Injury Perception

INJURY PERCEPTION

When is an “injury” an “Injury”?

Or would that be better phrased when is a “niggle” or an “ache” an “injury”?

It is not uncommon for a new appointment to come up, and through the discussion of the case, there usually has been a tipping point as to why this person has sought treatment at this time. It can be the upcoming overseas trip, a pending new arrival to the family or the approaching season on the sporting calendar and many other reasons. In a lot of cases, the symptoms of the injury have not changed all that much over the preceding days/week however the circumstances surrounding the person has and hence the motivation to resolve the issue has changed. The perception of this injury has changed.

Recently I was following a live tweet of the Salzburg Sports Physiotherapy Symposium (SSPS) and the idea of injury perception was discussed. The discussion focused around the idea of time loss and the idea that people (or in the case of the presentation, the athlete) only consider something an injury when it impacts on performance and thus impacts on participation or involvement. Take a look at the following image showing part of the presentation.

In relation to an athlete, injury and performance are clearly defined and obvious with a clear link to ability and participation, however I think the lines get blurred when we discuss injury over a generalised population due to the variety of circumstances that are inherently changeable, to summarise, consideration of an injury is a matter of circumstance and those circumstances are always changing. (That ankle might feel really sore when it comes to taking the bins out however it doesn't feel so bad when kicking the football with the kids in the backyard)

The first aspect of this chart, - Impact on performance - across a generalised population Is variable from person to person depending on circumstances and can mean many things from our ability to work and complete tasks, our involvement with family activities and the ability to look after them to our overall enjoyment in our day to day lives. Performance is very much an athlete driven word there, if we change that to impact on daily living, it becomes a lot more relatable.  

The importance of an event is going to impact on how we perceive an injury. For an athlete this could be the difference between a regular season match or a finals game. When applied to a general population we can discuss - for instance - taking a day off work due to injury could be deemed suitable when workload is quiet but taking the day off when there is a full schedule of important meetings and so on involved,in this event the injury takes a back seat.

When it comes to self management it is a goal of mine and all the Osteopaths at Rockhopper to help people into the best position to manage their own bodies. The physical component of injury is obviously a focus point for us and our management of your injury will come in various forms from hands on in clinic treatment to out of clinic directives such as stretches, exercise programs, educational content.

However self management doesn't always mean management in isolation or on your own. A key component of self management is being able to discern when the need for follow up treatment or additional help is required. As shown in the image way up the top of this page, a key aspect of perception is understanding and if we can identify and understand an injury that will change how we perceive it and put us in a much better position to manage it now and also in the future.

So, with all the discussion here, I'd make a few changes to this chart and present it as shown below.