Context: Tennis athletes are often exposed to rigorous training and competition schedules which may lead to increased joint pain if not managed appropriately. One method of managing training workload is to implement the acute to chronic workload ratio using internal workload metrics such as rate of perceived exertion (RPE). Previous research has determined that high chronic workloads relative to small spikes in acute workloads protect against injury. No studies, however, have attempted to investigate training workload and its relationship to joint pain. Therefore, the purpose of this study is to determine if high chronic workloads with limited spikes in acute workloads decrease self-perceived joint pain in adolescent tennis players. Methods: Thirty-two junior elite tennis players (15±2 years; male=21) were followed for 23 consecutive weeks. Rate of perceived exertion workload data were collected every day after training/match sessions. Players were instructed to provide a subjective rating of RPE (range:0-10) as an estimate of training intensity. Session RPE (sRPE), a measure of internal workload was calculated by multiplying the training/match session RPE by the session duration in minutes. Players self-reported joint pain using AthleteMonitoring Software. Joint pain was recorded (range 0-4; where 4 indicates worst pain possible) based upon responses to the question "Was joint pain felt in any part of your body as a result of playing tennis todays" Session RPE data were organized into acute and chronic workloads in order to calculate the acute to chronic workload ratio (ACWR) which was the primary independent variable. Acute workload was determined as the total sRPE for one week, while a 4-week rolling average sRPE represented chronic workload. Joint pain was the dependent measure and expressed as a percentage of the total reported pain for that week. A multiple linear regression model was used to determine if ACWR from the previous week was a significant predictor of joint pain when controlling for the covariates age, sex, previous injury history, and years of experience. The SPSS complex sampling procedures was used to control for violations of independent observations that are unavoidable with longitudinal injury data. Results: The average ACWR for participants was 1.12±0.66. The average pain score for participants was 22% (95%CI 0.15-0.28). Linear regression analysis indicated that the ACWR from the previous week was associated with joint pain score the following week (Wald F130=4.67; R2=0.10; p=0.04). Conclusions: This study was the first to associate joint pain with the ACWR in tennis players. While results are significant the correlation is weak as 10% of the variation in joint pain scores are explained by the preceding week`s ACWR. In this sample, the percentage of reported pain is relatively low and lacked variability which could be one reason why the model generated weak correlations.
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