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Research into injury prevention in circus also useful for sports


by Frank Molema | 12 December 2019

When studying injury prevention at Cirque du Soleil, human movement scientist Evert Verhagen of the Amsterdam UMC reached an important conclusion: giving people freedom motivated them to come up with solutions to problems. "It changes the perception of injury prevention."

XL39EvertVerhagen-1 copyCirque du Soleil had a problem: although the circus could patch up injured artists, they had no knowledge of injury prevention and its implementation. That is why some years ago the circus came to the Amsterdam Collaboration on Health and Safety in Sports (ACHSS), an initiative that brings together scientists in athletic health.

Common ground with sport
Evert Verhagen, chairman of the ACHSS on behalf of the Amsterdam UMC, was positive about Cirque du Soleil's request. He saw the similarities with sport: circus artists too try to deliver optimal performance with their bodies. "But when I saw a show for the first time, my first thought was: ‘it will not be easy’, says Verhagen, looking back on when he began his study.

He continues: “Cirque du Soleil is just very different. In football or volleyball, all members of the team have similar roles: they either run after the ball or hit the ball. At the circus, there are fifty performers who all have different roles. What’s more, every show is different. And that for two shows a day, five days a week. "

"All we have done is adjust the mindset"

Reactive action
Verhagen and his colleagues nevertheless succeeded in reducing the number of injuries in the circus. Thanks to a shift in culture, according to the researcher. “The only thing we have done is adjust their mindset. The attitude towards the performers used to be very reactive. 'Come and see us if there is something wrong', was the idea. Managers, too, took a reactive stand, so the employees took little initiative. They stuck to the bare essentials.’

CirqueDuSoleil-1Verhagen decided to tackle this way of thinking. For example, he gave physiotherapists more freedom and asked them to reconsider certain things. "They have the knowledge, because they have the training", Verhagen explains. “When it comes to implementing preventive measures, the best trainers and physios rely on their gut feeling: critical common sense. Many others will shy away from this, but at least you can ask them to think about it. Then you see them get motivated, and make good points. And that leads to solutions."

Injury prevention as a complex system
By changing the way of thinking of team supervisors, board members, fitness trainers or physios, Verhagen hopes that they will incorporate injury prevention into their work as a matter of course. This is possible not only in a company such as Cirque du Soleil, but also in a sports club.

The conclusion from the research at Cirque du Soleil is that 'systematic thinking' can be applied to understand injury prevention as a complex system. The researchers would like to clear up a common misunderstanding. “Many people think: A leads to B. If I remedy A, B will be resolved, but it is not that simple. A and B are linked to all sorts of other factors. If you change one thing, you change much more."

Systematic thinking
According to Verhagen you have to take a closer look at the whole context of an athlete: in other words: the entire system. Little pin pricks can be an indication of much more than one big arrow. Every stakeholder, directors or coaches, for instance, all have a responsibility and can make contributions from their own roles within the system.

"Do not focus on the athlete, but rather on the people around the athlete. It will change your view of injury prevention"

Verhagen will not easily forget the Cirque du Soleil study, and what he has taken away from it. “The question is: how do you get people to come up with solutions of their own? How can you package a message in such a way that it becomes their own? Instead of always presenting them with exercises or programs, they should take the initiative. Freedom inspires solutions. Do not focus on the athlete, but rather on the people around the athlete. It will change your view of injury prevention. I do not know yet how we can operationalize this, that is something for the future.”

For more information: From the safety net to the injury prevention web: applying systems thinking to unravel injury prevention challenges and opportunities in Cirque du Soleil (pdf)

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