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Exploring the psychological aspects of sport injury
Exploring the psychological aspects of sport injury

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3 Professional boundaries in sport and exercise psychology

In this course you are specifically interested in examining the psychological aspects of sport injury. Therefore, as you explore the roles that different people take on within a multidisciplinary support team it is important that you address the question of whose role it is to provide sport and exercise psychology support to the injured person. This may seem a simple question at first, but as you start to examine the case study with Travis’s experience you will see that it is not quite as straightforward as it first appears.

Activity 4 Whose role is it to provide sport and exercise psychology support?

Timing: Allow about 20 minutes

In this activity you will meet Lydia, a physiotherapist, who is helping Travis with his treatment, and Wilma, Lois’s coach.

1. Read the paragraph below about Travis and decide how his physiotherapist Lydia should proceed.

Case study: The role of Travis’s physiotherapist

Travis is currently undergoing treatment for his rotator cuff injury with a local physiotherapist, Lydia. Lydia has recently read a paper about the psychological aspects of injury and is concerned that Travis isn’t coping with his injury very well. She feels that he would benefit from using some sport and exercise psychology interventions such as imagery and relaxation techniques.

Other than Lydia and his personal trainer, Travis isn’t being supported by any other professionals. The clinic Lydia works at doesn’t employ a sport and exercise psychologist and Lydia is unsure whether she should talk to Travis about how he’s feeling and recommend some psychological techniques for him to try.

A woman in a light and airy room perches on a couch covered in towels.
Figure 5 Travis’s physiotherapist, Lydia
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2. If you hold a role in sport and fitness (e.g. coach or instructor) think about how you would deal with an injured athlete/exercise participant who you feel is not coping very well with sport injury and would benefit from sport and exercise psychology support. What do you think your role would be in the process? How would you support the injured person? What would you do?

If you don’t hold such a role, try to imagine what Lois’s coach Wilma would do.

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  1. Sport and exercise psychology support should be provided by a qualified sport and exercise psychologist. In the UK only those registered with the Health and Care Professions Council (HCPC) are legally allowed to use the title ‘sport and exercise psychologist’. You can check whether a sport and exercise psychologist is registered through the ‘check the register [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] ’ section of the HCPC website. That doesn’t mean that other people such as coaches, instructors and sports therapists can’t integrate an awareness of sport and exercise psychology into their practice, however.

    Lydia’s dilemma indicates the difficulties that some practitioners face in identifying where the professional boundaries lie with regard to sport and exercise psychology. Lydia has rightly identified that sport and exercise psychology support is an important part of the injured person’s rehabilitation programme and in line with the biopsychosocial approach she is taking a holistic approach to treating Travis. She is, however, not qualified to prescribe psychological strategies to aid his rehabilitation and should avoid doing so. She should refer him to a sport and exercise psychologist to do that.

    As a physiotherapist working in sport it would be beneficial for her to develop links with a local sport and exercise psychologist (Heaney et al., 2015). Whilst Lydia is not qualified to deliver sport and exercise psychology support to Travis she can still deliver what Heaney (2006) terms ‘frontline’ psychological support, which could involve social support e.g. listening to Travis talk about how the injury is making him feel.

  2. Here’s what Lois’s coach Wilma had to say:
Case study: The perspective of Lois’s coach Wilma

When Lois first got injured I could see that she was struggling to cope. She was saying lots of negative things about her future in athletics and I could see that becoming a barrier to her recovery. I saw my role as trying to be positive about the injury and to motivate her. I felt it was really important for her to talk to a sport psychologist, so I encouraged her to do so because I’m not an expert in that area.

A woman in athletic gear stands on a racetrack in front of a hurdle.
Figure 6 Lois’s coach, Wilma

I was really pleased that the sport psychologist wanted to talk to me because then we could work together to support her – I was able to reinforce the things he was doing with her and vice versa. I think I learned as much from him as Lois did! I have a really close relationship with Lois as I’ve coached her for seven years and she looks to me for support and guidance, so my job is to listen to her and offer her support and to let her know that I still value her. To keep her motivated I get her to come to the track to do her rehab exercises at the same time that the rest of my group train – that way she still feels part of the group. I also encourage my other athletes to talk to her about how she’s feeling since some of them have been through injuries before so understand what she’s going through.

(Wilma, Lois’s coach)

Wilma’s comments emphasise the important role that coaches and others play in providing social support to the injured person, something you will explore later in the course.