Beer, Vodka, and Sports Injury? A guest blog by Dr Tim Gabbett

Following on from Tom’s blog about finding the G-Spot I am thrilled to give you a blog by the big G himself, the godfather of load management… Dr Tim Gabbett. Now if you’ve been living under a rock for the last few years and don’t know who Tim is please check his profile here. Tim has done a blog that questions and challenges some commonly held and beliefs about high levels of exercise or training being a high risk for injury, when in fact it could be the exact opposite. So without further ado, I will hand over to Dr Tim for him to explain more…

What Does Beer and Tequila Have To Do With Sporting Injuries?

Imagine you are approaching the age where you are legally allowed to drink alcohol. You and your friends plan a ‘big night out’ to celebrate the important milestone. The only problem is that you have never consumed alcohol before. You drink one beer and you are inebriated, because you have no ‘tolerance’ to beer (let’s call it “beer tolerance”). Over a period of time (e.g. the next 6 months) you and your friend’s party every Friday and Saturday night; you can now drink 6, 7, or even 8 beers before you get drunk. You have improved your beer tolerance.

Just Because You Have Beer Tolerance, Doesn’t Mean You Can Handle “Rocket Fuel”

As you become more confident in your partying ways, you decide to experiment with more exotic drinks. You attempt tequila ‘shots’ and become sick (immediate effect) and hungover (delayed effect). You are quickly learning that not all alcoholic beverages carry the same risk. You quickly learn that having a tolerance to beer does not automatically provide a defence against alcoholic spirits

What Does Alcohol have to do with Sporting Injuries?

Apart from the obvious link between sport and alcohol consumption (e.g. think celebrating a good victory), the ability to develop “beer tolerance” following consistent exposure to beer is similar to the tolerance one develops when regularly exposed to training load. The first training session is always the hardest, but over time the soreness experienced following training is reduced. However, it is important to consider that just as beer and tequila carry different risks, not all training carries the same risk either 1. The training tolerance developed from continuous low-speed running (analogous to beer load) does not mean that a tolerance to high-speed running or sprinting (analogous to tequila) has been developed.

The Acute:Chronic Alcohol Ratio

The Seattle Sounders Football Club hosted their annual sports science conference in June 2016. Over the conference dinner, the authors hatched a plan to study the effect of alcohol consumption on the risk of hangover symptoms in delegates attending the conference. We hypothesized that the ability to tolerate alcohol on an acute basis (i.e. a single night of drinking; acute alcohol load) would be directly related to how much alcohol the delegates had consumed in the 4-week period leading up to the conference (i.e. chronic alcohol load). We modified the acute:chronic workload ratio, as others have calculated for training load 2-4 to calculate an acute:chronic alcohol ratio.

The Challenges of Data Collection in Sporting Environments

Sports medicine practitioners (including physiotherapists, strength and conditioning coaches, and sport scientists) often discuss workload monitoring and the challenges associated with athlete “non-compliance”. Of the 100 delegates attending the conference, 17% completed our brief survey, highlighting that the challenges associated with data collection are not isolated to sport. More importantly, we found that delegates who “spiked” their ‘alcohol load’ (i.e. acute:chronic alcohol ratio >1.5) were 80% likely to suffer hangover symptoms, having 2.4 – 4.0 times greater risk than delegates with lower acute:chronic alcohol ratios (Figure 1). Delegates who drank regularly (i.e. those who had the highest chronic alcohol loads) and ‘paced’ their alcohol consumption during the conference dinner (i.e. those who had the lowest acute alcohol loads) experienced no symptoms.
Perhaps, these findings suggest that alcohol is not necessarily the problem, it’s the alcohol that you’ve been prepared for.

Figure 1
Figure 1

Similarities between Training Load and “Beer Load”

Although we would stop short of recommending drinking copious amounts of alcohol to improve health, building tolerance to alcohol is a useful metaphor when describing the effects of high training loads on injury risk. Firstly, as with our alcohol consumption survey where delegates with higher chronic “beer loads” had lower risk of hangover symptoms, athletes with higher chronic training loads also experience lower injury rates than those with lower chronic training loads.2,3,5,6 Secondly, when alcohol consumption in an acute period is “spiked” above what one is accustomed, there is an increased likelihood of negative consequences (i.e. hangover symptoms), just as there is a greater risk of injury when acute training loads are increased rapidly above chronic training loads.2-4,5-7

Moral of the Story

Whether you are commencing an exercise program for the first time, or an athlete competing in elite-level competition, some general training principles will apply. You will need to expose your body to training load in order to improve your training tolerance, but “spikes” in training load will likely increase the risk of injury. If you are unsure of your tolerance to high-intensity exercise, train at lower intensities until you build your tolerance. For those young men and women who are approaching the legal drinking age, and thinking about having “a big night out”; remember to build your tolerance to alcohol – “spikes” in alcohol consumption can lead to hangovers, and tequila ‘shots’ carry a far greater risk than beer. If you are unsure if you are adequately prepared for beer or tequila – drink water!
If you want to here Tim discuss this more listen to his NAF podcast he did with me a few months ago here
Tim J. Gabbett1, Heather McGill2, Jacqueline Flaherty3, Jenny Russell4, and Jay Campbell4

1 Gabbett Performance Solutions, Brisbane, Queensland, Australia

2 Physical TheraPT, San Francisco, California, United States of America

3 Flaherty Fitness, San Francisco, California, United States of America

4 Department of Health and Exercise Science, The University of Oklahoma, Norman, Oklahoma, United States of America


  1. Orchard JW, Blanch P, Paoloni J, et al. Cricket fast bowling workload patterns as risk factors for tendon, muscle, bone and joint injuries. Br J Sports Med 2015;49:1064-1068.
  2. Gabbett TJ. The training—injury prevention paradox: should athletes be training smarter and harder? Br J Sports Med 2016;50:273-280.
  3. Hulin BT, Gabbett TJ, Lawson DW, 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 2016;50:231-236.
  4. Hulin BT, Gabbett TJ, Blanch P, et al. Spikes in acute workload are associated with increased injury risk in elite cricket fast bowlers. Br J Sports Med 2014; 48:708-712.
  5. Murray NB, Gabbett TJ, Townshend AD, et al. Individual and combined effects of acute and chronic running loads on injury risk in elite Australian footballers. Scan J Sports Sci Med, (in press).
  6. Windt J, Gabbett TJ, Ferris D, et al. Training load–injury paradox: is greater preseason participation associated with lower in-season injury risk in elite rugby league players? Br J Sports Med 2016;:bjsports – 2016–095973. doi:10.1136/bjsports-2016-095973
  7. Blanch P, Gabbett TJ. 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;50:471-475.

Look out for Tim touring the world speaking, its well worth a visit if you can



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