Beyond the orthodox/CAM dichotomy: exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine

Coveney, Catherine, Faulkner, Alex, Gabe, Jonathan and McNamee, Michael (2020) Beyond the orthodox/CAM dichotomy: exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine. Social Science & Medicine, 251. a112905. ISSN 0277-9536

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Abstract

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 the 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 heterogeneous 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.

Item Type: Article
Keywords: UK, CAM, sports medicine, therapeutic decision-making, medical pluralism, therapeutic landscapes, medical practice, qualitative research
Schools and Departments: School of Global Studies > International Relations
Research Centres and Groups: Centre for Global Health Policy
Subjects: H Social Sciences > HM Sociology
R Medicine > RA Public aspects of medicine
R Medicine > RA Public aspects of medicine > RA0001 Medicine and the state. Including medical statistics, medical economics, provisions for medical care, medical sociology
R Medicine > RA Public aspects of medicine > RA0001 Medicine and the state. Including medical statistics, medical economics, provisions for medical care, medical sociology > RA0418 Medicine and society. Social medicine. Medical sociology
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Depositing User: Alex Faulkner
Date Deposited: 07 Apr 2020 07:06
Last Modified: 07 Apr 2020 07:15
URI: http://sro.sussex.ac.uk/id/eprint/90724

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