In elite and professional sports there is obvious incentive to ensure athletes make a prompt and successful return to action following injury. There is a clear impetus to push the envelope in an attempt to accelerate the recovery process and minimise the time spent on the sidelines. The impressive recovery times reported with common injuries in professional sports are testimony to the success of the progressive and innovative approaches presently employed. In a ‘high performance’ setting athletes benefit from having a staff of professionals at their disposal on a daily basis to support the endeavour. Given such dedicated support it is perhaps unsurprising that athletes at the top level also show a far higher likelihood of making a successful return to their preinjury level following severe injuries such as ACL rupture, compared to what is reported with performers at lower levels of competition. The stakes involved might differ below the elite level but there are nevertheless lessons to be learned from their approach to performance rehabilitation and return to competition. In this latest offering we explore the advances in how we deal with sports injuries and consider what lessons we might adopt to improve outcomes for performers at all levels.
First Do No Harm: Iatrogenics in Coaching and Practice
Iatrogenics is a term most commonly used in medicine. As attested by the Hippocratic oath (and the premise ‘First Do No Harm’), the medical profession is familiar with the concept that an intervention may pose potential risks and unforeseen consequences. In contrast, the idea that we may either not be helping or through our involvement inadvertently making the athlete worse off does not necessarily occur to coaches and practitioners. In this post we explore how iatrogenics applies in the context of coaching and practice, and make the case for considering potential risks as well as benefits before we intervene.
Tempering Athletes: Future Proofing Versus Acquired Fragility
Tempering is a process used to impart strength and toughness, and essentially serves to bring out the intrinsic properties of the material under stress. Athletes forged in the crucible of severely testing conditions may be similarly rendered highly resilient to future challenges and stressors. Those who successfully come through such trial by fire paradoxically often prove stronger from the experience. The notion that stressors can not only make systems more resilient, but in fact stronger and better as a consequence, speaks to the concept of antifragility, a phenomenon observed in nature and highlighted by Nassim Taleb who famously coined the term. In this post, we will bring this antifragility lens, and a general reticence to accept that sports injuries ‘just happen’, to reframe how we think about preparing athletes to ‘future proof’ them to risks and scenarios that we cannot fully anticipate. In place of safeguarding measures and interventions that seek to protect, we will make the argument for tempering athletes to harness and develop their intrinsic reserves and coping abilities. Adopting this perspective and general strategy for managing injury risk, we will outline some tactics to help guide practitioners in their approach.