Cumulative load refers to the total mechanical stress experienced by a joint or tissue over time, particularly during activities such as running or lifting. Understanding cumulative load is essential for preventing injuries, especially in athletes and active individuals. Recent studies have highlighted the importance of monitoring cumulative load to mitigate the risk of overuse injuries, which can arise from both excessive training and improper biomechanics [1-2].

Understanding cumulative load

Cumulative load encompasses both internal and external load metrics, which can be measured in various ways, including distance, speed, and frequency of activity. For instance, research indicates that cumulative loading can significantly influence injury risk, particularly in youth sports, where training loads are often not adequately monitored [1]. In running, cumulative load metrics such as tibial stress and ground reaction forces are critical for understanding the relationship between training intensity and injury risk [3-4]. Studies have shown that high cumulative loads, especially when sustained over time, can lead to conditions such as stress fractures and tendon injuries [4–5].

Moreover, the relationship between speed and cumulative load is complex. It has been found that slower running speeds can sometimes result in higher cumulative loads due to increased ground contact time and step frequency, which can lead to chronic injuries if not managed properly [5-6].

Therefore, it is crucial for athletes and coaches to understand how different training modalities affect cumulative load and to implement strategies that minimise injury risk.

The Role of Osteopathy in Managing Cumulative Load

Osteopathy offers a holistic approach to managing cumulative load and enhancing overall musculoskeletal health. Osteopathic practitioners focus on the interrelationship between the body's structure and function, employing manual techniques to improve mobility, reduce pain, and enhance recovery. This approach can be particularly beneficial for athletes who experience the effects of cumulative load on their joints and soft tissues.

Research has shown that osteopathic interventions can effectively reduce pain and improve functional outcomes in individuals suffering from musculoskeletal injuries [7–8]. Techniques such as myofascial release, joint mobilisation, and soft tissue manipulation can help alleviate the stress on joints and improve alignment, thereby reducing the cumulative load experienced during physical activities [9].

Incorporating osteopathy into a multidisciplinary team approach can further enhance injury prevention and rehabilitation strategies. A team comprising physiotherapists, osteopaths, and sports coaches can collaboratively develop individualised training programs that account for an athlete's specific cumulative load profile. This collaboration allows for a comprehensive assessment of biomechanics, training loads, and recovery strategies, ensuring that athletes can train effectively while minimising the risk of injury [10-11].