Verhagen Evert, McGinley Paul, McKay Carly D
Amsterdam Collaboration on Health and Safety in Sports, Department of Public and Occupational Health, Amsterdam Movement Sciences, Amsterdam UMC, University Medical Centres - Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
Medical & Anti-Doping, Football Division, UEFA, Nyon, Switzerland.
BMJ Open Sport Exerc Med. 2025 Apr 24;11(2):e002478. doi: 10.1136/bmjsem-2025-002478. eCollection 2025.
Injury prevention in sports remains a perpetual challenge, frequently hindered by linear approaches that fail to account for the complexity of real-world scenarios. We propose a paradigm shift in this perspective, framing injury prevention as a 'wicked problem' characterised by evolving, context-dependent factors and competing priorities. We suggest that while eliminating injuries entirely may not be feasible, their impact can be effectively reduced through tailored, adaptable solutions. We illustrate the practical application of this framework through a case study of Cirque du Soleil. By adopting a revised 'Sense-Think-Act' paradigm, interventions were collaboratively developed with performers, medical personnel and organisational leaders. This resulted in a 15% reduction in injuries and substantial decreases in missed performances and overuse injuries over 4 years. The success of this approach can be attributed to context-sensitive strategies that effectively balance injury risk mitigation with performance objectives. Our proposed view challenges traditional definitions of success in injury prevention, that is, developing 'optimal solutions' instead of 'ultimate solutions'. By rethinking injury prevention as a wicked problem, we nudge sports professionals to adopt flexible, sustainable practices that address the dynamic realities of their environments. Such a shift enhances injury prevention outcomes and aligns these efforts with the broader priorities of athletic communities.
体育中的伤害预防仍然是一项长期挑战,常常受到线性方法的阻碍,这些方法无法考虑现实世界场景的复杂性。我们提议在此视角上进行范式转变,将伤害预防视为一个“棘手问题”,其特点是因素不断演变、依赖具体情境且存在相互竞争的优先事项。我们认为,虽然完全消除伤害可能不可行,但通过量身定制、适应性强的解决方案,可以有效降低其影响。我们通过太阳马戏团的案例研究来说明这一框架的实际应用。通过采用修订后的“感知-思考-行动”范式,与表演者、医务人员和组织领导者共同制定干预措施。这使得伤害减少了15%,在4年时间里,错过演出和过度使用损伤大幅减少。这种方法的成功可归因于情境敏感策略,这些策略有效地在减轻伤害风险与绩效目标之间取得了平衡。我们提出的观点挑战了伤害预防中传统的成功定义,即开发“最优解决方案”而非“终极解决方案”。通过将伤害预防重新定义为一个棘手问题,我们促使体育专业人员采用灵活、可持续的做法,以应对其环境的动态现实。这种转变提高了伤害预防的效果,并使这些努力与体育界更广泛的优先事项保持一致。