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

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Version 2 2023-06-12, 09:26
Version 1 2023-06-09, 21:03
journal contribution
posted on 2023-06-12, 09:26 authored by Catherine Coveney, Alex Faulkner, Jonathan Gabe, Michael McNamee
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.

Funding

Emerging intersections of biomedical technology and elite sport: institutions, practices and ethics; G1160; ESRC-ECONOMIC & SOCIAL RESEARCH COUNCIL; ES/K010956/1

History

Publication status

  • Published

File Version

  • Published version

Journal

Social Science & Medicine

ISSN

0277-9536

Publisher

Elsevier

Volume

251

Article number

a112905

Department affiliated with

  • International Relations Publications

Research groups affiliated with

  • Centre for Global Health Policy Publications

Full text available

  • No

Peer reviewed?

  • Yes

Legacy Posted Date

2020-04-07

First Open Access (FOA) Date

2020-04-07

First Compliant Deposit (FCD) Date

2020-04-06

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