We must remember the three P's to get into the game and stay in the game - positions, patterns & power.
Yet, in many sports, these may not matter as much as what happens once in the game – the application of sports-specific skill.
As such, we must remember that our role, as performance and support staff, is to give athletes back to their technical and tactical coaches. Our role is not to detract from their ability to spend time practicing the game or sport they are in. That is why adaptability to forces, energy and load, ie durability, matters
An athlete who has to miss or modify training is less likely to achieve performance success. This is supported by long term prospective research in elite athletes . It is clear from this research at the Australian Institute of Sport that the inability to be robust enough to complete more than 80% of planned training program negatively affects the likelihood of performance success. It is also clear from data from UEFA, “from an unnamed club which – over a ten-year period in which it employed four coaches – only won silverware with the bosses who had a lower-than-average number of injuries within their squads. "Is this a coincidence? We don't believe it is.", says Jan Ekstrand, vice-chairman of the UEFA Medical Committee. 
In light of these clear, long-term, links between durability and performance success, we revisit the earlier statement – “Our role is not to detract from their ability to spend time practicing the game or sport they are in.” Thus we have a fine balance between pushing athlete development and catching those elements that indicate an increased likelihood of future injury – that which limits durability and performance success. This is a key premise behind mobility and stability for performance, that:
"Our intent to push athlete development is to be balanced by intent to not be part of the problem that limits them."
1. Raysmith, B.P. and M.K. Drew, Performance success or failure is influenced by weeks lost to injury and illness in elite Australian Track and Field athletes: a 5-year prospective study. Journal of Science and Medicine in Sport, 2015.
2. Ekstrand, J., Preventing Player Injuries. http://www.uefa.org/football-development/technical/coach-education/news/newsid=1987291.html, 2013.
3. Blanch, P. and T.J. Gabbett, Has the athlete trained enough to return to play safely? The acute:chronic workload ratio permits clinicians to quantify a player's risk of subsequent injury. Br J Sports Med, 2015.
4. Hulin, B.T., et al., Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers. Br J Sports Med, 2014. 48(8): p. 708-12.
5. Hulin, B.T., et al., The acute:chronic workload ratio predicts injury: high chronic workload may decrease injury risk in elite rugby league players. Br J Sports Med, 2015.
6. Bowen, L., et al., Accumulated workloads and the acute:chronic workload ratio relate to injury risk in elite youth football players. Br J Sports Med, 2016.
7. Tucker, K.J. and P.W. Hodges, Motoneurone recruitment is altered with pain induced in non-muscular tissue. Pain, 2009. 141(1-2): p. 151-5.
8. Tucker, K., et al., Similar alteration of motor unit recruitment strategies during the anticipation and experience of pain. Pain, 2012. 153(3): p. 636-43.
9. Shadmehr, A., Z. Jafarian, and S. Talebian, Changes in recruitment of pelvic stabilizer muscles in people with and without sacroiliac joint pain during the active straight-leg-raise test. J Back Musculoskelet Rehabil, 2012. 25(1): p. 27-32.
10. Renkawitz, T., D. Boluki, and J. Grifka, The association of low back pain, neuromuscular imbalance, and trunk extension strength in athletes. Spine J, 2006. 6(6): p. 673-83.
11. Radebold, A., et al., Impaired postural control of the lumbar spine is associated with delayed muscle response times in patients with chronic idiopathic low back pain. Spine (Phila Pa 1976), 2001. 26(7): p. 724-30.
12. Park, J. and J.T. Hopkins, Induced anterior knee pain immediately reduces involuntary and voluntary quadriceps activation. Clin J Sport Med, 2013. 23(1): p. 19-24.
13. Bank, P.J., et al., Motor consequences of experimentally induced limb pain: a systematic review. Eur J Pain, 2013. 17(2): p. 145-57.
14. Bley, A.S., et al., Propulsion phase of the single leg triple hop test in women with patellofemoral pain syndrome: a biomechanical study. PLoS One, 2014. 9(5): p. e97606.
15. Cholewicki, J., et al., Neuromuscular function in athletes following recovery from a recent acute low back injury. J Orthop Sports Phys Ther, 2002. 32(11): p. 568-75.
16. Cholewicki, J., et al., Delayed trunk muscle reflex responses increase the risk of low back injuries. Spine (Phila Pa 1976), 2005. 30(23): p. 2614-20.
17. de la Motte, S., B.L. Arnold, and S.E. Ross, Trunk-rotation differences at maximal reach of the star excursion balance test in participants with chronic ankle instability. J Athl Train, 2015. 50(4): p. 358-65.
18. Deschamps, T., et al., Influence of experimental pain on the perception of action capabilities and performance of a maximal single-leg hop. J Pain, 2014. 15(3): p. 271 e1-7.
19. Elsig, S., et al., Sensorimotor tests, such as movement control and laterality judgment accuracy, in persons with recurrent neck pain and controls. A case-control study. Man Ther, 2014. 19(6): p. 555-61.
20. Graven-Nielsen, T., et al., Stimulus-response functions in areas with experimentally induced referred muscle pain--a psychophysical study. Brain Res, 1997. 744(1): p. 121-8.
21. Graven-Nielsen, T., et al., Inhibition of maximal voluntary contraction force by experimental muscle pain: a centrally mediated mechanism. Muscle Nerve, 2002. 26(5): p. 708-12.
22. Graven-Nielsen, T., P. Svensson, and L. Arendt-Nielsen, Effects of experimental muscle pain on muscle activity and co-ordination during static and dynamic motor function. Electroencephalogr Clin Neurophysiol, 1997. 105(2): p. 156-64.
23. Greene, H.S., et al., A history of low back injury is a risk factor for recurrent back injuries in varsity athletes. Am J Sports Med, 2001. 29(6): p. 795-800.
24. Henriksen, M., et al., Experimental quadriceps muscle pain impairs knee joint control during walking. J Appl Physiol (1985), 2007. 103(1): p. 132-9.
25. Henriksen, M., et al., Adaptations in the gait pattern with experimental hamstring pain. J Electromyogr Kinesiol, 2011. 21(5): p. 746-53.
26. Hodges, P.W. and G.L. Moseley, Pain and motor control of the lumbopelvic region: effect and possible mechanisms. J Electromyogr Kinesiol, 2003. 13(4): p. 361-70.
27. Hodges, P.W., et al., Experimental muscle pain changes feedforward postural responses of the trunk muscles. Exp Brain Res, 2003. 151(2): p. 262-71.
28. Hodges, P.W. and K. Tucker, Moving differently in pain: a new theory to explain the adaptation to pain. Pain, 2011. 152(3 Suppl): p. S90-8.
29. Janssens, L., et al., Greater diaphragm fatigability in individuals with recurrent low back pain. Respir Physiol Neurobiol, 2013. 188(2): p. 119-23.
30. MacDonald, D., G.L. Moseley, and P.W. Hodges, Why do some patients keep hurting their back? Evidence of ongoing back muscle dysfunction during remission from recurrent back pain. Pain, 2009. 142(3): p. 183-8.
31. Moseley, G.L., et al., The threat of predictable and unpredictable pain: differential effects on central nervous system processing? Aust J Physiother, 2003. 49(4): p. 263-7.
32. Palmieri-Smith, R.M., et al., Pain and effusion and quadriceps activation and strength. J Athl Train, 2013. 48(2): p. 186-91.
33. Beaulieu, M.L., E.M. Wojtys, and J.A. Ashton-Miller, Risk of anterior cruciate ligament fatigue failure is increased by limited internal femoral rotation during in vitro repeated pivot landings. Am J Sports Med, 2015. 43(9): p. 2233-41.
34. Baumhauer, J.F., et al., A prospective study of ankle injury risk factors. Am J Sports Med, 1995. 23(5): p. 564-70.
35. Croisier, J.L., Factors associated with recurrent hamstring injuries. Sports Med, 2004. 34(10): p. 681-95.
36. Gribble, P.A., et al., Prediction of Lateral Ankle Sprains in Football Players Based on Clinical Tests and Body Mass Index. Am J Sports Med, 2015.
37. Smith, C.A., N.J. Chimera, and M. Warren, Association of y balance test reach asymmetry and injury in division I athletes. Med Sci Sports Exerc, 2015. 47(1): p. 136-41.
38. Kiesel, K.B., R.J. Butler, and P.J. Plisky, Limited and Asymmetrical Fundamental Movement Patterns Predict Injury in American Football Players. J Sport Rehabil, 2013.
39. Gabbe, B.J., K.L. Bennell, and C.F. Finch, Why are older Australian football players at greater risk of hamstring injury? J Sci Med Sport, 2006. 9(4): p. 327-33.
40. Gabbe, B.J., et al., Predictors of hamstring injury at the elite level of Australian football. Scand J Med Sci Sports, 2006. 16(1): p. 7-13.
41. Warren, P., et al., Clinical predictors of time to return to competition and of recurrence following hamstring strain in elite Australian footballers. Br J Sports Med, 2010. 44(6): p. 415-9.
42. Nadler, S.F., et al., Relationship between hip muscle imbalance and occurrence of low back pain in collegiate athletes: a prospective study. Am J Phys Med Rehabil, 2001. 80(8): p. 572-7.
43. Malliaras, P., J.L. Cook, and P. Kent, Reduced ankle dorsiflexion range may increase the risk of patellar tendon injury among volleyball players. J Sci Med Sport, 2006. 9(4): p. 304-9.
44. Knapik, J.J., et al., Preseason strength and flexibility imbalances associated with athletic injuries in female collegiate athletes. Am J Sports Med, 1991. 19(1): p. 76-81.
45. Soderman, K., et al., Risk factors for leg injuries in female soccer players: a prospective investigation during one out-door season. Knee Surg Sports Traumatol Arthrosc, 2001. 9(5): p. 313-21.
46. Dallinga, J.M., A. Benjaminse, and K.A. Lemmink, Which screening tools can predict injury to the lower extremities in team sports?: a systematic review. Sports Med, 2012. 42(9): p. 791-815.
47. Thorborg, K., et al., Hip adduction and abduction strength profiles in elite soccer players: implications for clinical evaluation of hip adductor muscle recovery after injury. Am J Sports Med, 2011. 39(1): p. 121-6.
48. Gonell, A.C., J.A. Romero, and L.M. Soler, RELATIONSHIP BETWEEN THE Y BALANCE TEST SCORES AND SOFT TISSUE INJURY INCIDENCE IN A SOCCER TEAM. Int J Sports Phys Ther, 2015. 10(7): p. 955-66.
49. Gribble, P.A., J. Hertel, and P. Plisky, Using the Star Excursion Balance Test to assess dynamic postural-control deficits and outcomes in lower extremity injury: a literature and systematic review. J Athl Train, 2012. 47(3): p. 339-57.
50. Fousekis, K., et al., Intrinsic risk factors of non-contact quadriceps and hamstring strains in soccer: a prospective study of 100 professional players. Br J Sports Med, 2011. 45(9): p. 709-14.
51. Fousekis, K., E. Tsepis, and G. Vagenas, Intrinsic risk factors of noncontact ankle sprains in soccer: a prospective study on 100 professional players. Am J Sports Med, 2012. 40(8): p. 1842-50.
52. Schache, A.G., et al., Can a clinical test of hamstring strength identify football players at risk of hamstring strain? Knee Surg Sports Traumatol Arthrosc, 2011. 19(1): p. 38-41.
53. Zazulak, B.T., et al., Deficits in neuromuscular control of the trunk predict knee injury risk: a prospective biomechanical-epidemiologic study. Am J Sports Med, 2007. 35(7): p. 1123-30.
54. Zazulak, B.T., et al., The effects of core proprioception on knee injury: a prospective biomechanical-epidemiological study. Am J Sports Med, 2007. 35(3): p. 368-73.
55. Bourne, M.N., et al., Eccentric Knee Flexor Strength and Risk of Hamstring Injuries in Rugby Union: A Prospective Study. Am J Sports Med, 2015. 43(11): p. 2663-70.
56. Arakawa, H., et al., The effects of ankle restriction on the multijoint coordination of vertical jumping. J Appl Biomech, 2013. 29(4): p. 468-73.
57. Chaabene, H., et al., Physical and physiological profile of elite karate athletes. Sports Med, 2012. 42(10): p. 829-43.
58. Cibulka, M.T., et al., The Relationship between Passive Glenohumeral Total Rotation and the Strength of the Internal and External Rotator Muscles, a Preliminary Study. Int J Sports Phys Ther, 2015. 10(4): p. 434-40.
59. Douda, H.T., et al., Physiological and anthropometric determinants of rhythmic gymnastics performance. Int J Sports Physiol Perform, 2008. 3(1): p. 41-54.
60. Fry, A.C., et al., Anthropometric and performance variables discriminating elite American junior men weightlifters. J Strength Cond Res, 2006. 20(4): p. 861-6.
61. Garcia-Pinillos, F., et al., Impact of limited hamstring flexibility on vertical jump, kicking speed, sprint, and agility in young football players. J Sports Sci, 2015. 33(12): p. 1293-7.
62. Gleim, G.W. and M.P. McHugh, Flexibility and its effects on sports injury and performance. Sports Med, 1997. 24(5): p. 289-99.
63. Hoch, M.C., et al., Dorsiflexion and dynamic postural control deficits are present in those with chronic ankle instability. J Sci Med Sport, 2012. 15(6): p. 574-9.
64. Mackala, K., et al., The Relationship between 200 m Performance and Selected Anthropometric Variables and Motor Abilities in Male Sprinters. Coll Antropol, 2015. 39 Suppl 1: p. 69-76.
65. Macrum, E., et al., Effect of limiting ankle-dorsiflexion range of motion on lower extremity kinematics and muscle-activation patterns during a squat. J Sport Rehabil, 2012. 21(2): p. 144-50.
66. McCullough, A.S., et al., Factors affecting flutter kicking speed in women who are competitive and recreational swimmers. J Strength Cond Res, 2009. 23(7): p. 2130-6.
67. McKean, M.R. and B. Burkett, The relationship between joint range of motion, muscular strength, and race time for sub-elite flat water kayakers. J Sci Med Sport, 2010. 13(5): p. 537-42.
68. Mermier, C.M., et al., Physiological and anthropometric determinants of sport climbing performance. Br J Sports Med, 2000. 34(5): p. 359-65; discussion 366.
69. Sauers, E.L., et al., Hip and glenohumeral rotational range of motion in healthy professional baseball pitchers and position players. Am J Sports Med, 2014. 42(2): p. 430-6.
70. Strzala, M., et al., Swimming speed of the breaststroke kick. J Hum Kinet, 2012. 35: p. 133-9.
71. Talukdar, K., et al., The role of rotational mobility and power on throwing velocity. J Strength Cond Res, 2015. 29(4): p. 905-11.