ENS 438 Final: Final Exam Study Guide
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Department
Exercise And Nutritional Sciences
Course
ENS 438
Professor
Tinely
Semester
Spring

Description
ENS438 FINAL EXAM STUDY GUIDE ● TINLEY’S NOTES: ○ The malingering injured athlete can lead to burnout in the attending attending clinician / therapist ○ Personality characteristics can and do contribute to injury levels ○ Compression is NOT indicated in the immediate treatment of concussion ● What does Nixon have to say about being disabled in society? ○ “Disability” has a different definition in sport than in larger society ■ Can refer to persons with permanent disabilities or a category in athletic competition ■ Paradox - “disabled” in society, but abled-bodied in the world of sports ○ Impairment: a bio-medical condition, an organic or functional disorder that underlies a disability or handicap ■ May hinder the effective ability to function in the same role as unimpaired ■ Impairments are the basis for disabilities ■ The extent to which the impaired is disabled is based on the task, role, or activity ● Therefore, disability is situational ○ Being handicapped is situational ○ The relationship of one’s personal impairment and disability to their resources and environment affects the performance ○ Handicaps are like disabilities in that they are the result of how people construct environments, relationships, or roles and NOT the inevitable result of impairments ● Review key ideas on Ethics and Sports Injury ○ Moral reasoning must be: ■ Impartial ■ Consistent ■ Steeped and supported in example ■ Considering of contexts, motives, and effects ■ Moral pluralism plus ethical theory and discourse leads to reason ○ Ethical Maxims: what should guide us in our moral decisions in how sports are played ■ The Golden Rule ● How would you like to be treated? ■ The Utilitarian Principle ● Greatest good for the greatest number (not as easy as it seems) ■ Kant’s Categorical Imperative ● Action taken that could or should be law or rule of behavior (nothing is contextual) ● “Act only according to that maxim… which should become universal law” (10 Commandments?) ■ The Professional Ethic ● Actions taken that (lead to injury) would be considered proper or improper by a disinterested panel of professional colleagues ■ The TV test ● Would i feel comfortable explaining a national audience about the action? ○ Allows self-deception, but is founded in “positive character building” ● What are some of the media influences on sports injury, illness, pain and rehabilitation? ○ The portrayed sports and athletes become more well known ○ Illustrates pain and drama ○ Effects our “stake in content” ○ Attract sponsors / increased viewership ○ Relates to our own humanness ■ Coverage privileges men over women ■ Heterosexuality is assumed, homosexuality is mostly erased and ignored ■ Coverage reproduces dominant ideas about manhood, but may challenge ideas about femininity ● Review our lecture on PED use in sport and its influence on sports injury and illness. ○ Substance abuse constitutes a form of deviant over-conformity to the Sport Ethic ○ Such substances will be used as long as athletes believe they enhance performance and enable athletes to remain in the game they love ○ Drug Use & Deviant Overconformity (Jay Coakley) ■ Banned substance use remains high in sport ■ Occurs in context of young athletes looking to become “elite” (shifting definition) ■ PED use does not exist in a vacuum ■ Motives vary from skill development to body image to competitive readiness to moral challenge ■ Rarely used in consideration of general health and well being ■ Social influences include coaches, media, sponsors, family, peers, and teammates ■ PED use has an understudied relationship with sports injury rate → why? ● Four “prolympic” expectations of elite athlete associate with normative PED use and high injury rates ○ Dedication to the game ○ Strives for distinction ○ Accepts risks and plays through the pain ○ Will overcome all obstacles in pursuit of excellence and other possibilities ○ Why is substance use in sport so prevalent today? ■ The visibility and resources associated with sports have fueled massive research and development efforts, and increased the availability of substances ■ People are fascinated with technology and want to use it to push human limits ■ The modern rationalization of the body influences how people see the mind-body relationship ■ There’s a growing emphasis on self medication ■ Money ○ Nutritional aid ■ Nutrients designed to increase physical power, mental strength, or mechanical edge ■ Example: protein supplements ○ Physiological aid ■ Designed to increase natural processes to increase physical power ■ Example: blood doping ○ Psychological aid ■ Designed to enhance psychological processes during sport performance to increase mental strength ■ Example: hypnosis ○ Mechanical aid ■ Designed to increase energy efficiency ■ Example: running shoes ○ How to control? ■ Test, educate, and alter the culture of winning ● What are the roles of stress and personality/behavioral factors on levels of sports injury, illness, pain, and rehabilitation? ○ Daily hassles are more strongly related to injury and illness than life stress ● What are the values to using the humanities to study some aspects of sports science? ○ Bioscience can tell us what IS the case ○ Humanities can tell us what OUGHT to be done about the case ○ Can’t work alone → always a two way street ● Know what cognitive appraisal, and distortion are and how they work in the psychology of sports injury and rehab. ○ Cognitive Appraisal ■ Athlete thinking about what has happened and what are their tools to overcome what has happened to them ● Everyone responds to injuries differently ● What is a malingering athlete and what can be done in knowing how to treat them? ○ Malinger = to pretend incapacity (as illness) so as to avoid duty or work ○ Conscious Malingering ■ Athlete who intentionally lies about an injury (or symptoms of an injury) for purposes of secondary gain ■ Other deceptive ■ Adaptive reaction to adverse circumstances ■ Usually because of need for attention and fears ■ Background ● Greatest need = attention; greatest fear = getting caught ● Learned behavior from parents, friends, other athletes, coaches ● Immunity from punishment ● Often spoiled in early years (lying and deception allowed ● Have a history of deceiving and exploiting others ■ Detection ● External incentive ● Narcissistic behavior (self-centered) ● Avoidance behavior ○ Eye contact ○ Talking about specifics ○ Does not keep appointments ○ Etc. ● Denies responsibility of arising from absence ● Inconsistent behavior ● Lack of emotional response to injury ● Lack of cooperation ○ Subconscious Malingerer ■ In an attempt to repress unacceptable desires / wishes, underlying energy gets directed towards somatic symptom ■ “The functional capabilities of an organ or systems become seriously compromised or completely inhibited despite the system / organ’s structural integrity” ● Self-deceptive ● Diagnosed by qualified personnel after authentic pathology has been ruled out ■ Symptoms of referral ● Do i recognize / know how much about his problem? ● Am i the appropriate resource? ○ Treatment ■ Develop a relationship and use active listening skills, particularly empathy ● May be challenging because you have little respect, like admiration for them ■ Malingering will continue only if it produces secondary gain (fear avoidance vs. attention) ■ Confront in a non-accusatory fashion ■ Give strictly defined boundaries and agree on goals ● e.g. athletes who cannot practice for 2 days prior to a game will not play, regardless of talent ■ Reward desired behavior, withhold reward for undesirable behaviors ■ Open the “need to know” circle (use referral) ● Know what we said about “kinds of pain.” ○ Pain plays a central role in an athlete’s life ○ Pain = sensory input (nociception) + subjective interpretation ○ Self-reported pain is always a reflection of biological events and interpretation ○ Cognitive distortions and pain ■ Catastrophizing? ● “Muscles tearing apart” vs. “tightness” ■ Personalization? ● “Like being stabbed with a knife” vs. “stabbing pain” ○ Observational measures of pain ■ Facial? ■ Vocal? ■ Gestural? ■ Postural? ○ Factors affecting pain perception ■ Personal factors ● Age and sex ● Pain history ● Coping skills ● Personality ● Perception and tolerance ■ Medical factors ● Amount of tissue damage ● Treatment ● Medication ● Skills of sports medicine team ■ Sociocultural influences ● Ethnic norms for pain expression ● Social support of friends, family, team ■ Sport context ● Pain expression norm for sport ● Sport situation winning / losing, championship game ● Importance of athlete ● Read Weinberg and Gould. ○ Athletic Injuries and Psychology ■ What are the psychological factors that play a role in sport injury levels? ● Personality factors ● Predisposed attitudes toward challenge ● Stress levels ■ What are the strategies for coping with injury-related stress? ● Have a balanced attitude toward sport ● Develop and use proper skills ● Reduce stress by… strategies ■ Which other factors are included in the stress model of sports injury? ● Perception of threat ● History of stressors ● Distractors ● Social support ● Misc. coping resources ■ What do the number of sport related injuries tell us? ● Injuries in sport is on the rise ● Sport is less violent ● Sport reflects social changes ● Science and technology have NOT had a profound effect on the safety of athletes ■ How do sport injuries happen? Relationship between stress and injury ● Attentional disruption ● Increased muscle tension ● Social influences (peer pressure, overbearing parents and coaches) ● All of which make the athlete prone to injury ● Read Young and White. ○ Threats to Sports Careers - Young and White Interview athletes and discuss ■ Hidden Pain ● Athletes deny the pain ● Suppressing physical and mental impact on the body ● Willingness to conceal pain ● Athletes blatantly ignore pain on the field and pass it off to teammates, coach, as if it’s not there → largely due to social pressure ■ Disrespected Pain ● Injury tolerance is possible because of an attitude of disrespect toward pain ● Differentiating pain from injury ● Often require prescription drug treatment and even surgery ● Female athletes also feel irreverent, even indignant about pain ● Coping mechanisms include denial and pain killers ● Block out pain ● Athletes use drugs / painkillers to deal with short-term sensation / block it out, but it doesn’t help fix the problem in long-term ■ Unwelcomed Pain ● The rules of masculinist sports culture also require that intense pain is controlled and masked ● Apparent negligence of those surrounding the athlete ● Being hurt appears to be unwelcomed by coaches ● Being hurt is seen as an inconvenience ● Female athletes concealed pain to avoid alienating teammates and coaches ● Athletes disciplined after quitting from an injury ● Teammates, coaches, family, friends react poorly to athlete in pain; doesn’t help the healing process ■ Depersonalized Pain ● Injury = bodily betrayal ● Injured parts referred to as objects ● Injured body part was not their own ● Athletes were humbled, even embarrassed, by the vulnerability of their bodies ● Athletes view their body instrumentally ○ They, the person, become detached from their pain and their body, so they don’t care about playing with pain ● Review all of our lectures on disengagement and retirement from sport. ○ Disengagement ■ The process of leaving sport or withdrawing from the role of sport competitor due to ● Cut (eliminated from the team) ● Injury / illness ● Age ● Voluntarily - for other reasons ○ Common themes experienced by most injured / retiring athletes ■ Loss of identity ■ Separation from “the crowd” (LOSS OF COMMUNITY) ■ Problems in relationships with others ■ Obesity and other health problems (LOSS OF BODY) ■ Aborted attempts to recapture lost status in non-athletic contests (LOSS OF STATUS) ○ “The Looking Glass Self” ■ Crowd is a “mirror” into which the athlete gazes ■ Mirror cracks with injury and disengagement ■ Feels alienated, isolated, and disconnected ● What do Jirasek and Hurych have to say about pain and suffering in sports injury? ○ Agon in Society ■ The process of challenge, interpersonal rivalry, and the endeavor to achieve victory through competition ■ Competition has been a social construction since pre-history and feudal periods ■ Parallels between sports and war ■ “Agon” extended beyond sports is not only competition, but the killings of one’s opponent ■ “The wish to fight, to find the best, is a constitutive aspect of personality and society” ■ The agon motive has shifted to symbolic death, often in and through sports ■ “The most important part from these symbolic forms of agon motive is found in sports” ■ Pain is an authentic part of the war agon ■ Seen in Homer and seen in modern day sports cliches ■ We suffer through training in preparation of war or war-like scenarios ○ 4 principles on the purpose of pain in sports ■ A sign of one’s training ■ A sign of maximum exertion to reach top achievement ■ A sign of substantial component of a specific sport ■ A demonstration of lost sports authenticity (when pain = loss of participation) ■ Pain as a physical phenomenon ■ Pain validates and connects the mind / body continuum ■ Pain is not just a cause and effect relationship, but subject to “the consequence and product of historical, cultural, and social conditions” ■ Pain as a meaningful phenomenon ■ We find meaning in our lives in and through the ways (and details of ) how we experience pain and suffering ■ Pain and suffering: a training regime and a way of living ■ How can we feel we are well enough prepared unless we have suffered? ● As soldiers? As athletes? As students? As workers? ● Why does an athlete’s opinion in healing a sports injury matter? ○ Helps them get invested in their rehabilitation process in order to buy in ○ Gives them a sense of ownership and control ● Review the psychosocial aspects of sports rehabilitation. ○ 5 Stages of Grief: an athlete may experience these post-injury ■ Denial: “I’m not that hurt” ■ Anger: “Damn, this sucks!” ■ Bargaining: “Okay, I’ll work on my other areas” ■ Depression: “Why do I feel sad about being hurt?” ■ Acceptance: “Okay, I’m mortal. Now how do we fix this and get on with my life?” ○ Common responses to injury ■ Disbelief ■ Fear ■ Rage ■ Depression ■ Tension ■ Fatigue ■ Rehab ○ Sociological effects of injury ■ Pressure from coaches, teammates, family, and media to return sooner than prudent ■ Due to need to win, financial demands over involvement of community, success ideology, additional psychological stress
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