Craig Pickering

Sports Science Monthly – March 2020

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Every month we take a deep dive into the latest research in sports science. Athletes often complaint about small niggles, but how seriously that needs to be taken has not been researched much. In this month’s edition we start off by taking a look at new research on the topic, plus updates on the art of coaching, performance health, youth sports scaling, sports psychology technology, and high pressure training.

As always, the full Sports Science Monthly is available exclusively to HMMR Plus Members. You can browse the past topics on our archive page. The first topic below is free to everyone, but sign up now to read about all the latest research. To get an idea of what Sports Science Monthly is all about, the April 2016 edition is available in its entirety for free.

This Month’s Topics

Analyzing the connection between niggles and injuries

» Quick Summary: Whilst athletes may frequently have various different “niggles”—“mini-injuries” that they’re currently trying to manage—so far there is little research exploring just how concerning these niggles should be managed. This research suggests that, when an athlete is carrying a niggle, they are over three times more likely to suffer a severe injury within the next seven days – suggesting that we should take niggles seriously.

As any high-level athlete will tell you, it’s very rare that you feel 100% of any given day. Looking back on my career, it seems like I was regularly managing a number of on-going issues that, whilst they didn’t stop me from training, often caused me to “manage” my workload. These niggles are a common part of regular training and competition, but it’s not all that clear just how concerning they should be, and, as a result, just how much attention athletes should pay to them.

A recent study, published in Science and Medicine in Football, aimed to explore the effect of niggles on injury occurrence in a group of footballers. For the purpose of this study, injuries were categorized as “time loss” or “non-time loss.” As might be obvious, time loss injuries are those that cause some time from regular training and/or competition to be missed, whilst non-time loss injuries are those that, whilst present, don’t reduce the time that athlete spends training or competing—a niggle, in other words. Niggles tend to indicate that tissue is beginning to fail, and so might be a precursor to a future injury; whether there was an association between niggles (or non-time loss injuries) and future injury was what this study tried to find out. To do this, the authors recruited semi-professional footballers from 25 different teams based in Australia. The players were all undertaking a minimum of three football-based sessions—either training or a match—per week, and they were followed across the course of competitive season. Data on both time loss and non-time loss injuries was collected; non-time loss injury data was collected through the use of a questionnaire aimed at determining the occurrence of health problems within the players.

In total, 218 players participated in this study. Overall, the risk of suffering a time loss injury within seven days of reporting no health problems was 6%, suggesting that injuries when no niggle was present were pretty uncommon. When players reported “full participation with problems”—i.e. a niggle—there was a 3.3 times increased risk of a time loss injury occurring within the next seven days. This risk increased when the niggle reduced the time the athlete could train for, with a 6.5 times increased risk of injury. This suggests, quite nicely, that any niggle is a risk for injury, and that, the more severe the niggle, the greater the risk.

However, as I’ve written about before in this column, an additional aspect to consider is just how common injuries are when an athlete demonstrates a risk factor. As detailed about, when a player reports a niggle that doesn’t affect their time spent training, they are 3.3 times more likely to suffer a subsequent injury within seven days. This might suggest to us that any niggle should be cause for the athlete to sit out training until they recover. However, this might cause the athlete to miss training unnecessarily; in this study, when players reported a niggle, they suffered a subsequent injury on 67 occasions afterwards, but did not suffer a subsequent injury (at least within 7 days) on 237 occasions. This means that having a niggle is predictive of future injury on only 22% of occasions. The question for coaches and support staff is just how comfortable with this risk they are; pull the player out unnecessarily, and they miss training load and potential improvements, but leaving them in increases their risk of injury. As always, it’s a balancing act.

This all suggests that niggles are not always benign, and they have a significant risk of progressing to a future injury. However, most (~80%) niggles don’t progress to a serious injury in this way. A niggle, therefore, is an early warning sign, which suggests that the player/athlete needs to be monitored more closely, and that capacity in the affected tissue should be further developed to ensure it can meet the required demands. In doing so, and as suggested by these authors, the monitoring of niggles can become another tool in the injury risk reduction box for us to use with our athletes.


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