Return-to-Play Practices Following Hamstring Injury: A Worldwide Survey of 131 Premier League Football Teams

Epidemiology of Hamstring Tears in National Collegiate Athletic Association Athletes: Findings From the National Collegiate Athletic Association Injury Surveillance Program Between 2014/2015 and 2018/2019

OBJECTIVE

To describe the epidemiology of hamstring tears in National Collegiate Athletic Association (NCAA) sports.

DESIGN

Descriptive epidemiology study. Athletic trainers from NCAA schools reported injuries to the NCAA Injury Surveillance Program.

SETTING

A convenience sample of NCAA hamstring tear injuries during the 2014/2015 through 2018/2019 academic years.

PATIENTS OR PARTICIPANTS

NCAA student-athletes.

INDEPENDENT VARIABLES

Sport, sex, event type, season segment, injury history, and activity at the time of injury.

MAIN OUTCOME MEASURES

Injury counts, rates, and proportions were used.

RESULTS

Two thousand ninety-six hamstring tears from 8 474 400 athlete-exposures (AEs) were reported (2.47 per 10 000 AEs). Rates were highest in Men's Soccer (5.97 per 10 000 AEs) and Women's Soccer (3.13 per 10 000 AEs), among all Men's and Women's sports, respectively. Competition-related rates in Men's and Women's sports were highest in 2015 to 2016 then followed a decreasing pattern across the remainder of the study period. Among sex-comparable sports, rates were higher in men's (compared with women's) Baseball/Softball, Soccer, and Track and Field. The prevalence of recurrent injuries was comparable among men's (14.8%) and women's (11.5%) sports. Time loss hamstring tears were more prevalent in Men's sports than Women's sports [injury proportion ratio = 1.33; 95% confidence interval, (1.21, 1.47)].

CONCLUSIONS

Overall, hamstring tear rates were higher across all Men's sports compared with Women's sports. Rates across event type were comparable in several sports; and so, adjustments to practice are needed considering that practice environments are more modifiable than competitions. Indeed, improving hamstring tear prevention programs to reduce the burden of this injury in NCAA athletes remains critical.

Injury prevention in Brazilian women's football: Perceptions of physiotherapists and practices within elite clubs

OBJECTIVES

To describe the perceptions of physiotherapists and the injury prevention practices implemented within elite women's football clubs in Brazil.

DESIGN

Cross-sectional study.

SETTING

Online survey.

PARTICIPANTS

Head physiotherapists from 32 Brazilian elite clubs.

MAIN OUTCOME MEASURES

Structured questionnaire.

RESULTS

Physiotherapists identified ACL rupture as the primary target for prevention. The top-five perceived injury risk factors included 'early return to sport after injury', 'workload too high', 'previous injury', 'poor sleep/rest', and 'muscle strength/power deficit'. 'Adoption of return to sport criteria' was almost unanimously recognized as a very important preventive strategy. 'Poor infrastructure' was elected as the main barrier to implementing prevention programs. From a practical standpoint, at least two-third of clubs implemented multi-component exercise interventions for injury prevention. These interventions typically encompassed flexibility/mobility, balance/proprioception, lumbo-pelvic stability, and agility exercises, alongside exposure to sprinting. Strength training routines typically included traditional, functional, and eccentric exercises. Most teams also employed other prevention strategies, including adoption of return to sport criteria, internal workload monitoring, post-exercise recovery modalities, preseason risk factor screening, and application of rigid strapping tapes.

CONCLUSIONS

This study provided unprecedented insights into the physiotherapists' perceptions and injury prevention practices implemented within elite women's football clubs.

Shared decision-making with athletes: a survey study of healthcare professionals' perspectives

Objectives

Shared decision-making (SDM) is a trending topic in athlete health care; however, little is known about its use in a sports context. This study aimed to measure knowledge and self-perceived practice of SDM among healthcare professionals working with athletes. This study evaluates SDM attitudes and preferences and explores how healthcare professionals perceive the factors influencing SDM.

Methods

A web-based cross-sectional survey with open-ended and closed-ended questions.

Results

Our survey was completed by 131 healthcare professionals. The majority (63.6%) reported to prefer SDM and to be confident in their SDM skills (81.1%). Despite this inclination and confidence, only one in four clinicians reported consistent practice of SDM when feasible. Additionally, most clinicians lacked SDM knowledge. The barriers perceived by healthcare professionals included time constraints (17.6%), limited patient knowledge (17.6%), limited patient motivation (13.5%) and language barriers (16.2%). Importantly, two-thirds of the participants believed that SDM in athlete health care differs from SDM in non-athletes due to the high-pressure environment, the tension between performance and health, and the involvement of multiple stakeholders with potentially conflicting interests.

Conclusions

Although healthcare professionals preferred SDM, they did not fully understand nor routinely practice it. Most healthcare professionals perceive SDM in athlete health care to differ from SDM in the general population. Therefore, to inform the implementation of SDM in athlete health care, future research is crucial to understand better what makes practising SDM unique in this setting.

On-field rehabilitation in football: current practice and perceptions. A survey of the English Premier League and Football League

INTRODUCTION

Return to play related research is increasing rapidly, with two recent competency-based frameworks offering conceptualised support for on-field rehabilitation (OFR) decision-making. It is still unknown, however, who is responsible for OFR and how they typically select, monitor, and progress OFR processes.

AIMS

The purpose of this study was to investigate current OFR practice within English professional football to support practitioners with decision-making and highlight opportunities for future research related to the design, monitoring, and progression of OFR.

METHODS

Sixty-nine practitioners responsible for the design and implementation of OFR at 69 clubs (75% of the English Premier League and Football League) responded to a survey containing 30 questions (14 open and 16 closed).

RESULTS

The main findings were that therapists (physiotherapists/sports therapists) have the largest influence on OFR, followed by physical performance coaches (sports scientists/strength and conditioning coaches), technical coaches and medical doctors. There was more agreement for the ordering of specific OFR drills earlier in the process when activities are easier to control. The most frequently reported objective monitoring tool was global positioning systems (GPS), with functional/clinical experience/expertise remaining subjectively vital. GPS outputs (e.g., sprint metrics and accelerations/decelerations) were most used for between session decision-making, with verbal communication being key for within session decision-making.

CONCLUSION

Future research should use evidence of current practice, such as drill design and monitoring techniques, to explore drill-level analysis and give practitioners greater insights into which stage of current OFR frameworks specific drills fall, and how they might be more objectively progressed/regressed.

Coaches' Perceptions of Common Planning Concepts Within Training Theory: An International Survey

BACKGROUND

The planning of training is a popular yet controversial topic among coaches and sports scientists. Periodisation is often presented in the literature as the most efficacious approach to planning training. While historically surveys of coaches appeared to support this a key failing was that no unified definition of periodisation exists. Recent surveys offering a periodisation definition and an alternative planning methodology found many choosing the alternative therefore questioning periodisation's wide acceptance. The current survey looked to explore how coaches perceived specific concepts, drawn from the literature, that relate to the planning of training.

METHODS

106 coaches [age range: 18-65+ years, 31% 15+ years coaching, 58% individual-events/sports and 32% international level] from across the world completed a novel cross-sectional online survey on the planning of training and the training process. Topics included use of periodisation, division of time into discrete periods, assignment of goals and training to pre-determined periods and the adaptability of pre-established plans.

RESULTS

The majority described their planning approach as training periodisation (71%). Similarly, there was strong agreement with the necessity to determining a goal for the season (85%) and divide the season into distinct manageable periods of time (73%). When examining whether physical adaptations are achievable within specific and fixed timeframes only a minority (33%) agreed, a similar result was found for training physical capacities in a sequential order (37%). Finally, there was limited support for training targets remaining fixed over a training period (10%).

CONCLUSIONS

As a tool for the planning of athlete's training, periodisation is often presented as the best and most popular approach. Recent research however has highlighted possible discrepancies in its usage among practitioners. The results of this survey echo this and question the acceptance of periodisation concepts even among periodisation users. In part this may be due to key tenets of periodisation no longer being supported by research or practice. A lingering question then is whether the beliefs of coaches, developed through experience and supported by research, will continue to be marginalized. If sports scientists wish to aid coaches then they need to be engaged in future research initiatives as co-collaborators.

Managing Lower Limb Muscle Reinjuries in Athletes: From Risk Factors to Return-to-Play Strategies

Muscle injuries and subsequent reinjuries significantly impact athletes, especially in football. These injuries lead to time loss, performance impairment, and long-term health concerns. This review aims to provide a comprehensive overview of the current understanding of muscle reinjuries, delving into their epidemiology, risk factors, clinical management, and prevention strategies. Despite advancements in rehabilitation programs and return-to-play criteria, reinjury rates remain alarmingly high. Age and previous muscle injuries are nonmodifiable risk factors contributing to a high reinjury rate. Clinical management, which involves accurate diagnosis, individualized rehabilitation plans, and the establishment of return-to-training and return-to-play criteria, plays a pivotal role during the sports season. Eccentric exercises, optimal loading, and training load monitoring are key elements in preventing reinjuries. The potential of artificial intelligence (AI) in predicting and preventing reinjuries offers a promising avenue, emphasizing the need for a multidisciplinary approach to managing these injuries. While current strategies offer some mitigation, there is a pressing need for innovative solutions, possibly leveraging AI, to reduce the incidence of muscle reinjuries in football players. Future research should focus on this direction, aiming to enhance athletes' well-being and performance.

Examination of the validity of the Injury-Psychological Readiness to Return to Sport (I-PRRS) scale in male professional football players: A worldwide study of 29 professional teams

Perceived confidence is an important dimension of an athlete's psychological readiness to return-to-play. However, there is no established and validated tool to evaluate confidence in professional football. This study aimed to provide preliminary evaluation of the internal structure of the Injury-Psychological Readiness to Return-to-Sport scale (I-PRRS) in a cohort of injured male professional footballers. Over an 18-month period, 29 teams from 17 leagues participated. Players sustaining injuries eliciting ≥ 3 weeks' time-loss were recruited. Cross culturally adapted to 4 further languages, the I-PRRS was administered on two occasions: 1) day before returning-to-training and 2) day before returning-to-match-play. In total, 113 injuries were recorded with 96 completed I-PRRS data sets collected. Confirmatory factor analysis indicated the I-PRRS was a unidimensional scale, with all items measuring the same construct. The scale demonstrated good internal consistency (ω = .88). When examining longitudinal invariance of the I-PRRS across administration time-points, indices of model fit supported scalar invariance. There was preliminary evidence of good internal structure for the I-PRRS in professional male footballers. However, before further research involving the I-PRRS can be endorsed, efforts to confirm or refute empirical developments pertaining to psychological readiness are necessary.

Typical weekly physical periodization in French academy soccer teams: a survey

In elite-level youth soccer players, weekly training periodization is of paramount importance to plan for short- and long-term physical development. The present study investigated current practices for physical periodization strategies in elite male French academies. An online survey was completed by elite French academies strength and conditioning coaches to determine the typical weekly periodization with particular reference to daily training in relation to match day (MD) in youth soccer players. The survey attempted to characterize the importance of physical development compared to match result, and practices used (expected difficulty and content) for each training session according to duration, exercises, and objective. The frequency rates of the responses were compared using two-tailed Chi-square tests with the significance level set at p < 0.05. Fortyfive questionnaires were analyzed. Respondents indicated that their training sessions focused mainly on physical development (95.6%) rather than match result. Active recovery (34.2%) and aerobic conditioning exercises (40.8%) were primarily conducted on MD+1 and MD+2 using passing circuits and aerobic technical drills. Physical development was mostly pursued during sessions on MD-4 (38.8%) and MD-3 (37.3%). The number of large-sided games was highest on MD-3 (58.1%). On MD-2 and MD-1, a decrease in the training load was highlighted, with speed (40.4%) and tapering sessions (52.4%) mostly implemented. Intensive use of small-sided games (92.3%) and reactivity exercises was observed at MD-1 (100.0%). Our results revealed discrepancies between the physical objectives set for each day and the content implemented, which could potentially be more physically demanding than expected.

How are hamstring strain injuries managed in elite men's football clubs? A survey with 62 Brazilian physical therapists

OBJECTIVE

To describe perceptions and practices of physical therapists from elite men's football clubs on the management of athletes with hamstring strain injury (HSI).

DESIGN

Cross-sectional study.

SETTING

Online survey.

PARTICIPANTS

Physical therapists from clubs engaged in the two main divisions of Brazilian men's football.

MAIN OUTCOME MEASURES

Practices for assessment and rehabilitation of athletes with HSI.

RESULTS

This survey had 62 physical therapists from 35 of the 40 eligible clubs (87.5% representativeness). Despite heterogeneity on assessment practices, all respondents use imaging exams, adopt injury classification scales, and evaluate aspects related to pain, range of motion, muscle strength, and functional status of athletes with HSI. Rehabilitation programs are usually divided into 3 to 4 phases. All respondents usually apply electrophysical agents and stretching in HSI rehabilitation programs, 98.4% apply strengthening exercises (93.5% include eccentrics), 96.8% manual therapy, 95.2% exercises that mimic the functional demands of football, and 93.5% lumbopelvic stabilization exercises. Muscle strength was the most reported return to play criterion (71% of respondents).

CONCLUSION

The present study allowed the sports physical therapy community to become aware of the approaches usually adopted for management of athletes with HSI who play in the highest level of Brazilian men's football.

The Effects of Fixture Congestion on Injury in Professional Male Soccer: A Systematic Review

BACKGROUND

Professional soccer teams are often required to compete with ≤ 4 days recovery between matches. Since congested schedules reduce recovery time between matches, players are possibly at an increased injury risk. To date, there are no published systematic reviews on the impact of match congestion on injuries during professional male soccer.

OBJECTIVE

The aim of this systematic review was to assess the effects of fixture congestion on injuries during professional soccer.

METHODS

Following pre-registration on the Open Science Framework ( https://osf.io/86m25/ ) and conforming with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, systematic searches of four electronic databases (PubMed, Scopus, SPORTDiscus, and Web of Science) were conducted by independent researchers from inception until February 2022. Articles were included if they were original articles written in English and contained relevant time-loss injury data (injury that results in unavailability for training and/or match-play) for male professional soccer players regarding periods of fixture congestion (a minimum of two matches with ≤ 4 days recovery).

RESULTS

A total of eight articles were included in the review. Five studies identified that congested fixture schedules expose players to increased match injury incidence, although layoff duration was typically lower during congested periods. Two studies identified that training and overall injury incidence were higher during congested periods, with another study identifying a lower training injury incidence during congested periods.

CONCLUSION

Injury risk is, overall, increased during fixture-congested periods; however, the layoff duration is typically shorter. The current findings have implications for practitioners regarding the management, periodisation, monitoring, and design of training and competition schedules.

Return to rugby following musculoskeletal injuries: A survey of views, practices and barriers among health and sport practitioners

STUDY DESIGN AND SETTING

Returning rugby players to the sport following musculoskeletal injuries is a multi-factorial and challenging process. A cross-sectional observational study was conducted among health and sport practitioners involved with injured rugby players in South Africa.

OBJECTIVES AND OUTCOME MEASURES

The views, current practices and barriers encountered by health and sport practitioners during return to rugby were investigated using a self-developed online survey.

RESULTS

64 practitioners participated in the survey including physiotherapists, orthopaedic surgeons, biokineticists and sports physicians. Return to sport (RTS) protocols were considered important, however, participants also indicated that they were slightly more likely to use anecdotal protocols compared to published protocols. Time frames, stages of healing, pain and subjective ratings along with functional outcome measures (such as range of motion, muscle function and proprioception) and sport-specific skills were rated as important and commonly utilised in different RTS phases (i.e., return to non-contact, return to contact and return to matches). The most commonly perceived barriers encountered were related to lack of access and time-constraints.

CONCLUSION

Return to rugby guidelines with consideration of a broad range of criteria and common barriers encountered should be developed to facilitate safe, practical and time-efficient return to rugby following musculoskeletal injuries.

Readaptación deportiva y retorno deportivo en el alto rendimiento. Del laboratorio al campo de juego: Una revisión de la literatura

Introducción En la actualidad, la readaptación deportiva se conoce como un proceso dinámico a nivel estructural y funcional de elementos del movimiento corporal humano tales como la caracterización de cualidades físicas, sinergias articulares y musculares, eficiencia y eficacia del movimiento y potencialización de habilidades funcionales para el deporte de alto rendimiento después de una lesión deportiva Metodología revisión de la literatura basados en los criterios PRISMA donde se hizo la búsqueda en las principales bases de datos tales como: Pubmed, Ebsco, Medline, Scopus, Science Direct con los siguientes terminos DeCS: Return to sport, Performance, sports, Return to training, Return to play, Rehabilitation, sports idioma de evidencia inglés, español, portugués, catalán y francés Resultados se pudo obtener la información de 74 artículos donde se estableció que el proceso de readaptación deportiva se basa en pilares específicos tales como movimiento, patrones funcionales, control de carga, monitorización, criterios de seguimiento por fase que permiten desarrollar un retorno exitoso al alto rendimiento deportivo. Conclusión la readaptación deportiva es un proceso que permite tomar decisiones basados en un proceso sistematizado generando la evolución del concepto de readaptador deportivo como un pilar esencial en el trabajo en el deporte de alto rendimiento en cualquier disciplina deportiva.   PALABRAS CLAVE: Return to Sport, Performance, sports, Return to training, Return to play

A Framework for Clinicians to Improve the Decision-Making Process in Return to Sport

Return-to-sport (RTS) decisions are critical to clinical sports medicine and are often characterised by uncertainties, such as re-injury risk, time pressure induced by competition schedule and social stress from coaches, families and supporters. RTS decisions have implications not only for the health and performance of an athlete, but also the sports organisation. RTS decision-making is a complex process, which relies on evaluating multiple biopsychosocial factors, and is influenced by contextual factors. In this narrative review, we outline how RTS decision-making of clinicians could be evaluated from a decision analysis perspective. To begin with, the RTS decision could be explained as a sequence of steps, with a decision basis as the core component. We first elucidate the methodological considerations in gathering information from RTS tests. Second, we identify how decision-making frameworks have evolved and adapt decision-making theories to the RTS context. Third, we discuss the preferences and perspectives of the athlete, performance coach and manager. We conclude by proposing a framework for clinicians to improve the quality of RTS decisions and make recommendations for daily practice and research.

Return to match running performance after a hamstring injury in elite football: a single-centre retrospective cohort study

Objectives

To determine the number of matches to return to pre-injury match running performance after sustaining an acute hamstring injury.

Methods

In this retrospective cohort study, the injuries of the players of the first, Under21, Under19, Under18 and Under17 teams of a professional football club in the period 2017-2020 were analysed. Acute hamstring injuries with a minimal absence from training or match play of 7 days were included. For running performance, we assessed the following variables: maximal velocity (km/hour), total distance, high-intensity distance (17.5-22.5 km/hour) and sprint distance (>22.5 km/hour). We calculated the average and 95% CI for these variables during the last five matches before the injury. The primary outcome was the number of matches to reach maximal velocity within the 95% CI of the player's individual pre-injury performance. Secondary outcome scores included the duration (in days and matches) to reach the other running performance variables.

Results

18 hamstring injuries in 15 players were included. 15 out of 18 injuries (83%) showed a return to pre-injury maximal velocity in the second match after return to play. The median number of matches to return to pre-injury maximal velocity was 2 (IQR 1-2). In the first match after return to play, pre-injury total distance was reached in 100% of the injuries, pre-injury sprint distance was reached in 94% of the injuries and pre-injury high-intensity distance was reached in 89% of the injuries.

Conclusion

Following an acute hamstring injury in elite football, pre-injury match running performance is reached in the first or second match.

Predictors of time to return to play and re-injury following hamstring injury with and without intramuscular tendon involvement in adult professional footballers: A retrospective cohort study

OBJECTIVES

In one English Premier League football club over four seasons, 1) describe the number of hamstring strain injuries (HSI) sustained using the British Athletics Muscle Injury Classification (BAMIC); 2) determine if intramuscular tendon HSI influenced the time to return to play (TTRTP) and reinjury rate; 3) determine the predictors of TTRTP and reinjury.

DESIGN

Retrospective cohort design.

METHODS

All first team players who sustained a HSI between 2014 and 2018 were included. Players underwent an MRI scan that was graded by a Radiologist using the BAMIC (0a-4) criteria. TTRTP, reinjury rate and information on suspected predictors were recorded.

RESULTS

Thirty-five HSI experienced by 24 players (age = 26 ± 4 years) were recorded over the 4 seasons. There was a difference in TTRTP between grades 1a and 2c (P = 0.007), but not between 2b and 2c (P = 0.845). Grade of HSI (P ≤ 0.001) and removal of the player (P < 0.001) were predictors of TTRTP, with each increase in grade resulting in an additional 3 days of TTRTP, and being removed, an additional 11 days. Grade and all other predictors did not influence reinjury rate, albeit higher odds were evident for previous HSI, experiencing the HSI during sprinting, passing a ball or stretching, and reported increase days of pain during walking.

CONCLUSIONS

HSIs extending into the intramuscular tendon (2b cf. 2c) did not influence TTRTP or re-injury, albeit TTRTP was affected by the BAMIC grade and if the player was removed from activity.

Return to Play After a Hamstring Strain Injury: It is Time to Consider Natural Healing

Return to play (RTP) criteria after hamstring strain injuries (HSIs) help clinicians in deciding whether an athlete is ready to safely resume previous sport activities. Today, functional and sport-specific training tests are the gold standard in the decision-making process. These criteria lead to an average RTP time between 11 and 25 days after a grade 1 or 2 HSI. However, the high re-injury rates indicate a possible inadequacy of the current RTP criteria. A possible explanation for this could be the neglect of biological healing time. The present review shows that studies indicating time as a possible factor within the RTP-decision are very scarce. However, studies on biological muscle healing showed immature scar tissue and incomplete muscle healing at the average moment of RTP. Twenty-five percent of the re-injuries occur in the first week after RTP and at the exact same location as the index injury. This review supports the statement that functional recovery precedes the biological healing of the muscle. Based on basic science studies on biological muscle healing, we recommend a minimum period of 4 weeks before RTP after a grade 1 or 2 HSI. In conclusion, we advise a comprehensive RTP functional test battery with respect for the natural healing process. Before deciding RTP readiness, clinicians should reflect whether or not it is biologically possible for the injured tissue to have regained enough strength to withstand the sport-specific forces. In an attempt to reduce the detrimental injury-reinjury cycle, it is time to start considering (biological healing) time.

Associations Between Two Athlete Monitoring Systems Used to Quantify External Training Loads in Basketball Players

Monitoring external training load (eTL) has become popular for team sport for managing fatigue, optimizing performance, and guiding return-to-play protocols. During indoor sports, eTL can be measured via inertial measurement units (IMU) or indoor positioning systems (IPS). Though each device provides unique information, the relationships between devices has not been examined. Therefore, the purpose of this study was to assess the association of eTL between an IMU and IPS used to monitor eTL in team sport. Retrospective analyses were performed on 13 elite male National Collegiate Athletic Association (NCAA) Division I basketball players (age: 20.2 ± 1.2 years, height: 201.1 ± 7.6 cm, mass: 96.8 ± 8.8 kg) from three practices during the off-season training phase. A one-way analysis of variance was used to test differences in eTL across practices. Pearson’s correlation examined the association between the Distance traveled during practice captured by IPS compared to PlayerLoad (PL), PlayerLoad per Minute (PL/Min), 2-Dimensional PlayerLoad (PL^2D), 1-Dimensional PlayerLoad Forward (PL^1D-FWD), Side (PL^1D-SIDE), and Up (PL^1D-UP) captured from the IMU. Regression analyses were performed to predict PL from Distance traveled. The eTL characteristics during Practice 1: PL = 420.4 ± 102.9, PL/min = 5.8 ± 1.4, Distance = 1645.9 ± 377.0 m; Practice 2: PL = 472.8 ± 109.5, PL/min = 5.1 ± 1.2, Distance = 1940.0 ± 436.3 m; Practice 3: PL = 295.1 ± 57.8, PL/min = 5.3 ± 1.0, Distance = 1198.2 ± 219.2 m. Significant (p ≤ 0.05) differences were observed in PL, PL^2D, PL^1D-FWD, PL^1D-SIDE, PL^1D-UP, and Distance across practices. Significant correlations (p ≤ 0.001) existed between Distance and PL parameters (Practice 1: r = 0.799–0.891; Practice 2: r = 0.819–0.972; and Practice 3: 0.761–0.891). Predictive models using Distance traveled accounted for 73.5–89.7% of the variance in PL. Significant relationships and predictive capacities exists between systems. Nonetheless, each system also appears to capture unique information that may still be useful to performance practitioners regarding the understanding of eTL.

Monitoring External Training Loads and Neuromuscular Performance for Division I Basketball Players over the Preseason

Limited research has paralleled concomitant changes in external training load (eTL) and countermovement jump (CMJ) performance. Therefore, this investigation characterized eTL and CMJ performance changes across preseason training in Division 1 male collegiate basketball athletes, while examining the influence of position (Guard vs. Forward/Center) and scholarship status (Scholarship = S vs. Walk-on = WO). During 22 practices, eTL was monitored in 14 male athletes, with weekly CMJs performed to quantify neuromuscular performance (Jump Height [JH], Flight Time:Contraction Time [FT:CT], Reactive Strength Index Modified [RSI_Mod ]). PlayerLoad per minute was significantly higher during W1 and W2 (5.4 ± 1.3au and 5.3 ± 1.2au, respectively; p < 0.05) compared to subsequent weeks, but no additional differences in eTL parameters across time were observed. Scholarship athletes displayed greater PlayerLoad (S = 777.1 ± 35.6, WO = 530.1 ± 56.20; Inertial Movement Analysis (IMA) IMA_High (S = 70.9 ± 15.2, WO = 41.3 ± 15.2); IMA_Medium (S = 159.9 ± 30.7, WO = 92.7 ± 30.6); and IMA_Low (S = 700.6 ± 105.1, WO = 405 ± 105.0;) (p < 0.05), with no observed differences in eTL by position. Moderate decreases in FT:CT and RSI_Mod paralleled increased eTL. Significant increases in practice intensity (W1 and W2) did not impact CMJ performance, suggesting athletes could cope with the prescribed training loads. However, moderate perturbations in FT:CT and RSI_Mod paralleled the weeks with intensified training. Cumulatively, scholarship status appears to influence eTL while player position does not.