What Role Have Strength Coaches Played in Rising Injury Rates?

Over the past 25 years, injury rates have climbed across nearly every sport and level of competition. At the same time, we’ve seen an unprecedented boom in human performance.Never before have athletes been faster, stronger, or better equipped, and never before have strength coaches had so many tools, technologies, and systems at their disposal.

So, how do these two truths coexist?

How have we evolved so much as a profession, and yet seen such consistent decline in athlete availability? It’s a question worth asking, and one we can’t keep sidestepping.

Years ago, Dan Pfaff said something to me that has always stuck with me. While talking about athlete risk and availability he said, “The most dangerous person in an athlete’s life is the one who writes their program.”

Coming from Dan, that’s a statement with weight. Because it reminds us that programming isn’t neutral. Every exercise, every loading choice, every omission carries consequence.

That sentence has become a quiet compass for me. It means we: the strength coaches, the performance staff, the so-called architects of athlete development, are also the curators of risk. Whether we acknowledge it or not, our decisions influence health trajectories as much as performance ones.

1. Greater Performance, Greater Responsibility

The evolution of strength and conditioning has been extraordinary. We’ve gotten really good at improving performance metrics and physical outputs. Athletes are running faster, lifting heavier, and producing force at levels we could only dream of a few decades ago.

But with greater expression comes greater responsibility to manage it. A Ferrari doesn’t break down because it’s a bad car, it breaks down because it’s built for precision, and precision requires care. The same is true for athletes. The more powerful and specialized they become, the more delicate the balance of management becomes.

We’ve built a lot more Ferraris in the last 25 years, but too often, we still manage them like Corollas. This isn’t a criticism of progress, it’s a call for proportional evolution in how we support that progress. Because when output capacity outpaces recovery capacity, the system eventually fails.

2. The Myopic Pursuit of Outputs

Somewhere along the way, we became obsessed with the numbers. Data, radar charts, dashboards, metrics, the constant chase to prove that what we’re doing is “working.”

And in fairness, this obsession came from a good place. For decades, strength coaches had to justify their existence. The only way to show value was through measurable improvement: faster sprints, bigger lifts, higher jumps.

But that narrow focus has come with a cost. In chasing outputs, we began to lose sight of the complete picture, the system itself.

Performance is not just what an athlete can produce, but what they can tolerate and sustain.We’ve built systems that celebrate force production, yet underappreciate durability, longevity, and consistency. We’ve elevated intensity over organization, and visibility over variability.

When everything becomes about the number, the number becomes the goal, and the athlete becomes secondary.

3. Health as Reactive Instead of Proactive

This is perhaps the most consequential outcome of our evolution: we’ve started to view health as separate, or worse, as reactionary.

We treat wellness and recovery as things to consider after something goes wrong.

Soft-tissue work happens after soreness.Regeneration starts after fatigue.Medical involvement ramps up after pain.

But injury prevention, or more accurately, injury probability, is about staying ahead of problems before they occur.

Athlete health isn’t a silo; it’s the governing variable for all other systems. Yet, organizationally, it’s often the last thing we budget for, the first thing we skip, and the easiest thing to dismiss when schedules get tight. Everyone has a great (theoretical) blueprint for internal communication but consistently cites communication as a chief organizational problem. 

If the past two decades have proven anything, it’s that outputs without oversight eventually lead to breakdowns. Oversaturation of one area of the system invariably compromises other parts of the system. 

Rebalancing the System

None of this is an indictment of strength and conditioning as a profession. If anything, it’s a testament to how powerful and influential our field has become.

But with improvement comes responsibility, not just to keep pushing performance forward, but to ensure it doesn’t outpace our ability to manage it.

We don’t need to slow progress, we need to support it. We need to bring health back into the conversation, not as the opposite of performance, but as its foundation.

We’ve mastered the art of creating capacity. Now we have to master the discipline of sustaining it. Because every gain in performance brings an equal demand for better management, and that’s where the future of strength and conditioning will be won.