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Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine
Catherine Coveney,
Alex Faulkner,
Jonathan Gabe,
Michael McNamee 
Social Science & Medicine, Volume: 251
Swansea University Author:
Michael McNamee
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DOI (Published version): 10.1016/j.socscimed.2020.112905
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,...
| Published in: | Social Science & Medicine |
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| ISSN: | 0277-9536 |
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2020
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| URI: | https://cronfa.swan.ac.uk/Record/cronfa53735 |
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2021-01-14T13:42:16.6704067 v2 53735 2020-03-04 Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine 85b0b1623e55d977378622a6aab7ee6e 0000-0002-5857-909X Michael McNamee Michael McNamee true false 2020-03-04 STSC 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. Journal Article Social Science & Medicine 251 0277-9536 UK, CAM, Sports medicine, Therapeutic decision-making, Medical pluralism, Therapeutic landscapes, Medical practice, Qualitative research 1 4 2020 2020-04-01 10.1016/j.socscimed.2020.112905 COLLEGE NANME Sport and Exercise Sciences COLLEGE CODE STSC Swansea University 2021-01-14T13:42:16.6704067 2020-03-04T15:24:29.7961606 Faculty of Science and Engineering School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences Catherine Coveney 1 Alex Faulkner 2 Jonathan Gabe 3 Michael McNamee 0000-0002-5857-909X 4 53735__16861__d08c3e972d6f4a4aabfe62b8de653452.pdf 53735.pdf 2020-03-17T09:43:13.9913239 Output 272498 application/pdf Version of Record true Released under the terms of a Creative Commons Attribution License (CC-BY). true eng https://creativecommons.org/licenses/by/4.0/ |
| title |
Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine |
| spellingShingle |
Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine Michael McNamee |
| title_short |
Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine |
| title_full |
Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine |
| title_fullStr |
Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine |
| title_full_unstemmed |
Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine |
| title_sort |
Beyond the orthodox/CAM dichotomy: Exploring therapeutic decision making, reasoning and practice in the therapeutic landscapes of elite sports medicine |
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85b0b1623e55d977378622a6aab7ee6e |
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85b0b1623e55d977378622a6aab7ee6e_***_Michael McNamee |
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Michael McNamee |
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Catherine Coveney Alex Faulkner Jonathan Gabe Michael McNamee |
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Journal article |
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Social Science & Medicine |
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251 |
| publishDate |
2020 |
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Swansea University |
| issn |
0277-9536 |
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10.1016/j.socscimed.2020.112905 |
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Faculty of Science and Engineering |
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School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences{{{_:::_}}}Faculty of Science and Engineering{{{_:::_}}}School of Aerospace, Civil, Electrical, General and Mechanical Engineering - Sport and Exercise Sciences |
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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. |
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2020-04-01T04:06:50Z |
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11.037166 |