Instrument 03 · Not open yet
Open Disputes
Four arguments the evidence has not settled, published rather than hidden.
These are the positions as they stand today.
When positions open, each will take a side and one mandatory sentence of
reasoning. No position is recorded without the sentence — a percentage split is a
statistic, and a percentage split with fifty sentences of practitioner reasoning behind
it is a paper.
Dispute 01The workload ratio is mathematically broken — and still on the dashboard
The acute:chronic workload ratio became the default load metric in professional sport after 2016. It has since been shown that the acute period sits inside the chronic average, so the two are coupled by construction and will correlate even with random data. The critique is a mathematical argument, not an interpretation, and it has not been rebutted on its own terms.
What survives is the underlying idea: rapid change in load matters more than absolute load, and undertrained players are fragile. What does not survive is the specific number. If your club is still red-flagging players on a ratio threshold, you are acting on an artefact.
Gabbett 2016 · Hulin 2016 · Impellizzeri 2020, 2021 · Lolli 2019 · Griffin 2020Will ask — Is the ratio still in use in your organisation, and what would it take to change that?
Dispute 02The concussion consensus lineage has an authorship problem
Paul McCrory, first author of the 2012 Zurich and 2016 Berlin concussion consensus statements and former Editor-in-Chief of the British Journal of Sports Medicine, has since accrued seventeen retractions and expressions of concern on roughly seventy-eight further articles, for plagiarism and duplicate publication.
The retractions concern his single-authored editorials, reviews and letters. Neither consensus statement has itself been retracted, and the 2023 Amsterdam statement supersedes both. We state the distinction precisely because both the temptation to bury it and the temptation to overstate it are real — and because most football protocols in force today descend from that lineage.
McCrory 2013, 2017 · Patricios 2023 · BMJ Group retraction noticesWill ask — How much should an authorship problem change a protocol — and do you know which lineage yours descends from?
Dispute 03The most-quoted number in women's football is contested
The claim that female footballers tear their ACL two to three times more often than men is repeated constantly. The best meta-analysis reports 2.2 times per exposure hour — but in that same dataset the raw incidence proportion was higher in men, matched-cohort comparisons showed no difference in relative risk, and heterogeneity was very high.
The ACL burden in women's elite football is real and severe — a median 292 days lost per injury in the UEFA women's study. That is the finding worth acting on. The multiplier is the finding worth quoting carefully.
Montalvo 2019 · Waldén 2011 · Hallén 2024 · Larruskain 2018Will ask — Should men’s-football findings be applied to the women’s game before they are tested there?
Dispute 04Prevention that works is not being done
The Nordic hamstring exercise roughly halves hamstring injury rates. Across 150 elite club-seasons, the programme was completed in full in 10.7% of them. Meanwhile hamstring injury has risen from 12% to 24% of all injuries in men's professional football over two decades.
This is not an evidence problem. It is an implementation problem — which means it is a leadership problem. The most valuable research question in football medicine is no longer what works, but what makes a club actually do it.
Petersen 2011 · van Dyk 2019 · Bahr 2015 · Ekstrand 2023Will ask — Why is the thing that works not being done?