Identify movement limitations before they become injuries

Tim Gabbett's 2016 paper in the British Journal of Sports Medicine described what he called the training-injury prevention paradox: athletes who train harder are both more likely to get injured (if load is introduced too quickly) and less likely to get injured (if high chronic loads are built gradually).

The key variable isn't how much you train — it's how quickly you increase the load. Gabbett found that when weekly training load was increased by 15% or more above the previous week, injury risk escalated dramatically. Keeping weekly increases within a 10% range and maintaining an acute-to-chronic workload ratio between 0.8 and 1.3 substantially reduced injury rates.

Both undertrained and overtrained athletes carry elevated risk. The goal is progressive, managed loading.

Movement asymmetry — differences between left and right in range, strength, or quality — is often flagged as a red flag in screening. But the relationship between asymmetry and injury risk is more nuanced than that.

Some degree of asymmetry is normal and expected, particularly in sports that load one side preferentially — cricket, tennis, golf. The Functional Movement Screen gained wide adoption on the premise that movement asymmetries could predict injury, but subsequent large-scale research has not reliably supported that claim.

The more useful clinical question isn't "is there asymmetry?" but "is this asymmetry meaningful given this athlete's sport, history, and load?"

A useful movement assessment checks a few things: whether basic movement patterns — squat, hinge, lunge, push, pull — are available with adequate range and control; whether there are meaningful strength deficits relative to body weight or the contralateral limb; whether there's pain or guarding during movement; and whether there's a mismatch between what the athlete is being asked to do and what their current capacity allows.

The Meeuwisse injury model from 1994 described injury as a predisposing vulnerability being exposed by a precipitating event. A movement screen looks for those predisposing vulnerabilities — the tight hip, the weak single-leg landing, the shoulder that can't reach overhead — before the precipitating event occurs.

An injury that doesn't happen requires zero rehab time, zero clinic visits, and zero lost training. Well-designed injury prevention programmes in sports like football and netball can reduce injury incidence by 30–50%.

In my practice, I see a lot of athletes after their second or third injury to the same body part. In most cases, the original rehab cleared the tissue but left the movement quality, load management, and strength deficits that contributed to the first injury completely unaddressed. Sorting those out before the next season is the most efficient use of anyone's time and money.