The Dilemma Faced by Athletes

One of my favorite reads from a few years ago (2017) was ‘The Athletes Dilemma’ by John Weston and I have just now re-read sections of it. Anyone who is working with athletes needs to read this book or at least be familiar with the issues that are addressed in the book. While the book is heavily weighted to the USA sporting context, the issues are applicable to any sport in any country and those issues are faced by all those working in sports medicine on a very regular basis.

The book does a deep dive into the length that professional athletes go to compete with little or no regard to the long term health consequences to themselves. Weston does an excellent analysis as to why they are so willing to do that. The institutions that facilitate this are also critiqued.

The risk of seeing the elite professional athletes do this is the example that they are setting for children for their sporting careers and the lengths that they may feel empowered to go to in order to succeed.

You only need to look at the historical example of sports like rugby league, particularly in Australia. It was a tough game played by tough men who seem to have the motto of ‘real men play when hurt’. The consequences of that history and attitude have been well documented, especially in recent news media headlines. The context has now changed substantially in recent years. The sports field is now the ‘office’ and occupational health issues are now being addressed as these athletes are paid for their work. That has not solved the problems or issues, especially for the ‘almost there’ athletes and the younger athletes, but has gone some way to protect the health and safety of athletes. This is obvious in the recent nature of the concussion management protocols at the professional and community sport level. There is still a long way to go.

What spurred me to revisit the book was the recent publicity given to the tennis player, Rafael Nadal and his Muller-Weiss Syndrome of the navicular in his foot. This is not a common problem and generally can be managed well if caught early and appropriate treatment started early, especially the management of the loads. Professional elite athletes need to compete to make money. Based on news media reports on Nadal’s injury, his team has been working hard on it so he could keep making money. He managed to win the Australian Open earlier this year and most recently won the French Open which given the injury is pretty awesome. However, I did read in the media that he played the final with his “foot asleep”: “We played with an injection on the nerve so the foot was asleep. That’s why I was able to play”. Whaaaaaaaaaaaat? What chance has he taken with his long term health? How much disability has he exposed his foot to? Is it going to need joint fusions in later years to walk with the associated disability with that? And more importantly what example has he set for younger athletes wanting to get to the top. As I said above, “Anyone who is working with athletes needs to read this book or at least be familiar with the issues that are addressed in the book“.

You can get the book here:
Amazon.com | Amazon.uk | Amazon.ca
FIshpond.nz
Cheaper preowned copies can be got from AbeBooks.

Postscript (September, 2023):
This study was just published, The Framing of ‘Playing Through the Pain’ in the Media: An Investigation of Rafael Nadal During the 2022 French Open, in which they analysed news reports around the local anaesthetic injections that Nadal got. They found that “The results revealed global news lacked critical coverage, normalized competing through injury under moral frames, and valorized such behavior as heroic and courageous”

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