Where biomedicalisation and magic meet: Therapeutic innovations of elite sports injury in British professional football and cycling (original) (raw)
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Social Science & Medicine
Elite athletes face extreme challenges to perform at peak levels. Acute and chronic musculoskeletal injuries are an occupational hazard while pressures to return to play post-injury are commonplace. Therapeutic options available to elite athletes range from novel 'cutting edge' biomedical therapies, established biomedical and surgical techniques, and physiotherapy, to a variety of non-orthodox therapies. Little is known about how different treatment options are selected, evaluated, nor how their uses are negotiated in practice. We draw on data from interviews with 27 leading sports medicine physicians working in professional football and cycling in the UK, collected 2014-16. Using idea of the 'therapeutic landscape' as a conceptual frame, we discuss how non-orthodox tools, technologies and/or techniques enter the therapeutic landscape of elite sports medicine, and how the boundaries between orthodox and non-orthodox therapy are conceptualised and navigated by sports medicine practitioners. The data provide a detailed and nuanced examination of heterogenous therapeutic decision-making, reasoning and practice. Our data show that although the biomedical paradigm remains dominant, a wide range of non-orthodox therapies are frequently used, or authorised for use, by sports medicine practitioners, and this is achieved in complex and contested ways. Moreover, we situate debates around nonorthodox medicine practices in elite sports in ways that critically inform current theories on Complementary and Alternative Medicine (CAM)/biomedicine. We argue that existing theoretical concepts of medical pluralism, integration, diversity and hybridisation, which are used to explain CAMs through their relationships with biomedicine, do not adequately account for the multiplicity, complexity and contestation that characterise contemporary forms of CAM use in elite sport.
Sport Education and Society, 2018
Sociological investigations into the athlete-medical practitioner relationship are scarce due to medical bias for positivist epistemologies. The aim of this research was to identify the scope and purpose of medical interventions for four athletes, within the context of social processes that enable medicine to claim athletic bodies as objects of practice and performance. The role and function of power in the athlete-medical doctor transaction and athlete embodiment were also of interest. Using a story-analyst approach grounded in narrative analysis, the ideologies of 'slim to win' and 'performance' were identified as the impetus for the athletes seeking the expertise of doctors. Doctors were positioned as accomplices in 'slim to win' and 'performance' ideologies within the athletes' stories, which influenced medical practices and compromised athlete health. Disciplinary power was enacted when the doctors observed, corrected and manipulated the athletes' bodies through medical practice. Athletes also had agency through renegotiating the meaning of the 'treatment' process by reconfiguring medical doctor's disciplinary power as forms of empowerment knowledge. This research highlights the complex nature of the athlete-medical doctor transaction and how these encounters can be productive and oppressive for athletes.
Medicine, Sport and the Body: A Historical Perspective - Chapter 2: This Sporting Life
In 1897 American college football was experiencing one of the earliest of its episodic crises due to a growing death toll of players. The whole issue was sensationalized in the newspapers as part of a circulation war. On 14 November one page of the New York Journal and Advertiser gave graphic details, including illustrations of the injuries -a broken backbone; concussion to the brain; and a fractured skull -sustained during games by three players who had died.
Athlete healthcare behaviour: an ethnographer's methodological conundrum
Medical Conference Papers, 2009
Behind every consumer's decision about utilizing health care products and services are their perception of health and illness (Hughner, 2008). Such lay understanding affect consumers' health behaviour and health outcomes (Moorman & Matulich, 1993); it also determines the choice and efficacy of conventional versus complementary and alternative medicine (CAM) products and services (Hughner, 2008). This paper examines these choices amongst a group of competitive athletes, specifically swimmers Competitive athletes operate in a unique social environment that may result in a culture that is different from the general population. As such this may influence the athletes' beliefs, motivations and impact on their health-seeking behaviour regardless of whether they are seeking help for an existing problem, for the prevention of problems, or for performance enhancement in their sport. seriously helpful in addressing the complex way in which drug use begins, is sustained, or stops (Backhouse et al., 2007).There is even less understanding of motivation for CAM use in athletes. It is this aspect of athletes CAM choices that is the focus of this paper. Any attempt to understand why competitive athletes seek CAM thus presents unique challenges to the researcher: it requires an understanding of health-seeking behaviour in the general community; the cultural norms of competitive athletes as a group; the perception of CAM and doping in the athlete community; the background knowledge of conventional medicine and CAM. There is also a need for the researcher to have a strong rapport with the informants and be trusted. As such it lends itself to ethnographic study. The skill set offered by the research team further supports this decision. The primary researcher is an elite athlete, an international swimmer, who is a practicing Doctor of Medicine with qualifications in Sports Medicine. He is supported by a team that includes a practitioner/academic in Chinese medicine; a specialist in politics and sport; and a qualitative researcher.
The rise and fall of the magic sponge: Medicine and the transformation of the football trainer
Social History of Medicine, 23 (2), pp. 261-279. , 2010
"Sports medicine has been largely neglected by historians. This article examines the devel- opment of the role of the football trainer from 1885 to 1992, placing it in the wider context of the shifting relationship between orthodox and unorthodox medicine. It is underpinned by two interde- pendent arguments. First, it can be argued that the origins of football trainers can be traced to unorthodox alternative medicine; their role developed largely outside a regulatory framework imposed by the medical profession despite attempts to marginalise irregular healers and practitioners of alternative medicine. Secondly, it is claimed that the treatments, practices and working conditions of trainers were shaped by the sub-culture of professional football, and were an amalgam of the uneven adoption of contemporary biomedical principles and scientific developments, especially in physiotherapy, and the persistence of traditional methods. "
Qualitative Research in Sport, Exercise and Health, 2014
This paper examines how the medical and non-medical skills of physiotherapists enable members of the profession to become central agents in the multidisciplinary teams (MDTS) which dominate sports healthcare. Drawing on empirical data derived from interviews with sports physiotherapists and doctors working in UK Olympic sport MDTs, this article argues that the role and influence of physiotherapy in elite sports healthcare can be explained in relation to physiotherapy's working practice traditions and the degree to which these traditions correspond to their specific patients' demands. Drawing on concepts such as medical dominance and relative practice autonomy drawn from the sociology of medicine, the paper argues that extended time, close physical contact and opportunities for experiential learning foster physiotherapist-patient mutuality, locates the physiotherapist as an inherent part of the recovery process, and leads to trusting and collaborative healthcare relations. The practice traditions of physiotherapy enable these practitioners to respond flexibly to the particular demands of elite sports clients, intertwining athletes' performance orientation with physiotherapists' treatment through blurring the boundary between healthcare and sports training. Physiotherapists thus become seen as 'useful' in the eyes of the clients who shape the demand for healthcare delivery in elite sport.
Towards a Discernable History of Sports Medicine
Canadian Bulletin of Medical History/Bulletin …, 2011
Abstract. Elite sport and the structures that support it such as sports medicine are increasingly at the forefront of public consciousness, especially when the Olympic Games come to town, or soccer players, their bodies fine-tuned by an ever growing array of ...
BMJ Open Sport & Exercise Medicine, 2021
While society watches athletes and artists on a screen during the COVID-19 pandemic, some proponents tout ‘normalcy’ as the moment live in-action play resumes again. However, when we ‘see’ these athletes, are we truly seeing them? Failing to understand and address athletes’ adversity faced during this pandemic amidst social pressures to return to play under a preconceived notion of ‘normal’ commoditises athletes; instead, we must humanise them while recognising additional burdens they bear amidst unmet healthcare needs. Athletes and performers represent a unique population; they stand at the intersection of racial and socioeconomic health inequity and societal expectations for entertainment. Returning to the field or stage suddenly, unscathed by effects of global viral and racial pandemics, is impossible. Instead, athletes face resuming play with a sobering realisation the pursuit of health is not fulfilled with the same tenacity for everyone. This editorial is to raise awareness to...