is possible that the patients ’ expectations might have affected the interval until their return to work. Patient expectations and a focus on return to work is important to promote from the first medical appointment.


Poor nutrition leads to development of chronic diseases Jun 24th, 2014
GraphicInternational research involving the University of Adelaide has shown for the first time that poor nutrition – including a lack of fruit, vegetables and whole grains – is associated with the development of multiple chronic diseases over time.

The results of the study, which looked at health, diet and lifestyle data of more than 1000 Chinese people over a five-year period, are published in this month's issue of the journal Clinical Nutrition.

Study co-author Dr Zumin Shi, from the University of Adelaide's School of Medicine suggested "Those participants who ate more fresh fruit and vegetables, and more grains other than wheat and rice, had better health outcomes overall. Grains other than rice and wheat – such as oats, corn, sorghum, rye, barley, millet and quinoa – are less likely to be refined and are therefore likely to contain more dietary fibre. The benefits of whole grains are well known and include a reduction in cardiovascular disease, diabetes and colorectal cancer."

Video - Dietitian Summary Jun 23rd, 2014

Video - Fat Vs Sugar Jun 23rd, 2014

Video - What is Diabetes Jun 22nd, 2014

Video - Energy Balance and Weight Loss Jun 22nd, 2014

Video - Exercise and Chronic Disease Jun 22nd, 2014

Video - Behaviour Change and New Years Resolutions Jun 22nd, 2014

Rationale for using an intermediary to assist small businesses with Injury Management Systems Jun 22nd, 2014
It is generally accepted that small enterprises with less than 50 employees have higher exposure to occupational hazards than larger organisations. Small enterprises often have limited resources to prioritise these risks and to improve the working environment, and they often have difficulties in complying with legislation. Small enterprises constitute a major challenge for the society’s effort to improve occupational injury management as they, on one hand, have extensive needs, and on the other hand, are difficult to reach. Just one worksite injury could produce serious economic consequences to a unprepared small business.

Central West Health and Rehabilitation work specifically with small enterprises as a trusted intermediary to assist with injury management processes.

Hasle and Limborg have developed a model for reaching out to small enterprises with intervention programmes. The model emphasises the need for inclusion of not only the concrete changes of the working environment but also the process in which small enterprises are approached and motivated to start a change process.



The model can be used to construct a stepwise procedure for the design of working environment programmes. The idea is to start from the right side of the model and subsequently work backwards through the chain in order to end up with a full designed programme. The design procedure therefore has five steps:

  1. Defining the OHS challenges of the target group (health outcome).

  2. Selecting methods and solutions that can improve the working environment by reducing the exposure and thereby producing the intended health outcome (improvement of the working environment).

  3. Developing theories about mechanisms which can motivate the target group to initiate change. On the general level, there are three main mechanisms: regulation, incentives, and information (change process).

  4. Analysing how the specific context of the target group may influence motivation and implementation of the intervention (context).

  5. Designing the programme which builds on the results of the four preceding steps (programme).

This method has been used in the development of a practical intervention programme aimed at small construction enterprises. The transparency opens the possibility for critical discussions and thereby improvements of both design criteria and design conclusions.

Contact Us for an Injury Management System Assessment

Fatal accidents in the Western Australian mining industry 2000-2012 Jun 21st, 2014
graphicThis report examines the 52 fatal mining accidents that occurred in Western Australia over the 13-year period from 2000 to 2012, inclusive. The information was analysed to identify common hazards, causation factors and critical activities.

Twenty-four causation factors were identified and used to provide a framework for analysis. A person might conduct 50 to 100 tasks during a shift, of which just one or two could lead to a situation with the potential for serious injury or death. So knowledge of the critical tasks is important when addressing risks. 

Factors for which trends or clusters were identified were:

  1. Occupation of deceased

  2. Duration in the role

  3. Duration at the mine site

  4. Supervisors Duration in the role

  5. Compliance with procedures

  6. Trigger events

  7. Time of day

  8. Surface or underground

  9. Commodity group

  10. Original equipment manufacturers’ procedures

  11. Age of deceased

  12. Roster cycles

These factors are discussed in more detail in the relevant document along with significance of trigger events to individual fatalities and critical activities.

Strategies to Help Employees Return to Work Jun 21st, 2014
Engaged and productive employees are the lifeblood of almost every business. No employer wants valuable human resources at home when they could be working. Time off work is unhealthy. The longer an employee is off work the less chance there is of returning to work (RTW).

The World Health Organization for example, stated in an international study that safe and productive work is a major source of physical and psychological well-being.

“Work is at the very core of contemporary life…, providing financial security, personal identity, and an opportunity to make a meaningful contribution to community life. (World Health Organisation)” 

Does your workplace currently have an Injury Management System as required by Workcover WA? Are you seeing the results that you expected to see? Maybe your workplace is fully insured or you are trying to manage your benefit programs in-house, or as part of duties of the HR Department. Have you become overburdened with administration and less than satisfactory results?

The key components of an Injury Management System should include:

Senior support

One of the foundations of a solid injury management is to get senior support on side. The challenge of managing disability in both human and financial terms is enormous, yet the factors involved in finding the right strategy are still poorly understood at an organizational level. There are many reasons to get an organisation interested in injury management.

Early Identification

Injury Management Systems begin with early identification of injuried workers.  Also crucial is the identification of potential conditions that can result in worker disability.

The sooner there are the correctly identified symptoms the sooner return to work planning can put in place strategies to resolve them. Early intervention is proactive and affords the opportunity to identify which claims may need special handling to resolve them early.

Evaluation of medical, psychosocial and return to work needs.

We have found three types of disability groups have come to light over the years.


The first is short duration claim where the patient has a well-defined acute episode (i.e. flu, strain or sprain). These cases will return to work often with minimal intervention.


The second group represents patients with sub-acute or progressive diseases or injuries. This population often needs help with ensuring the primary interventions are enough to progress back to health. They may need help in finding their way through the health care maze to a provider that can assist in resolving their medical or psychosocial issues. It is important to keep this group focused on the return to work goal and that may need assistance via a graduate RTW.


The third group are those with terminal or debilitating diseases, such as Chronic Pain, Cancer or Multiple Sclerosis, that may eventually prevent return to work. The primary needs are ensuring these people are familiar with the range of services available in their community and providing help with ongoing discussions on their level of ability.

Ability Management

In all three groups, there are essential best practices to bear in mind.

Focus on what the person can do, not the cure. If disability limits what a person can do due to illness, injury or a condition then effective management, rather than eliminating symptoms, discusses what the employee is able to do.

Symptoms such as pain are not disability, they are symptoms. Often staying at home and dwelling on the pain can lead to a Chronic Pain Syndrome. Work provides many people with friends, support networks, focus, meaning and distraction from ruminating on a condition. 

Focus on ability is the goal, while being compassionate but firm. It is important to work together and empathize with the conflicting feelings of pain versus disability; however, through gradual transition back to work the symptoms will decrease as the tolerance for activity or interaction increases.

Return to Work

Return to work should always be the goal.

From the first interaction with the employee, their physician, their manager, and/or the union representative (where applicable) make it clear that any treatment, medication, protocol or intervention is for returning the employee to work as soon as possible. Encourage health care providers to set up tentative return to work dates.

Discuss the appropriate treatment duration. For example, with a back injury, emphasize that a few days bed rest, active physiotherapy, rapid reactivation, and return to normal activity levels, is the general strategy for most people.

In this situation, it is also necessary to emphasize that returning to work is not about waiting for the absence of pain. What the employee is able to do, not pain, is the benchmark for returning to work.

Reasonable job accommodations or transitional jobs (i.e. suitable duties) are a necessary part of effective return to work. An effective return to work program often includes a phase in which the employee returns for specified periods and specific tasks. The intent should always be a return to a regular position. This could be either the pre-disability position – or another suited to the employee’s skills, capabilities and knowledge. Alternative duties should be re assessed regularly.

Measurement of the results

An effective injury management program needs to have a way to measure its outcomes.

Comparison of data from one period to the next is critical to measure the effectiveness of a particular intervention. When the goals set for the system are measurable it helps to determine their effectiveness. In the end you are able to say, “what was it before and how are we doing now.”

As well as gathering the data, there is the need to communicate the results and use them to drive prevention programs. When you get all parties involved to embrace the broader view of disability management it can be a very effective part of taking care of your business.

Contact Us for an Injury Management System Assessment

Video - Understanding Chronic Pain Jun 21st, 2014

Returning to work – a long-term process reaching beyond the time frames of multimodal non-specific back pain rehabilitation Jun 21st, 2014
imageLow Back pain (LBP) is a common health problem. Furthermore, long-term back pain often exerts a negative impact on participation in everyday activities. Health professionals strongly emphasise the importance of focusing rehabilitation on aspects that improve the patient’s well-being and quality of life. Return To Work (RTW) might then be a possible, but not a necessary, feature of LBP rehabilitation. This is one explanation for the modest effect rehabilitation has exerted on reduced sickness absence.

Previous research has found that focusing on the patient’s everyday life is important in efforts aimed at reducing sickness absenteeism and in increasing RTW as well-functioning everyday life can promote RTW. Still, other research has shown that patients may also experience uncertainty about how to proceed with the process of RTWafter rehabilitation is completed, particularly when there has not been a clear connection between features in the rehabilitation and the patients’ work situations. Furthermore, interventions that included structured meetings of employee, employer and health professional, that took up planning and agreements regarding suitable work modifications, appeared to be more effective in the promotion of RTW in people with back pain on long-term sick leave than the interventions that do not include these features. This is despite significant research highlighting the health benefits of work.


In the above study, Fifteen participants were interviewed, all were working with multimodal rehabilitation for people with non-specific back pain in eight different rehabilitation units. The participants experienced RTW as a long-term process reaching beyond the time frames of the medical rehabilitation. Their attitudes and, their patients’ condition, impacted on their work which focused on psychological and physical well-being as well as participation in everyday life. Health professionals often created an action plan for the RTW process, however the responsibility for its realisation was often transferred to others (i.e. the patient). The participants described limited interventions in connection with patients’ workplaces.


Rehabilitation programs targeting return to work (RTW) for people with non-specific back pain needs to include features concretely focusing on vocational issues.

Health and RTW is often seen as a linear process in which health comes before RTW. Rehabilitation programs could be tailored to better address the reciprocal relationship between health and work, in which they are interconnected and affect each other.

The RTW process is reaching beyond the time frames of the multimodal rehabilitation but further support from the patients are asked for. The rehabilitation programs needs to be designed to provide long-term follow-up in relation to the patients’ work.

Time to Move on Physical Activity as Usual Care for Mental Illness Jun 18th, 2014

Physical inactivity is estimated to cause 9% of premature mortality worldwide, but recognition of the benefits of being physically active is increasing. In addition to the cardiometabolic benefits of regular bodily movement, physical activity has repeatedly been shown to have antidepressant and anxiolytic qualities, both as monotherapy and as adjunctive therapy. At what point do we decide that sufficient evidence exists for a cultural change within psychiatric care, whereby exercise physiologists or physical therapists (and indeed dietitians) are considered as standard members of the multidisciplinary mental health team?

Simon Rosenbaum, BSc from the The George Institute for Global Health, Sydney, Australia gives us some good reasons why in this blog post:

Time to Move on Physical Activity as Usual Care for Mental Illness


The Role of the Australian Workplace Return to Work Coordinator: Essential Qualities and Attributes Jun 18th, 2014



In the Australian context, a return to work (RTW) Coordinator (or Injury Management Co-ordinator) assists an injured worker with workplace-based support and regulatory guidance for the duration of their injury. Coordinating the RTW process has been considered an effective approach for managing workplace injuries. This study aimed to provide insight as to the skills and attributes needed for the role of the workplace RTW Coordinator from their experience and perception.

Conclusion: Effective management by the RTW Coordinator of the complex RTW process is essential to facilitate a smooth transition for the injured worker, alongside maintaining a professional relationship with the employer and external stakeholders. The results of this study can be utilised to further improve the selection of future RTW Coordinators.

Three key themes clearly emerged:graphic

  1. Communication skills

  2. RTW Coordinator characteristics

  3. Managing the RTW process

Sedentary behavior increases the risk of certain cancers Jun 17th, 2014

Physical inactivity has been linked with diabetes, obesity, and cardiovascular disease, but it can also increase the risk of certain cancers, according to a study published June 16 in the JNCI: Journal of the National Cancer Institute. To assess the relationship between TV viewing time, recreational sitting time, occupational sitting time, and total sitting time with the risk of various cancers,  Schmid and Leitzmann of the  Department of Epidemiology and Preventive Medicine, University of Regensburg, Germany, conducted a meta-analysis of 43 observational studies, including over 4 million individuals and 68,936 cancer cases.

When the highest levels of sedentary behavior were compared to the lowest, the researchers found a statistically significantly higher risk for three types of cancer—colon, endometrial, and lung. Moreover, the risk increased with each 2-hour increase in sitting time, 8% for colon cancer, 10% for endometrial cancer, and 6% for lung cancer, although the last was borderline statistically significant. The effect also seemed to be independent of physical activity, suggesting that large amounts of time spent sitting can still be detrimental to those who are otherwise physically active. TV viewing time showed the strongest relationship with colon and endometrial cancer, possibly, the authors write, because TV watching is often associated with drinking sweetened beverages, and eating junk foods.

The researchers write “That sedentariness has a detrimental impact on cancer even among physically active persons implies that limiting the time spent sedentary may play an important role in preventing cancer….”

In the studies analysed, the least amount of time people spent sitting down was about two or three hours. Each two hours per day increase in sitting time above this level was said to increase the risk of bowel, endometrial and lung cancer.


Postures assumed when using laptop computers and desktop computers Jun 17th, 2014




This study evaluated the postural implications of using a laptop computer. Laptop computer screens and keyboards are joined, and are therefore unable to be adjusted separately in terms of screen height and distance, and keyboard height and distance. The posture required for their use is likely to be constrained, as little adjustment can be made for the anthropometric differences of users. In addition to the postural constraints, the study looked at discomfort levels and performance when using laptops as compared with desktops.



The results showed significantly greater neck flexion and head tilt with laptop use. The other body angles measured (trunk, shoulder, elbow, wrist, and scapula and neck protraction/retraction) showed no statistical differences. The average discomfort experienced after using the laptop for 20min, although appearing greater than the discomfort experienced after using the desktop, was not significantly greater. When using the laptop, subjects tended to perform better than when using the desktop, though not significantly so. Possible reasons for the results are discussed and implications of the fundings outlined.




Mental Toughness Jun 12th, 2014
graphic'Mental toughness' is a term that is often thrown around as central to high sports performance.

Defined as a personal capacity to produce consistently high levels of subjective (e.g., personal goal achievement) or objective (e.g., race times) performance despite everyday challenges and stressors as well as significant adversities.

Mental toughness is often discussed as a collection of personal characteristics including attributes such as self-confidence, optimistic thinking, buoyancy, self-determination and self-efficacy. Self Efficacy theory suggests the degree to which individuals perceive their actions as efficacious will determine how much effort they expend and for how long they persist on tasks.



Mental Toughness has been shown to be related to performance, and related to a social environment that nurtures autonomy, competence, and relatedness (termed autonomy-supportive). Autonomy-supportive environments are characterized by the offering of choice (within boundaries), the acknowledgment of feelings or perspectives, the use of noncontrolling actions and feedback, the provision of meaningful rationales, and the nurturing of individuals’ inner motivational resources (e.g., curiosity, enjoyment, belonging). In comparison, controlling environments are characterized by the manipulative use of rewards, negative conditional regard, intimidation, and excessive personal control.

It is suggesed that the provision of autonomy-supportive environments lead to the facilitation of mental toughness, whereas controlling environments may lead to the forestallment of mental toughness. Mental toughness development is contingent on an athlete being afforded opportunities to explore and engage in tasks volitionally (e.g., self-directed learning), perceiving themselves as competent and feeling challenged during learning (e.g., being able to demonstrate skill mastery, engage in competitive challenges), and feeling respected, cared for, and needed by those around them (e.g., positive social support, a sense of belonging).




Understanding Training Load Jun 12th, 2014
I get asked about training load quite a lot. Coaches will generally ask about how to periodise an athletes training load, athletes will ask about how can they adjust their training so that they can get better recovery or optimise this training load so they can peak for competition and parents want to know how they can ensure that their kids are going to be overtrained.

The first point to make is that training load is a very important variable to have under close control. It is possible to manipulate training variables within a week to maximise an athletes readiness to train. This has a double effect in that it decreases the risk of overtraining, leading to injury and illness, as well as increasing the likelihood that an athlete will gain a high level performance outcome.

I was at a conference in 2008 and heard a presentation from a prominent Performance Coach who was working with a Super Rugby team at the time. He used an analogy to describe training load that I quite like. He spoke about each athlete having a cup and every time we train or compete we are filling that cup with a volume of fluid congruent with the intensity of that that session or game. Every time that athlete performed an action to help their recovery, such as having a day off, getting a massage or doing a pool session, they empty their cup of a volume of fluid congruent with the benefit gained from the recovery modality. The end goal was to have the cup as full as possible without overflowing and when the cup did overflow, the athlete was at greater risk of illness and injury. I’m sure that there are people out there who could poke holes in this analogy but I like the imagery that it provokes.

This analogy points out the importance of managing training load and that it is about balance and in order to do that we need to have a tool for measuring an athlete’s training load. Training load is commonly assessed using a subjective assessment tool such as the RPE scale. The RPE scale is comes in various forms and correlates a number to a descriptor of an athlete’s level of exertion. In order to assess an athlete’s training load, we need to ask them to rate the difficulty of the training session within the first 30 minutes of them finishing the training session. We ask them to rate how difficult the session was physically and mentally and ask them to take into consideration how they felt prior to starting the session. This will alter the score based on their residual levels of fatigue. We then multiply this score by the duration of the session, which give us an arbitrary unit, which is our training load. We then total the score and record these values over a period of weeks.

There has been a lot of research about training load and while there are individual variations it has been found that when using the Borg 1-10 RPE scale, when athletes have a week of training where they are above 3500 points, they are at increased risk of having an adverse outcome such as injury or illness. Consecutive weeks of training load values greater than 3500 points can further increase the risk of injury and illness related to over training.

In my career I have found monitoring training load to be a very useful tool from a number of aspects, namely:

  • Maximising performance outcomes through ensuring effective difficulty of training contrasted with adequate recovery

  • Decreasing the risk of injury and illness through flagging consecutively high weekly training loads

  • Monitoring the training load of players as they return from injury to ensure adequate return to full fitness, while minimising the risk of re-injury

I have also found that there is no single structure that can be applied to any athlete. It is definitely more of an art rather than a science with regard to determining what an individuals training load tolerances are during various sections of the season. I have had some athletes who have been able to tolerate weekly training loads greater than 4000 points during pre-season, while other athletes can only manage less than 2000 points per week before they start to breakdown.

It is important to plan your season according to the requirements of the athletes from a training load point of view. During pre-season phase we need to have periods of increasing intensity contrasted with periods of rest and recovery in order to training hard to gain a physiological effect and then allow the body to recover. During the in-season phase we need to allow athletes a chance to peak for their games and competitions which are generally more taxing on their bodies than training sessions.

I want to present 3 case studies of athletes at various levels throughout their season. I hope that these give a good example of how different each athletes training load can be and how there isn’t necessarily a correct answer, other than doing what is right for the athlete.

The first case is of a junior elite athlete who plays cricket and is currently in her off-season phase. The emphasis of her training is essentially based in the gym and working on improving her bilateral strength as she has development significant asymmetry in both her upper and lower body throughout the last cricket season. As you can see from graph of the athletes weekly training load scores, she is barely reaching the limits of what she would be allowed normally during the pre-season phase.


We would normally give an athlete like this up an allowance of up to 3500 points per week and she has barely reached an average of 1000 across the 10 week off-season phase. In week 18 of the above graph she will switch into a pre-season phase where she will have a much more structured training load graph which will be more phasic to allow for adaptation and progressive overload as she becomes strong and fitter.

The second case is a basketballer who lives in regional Western Australia. She is involved in an elite development squad which trains fortnightly in Perth. There are 2 other girls who also live rurally and fortnightly they all travel between 5-6 hours to attend weekend camps for the squad. The weekend camps are very hard and they generally consist of two days with a cumulative training and game time of approximately 10 hours. The graph below demonstrates this fortnightly variation and ‘spike’of intensity followed by a lower volume week.


The above graph demonstrates an interesting pattern which shows a combination of two very key criteria. Firstly, the athlete was able to tolerate the heavy weeks better as her conditioning improved. Secondly, this graph shows the benefit of regular education to improve physical performance. As the athlete improves their ability to tolerate training load of high intensity also improves therefore, what would have been a very similar weekend camp results in a lower total training load. The second part of this equation is athlete education and improving training scheduling. I spent a lot of time educating the athlete on the importance of reducing her training load during the ‘off-weeks’. There are a number of ways that this can be done:

  • Reduce training time - instead of training for 90 minutes train for 60 minutes

  • Reduce training intensity - instead of doing a shooting session with repeat sprints in the session, do a shooting session with a slow jog between shots

  • Swap training sessions to recovery sessions - don’t get on the court, instead go to the pool and do a recovery session, get on a bike and do an off-loaded conditioning session or get a massage

The final training load graph that I would like to address is a field hockey athlete who is in the in-season phase. This athlete is currently doing 3-4 skills/conditioning sessions per week in addition to 2-3 weights sessions on top of games as weekends. This athlete can be best described as a very intense athlete who trains very hard during every session, irrespective of how their body and mind is feeling. The issue with athletes such as these is keeping their training load under control as they often struggle with holding back and run the risk of over training.


During week 13 the athlete developed a viral cold from which it took 3 weeks to fully recover. Note that prior to this period of time she had one week at 6000 points followed by one week at 3000 points, then three consecutive weeks over 3000 points. Ideally the athlete would have been given an easy week in week 12 (less than 1000 points), a moderate week in week 13 (2000 points) and then allowed to go back to normal in week 14. I would speculate that her illness would have been easier to manage had this process been undertaken. The difficulty with monitoring this athlete is that she is an amateur athlete who manages a lot of her own training sessions away from the gym. This is the first time that she is in our academy program as well and we are only just starting our education process with our athletes. In a professional team setting for example, we would have grabbed a hold of her at the start of week 12 and 100% controlled every aspect of her training from a duration and intensity point of view to allow her to still compete but at the same time ensure that she didn’t over train during consecutive weeks. A good lesson for us all!

So that is my little blog on training load, hopefully you have been able to gain some insight from the examples that I have given. My parting thoughts are my three mantras that you should always consider when attempting to manage training load:

  1. Manage each athlete as an individual

  2. Think about the athlete as a person - think physical and mental wellbeing

  3. Get the data on to paper in whichever format you deem necessary - if you don’t have data you have nothing!!

I hope you enjoyed this little read - all the best with your monitoring and I’ll chat with you next time.


Adrian Cois

Performance Coach

BAppSci (Exercise Science)


Media Release - Five Years of Health Reform COAG Jun 12th, 2014


Infographic - Exercise Jun 11th, 2014