Workload and Wellness as Risk Factors for Anterior Cruciate Ligament Injury in a Female Collegiate Lacrosse Athlete: A Level 3 Clinical CASE Report

In this level 3 clinical Contribution to the Available Sources of Evidence report, we explored potential risk factors in workload (eg, total distance, accelerations, and decelerations) and wellness (daily self-reports) that led to an off-season anterior cruciate ligament injury in a female collegiate lacrosse athlete (age = 19 years, height = 180 cm, mass = 63.5 kg). During the first 8 weeks, the athlete's workload was consistently higher (range, 12.3%-33.3%) compared with the team average. In week 7, the workload of the athlete and team decreased, followed by a workload spike in week 8, creating a load-reload pattern 1 week before injury. The wellness data showed a decrease in muscle readiness and energy and sleep duration 2 weeks before injury. Athletic trainers should be part of an interdisciplinary team using microtechnology and wellness tracking to determine if athletes have participated in high or fluctuating workloads or are experiencing poor wellness that could increase their risk of injury. Load-reload patterns in conjunction with wellness should be considered potential risk factors for athletes' injuries.