Project Conclusions and Recommendations (Draft 1)

Research questions and professional goals

In completing this project, my overarching aims were to better understand the psychological impact of chronic and overuse injury in dancers and to explore whether or not intensive physiotherapy can alleviate not only the physical but also the psychological impact on the dancer and more specifically to answer the following:

  • What are the possible negative psychological impacts of injury on the dancer?

Following a thematic analysis it became clear that frustration and upset were the biggest psychological effects. Frustration in particular coming up many times throughout the questionnaire and interview responses.

  • Are there any positive psychological impacts of chronic and overuse injury on dancers?

Dancers reported feeling motivated by their injury following the physiotherapy but not necessarily when the injury first took place and before they undertook medical treatment.

  • How do these potential psychological impacts manifest in the dance studio environment?

All the injuries which my participants had prevented them from dancing so this question became null and void.

  • What can be done to limit any negative psychological impacts of injury on dancers?

Physiotherapy came out as a positive way to limit negative psychological impacts.

  • Does physiotherapy make a difference to how young people cope with the psychological impacts of injury?

In this study the overall results showed yes it did making students feel “a lot more confident because I knew that it helped me so I was a lot more confident with my dancing”, “it made me more motivated to get back up and dance”, “I feel that physio definitely did help in a sense because if I didn’t have it it would probably have taken a bit longer for my ankle to get better”, “I could see and feel that I was making good progress and so I felt like I was on the right track and would eventually get better” and “you had someone there to help you and show you things. She gave you things that would help and told you like if you do this this might make you feel better. I suppose it did (help).”

To return to my overarching aims,

  • To better understand the psychological impact of chronic and overuse injury in dancers
  • To explore whether or not intensive physiotherapy can alleviate not only the physical but also the psychological impact on the dancer

I feel that I understand more clearly the specific issues arising from dance injury and believe that yes, intensive physiotherapy can help to alleviate both physical and psychological effects on the dancer.

 

Designing and delivering meaningful learning experiences

Having the physiotherapy sessions was ultimately a valuable experience for the dancers as without the sessions they may have struggled for longer with their injuries, they may not have known or considered having physiotherapy to help them with their injuries and they may therefore have suffered for longer with both the physical and psychological difficulties which arose from their injuries. Students were therefore able to get back into the studio more quickly to prepare for competition and examinations.

The questionnaires and interview questions allowed an opportunity to use literacy skills of reading and talking and to develop a knowledge an understanding of more complex vocabulary. An interview scenario can build confidence and allowed students to be analytical in their responses, going beyond simple yes and no responses and instead having to analyse and evaluate why they believed things to be so.

This is all valuable education and experience for young people.

 

Supporting learners in their development

It is the duty of all teachers to support their learners and encourage and aid them in their development. In this instance support was made available from the outset and was made clear to participants in my oral explanation and written information sheet which made clear that participation was entirely on a voluntary basis and they had the right to withdraw their consent or discontinue participation at any time. They could leave any responses on the questionnaires blank and did not have to answer the interview questions.

I was in close contact with the physiotherapists throughout the process who provided their own clarification and support as per company policy.

During the interviews some students did not understand particular questions and I differentiated and reworded them as a form of support.

 

Assessing and providing feedback to learners

There was no formal assessment involved with my project. Feedback to learners will have come from the weekly sessions with the physiotherapist who will have reported on progress made week-by-week and work to be conducted at home to support what was happening in the clinc. This would have been a potential area for further study to see, for example, if there was a particular number of sessions where impact started to be seen, however, given the small-scale nature of the study I was not privy to any feedback given to the learners at this stage.

 

Engaging in a meaningful development of your knowledge and skills in research, effective pedagogy and evaluation of your professional practice

One of my personal aims in completing this project was highlighted in my project proposal and was to ‘Develop my own research and project management skills.’ From the beginning to the end of the project there have been opportunities to develop a piece of work which took account of our prior knowledge from the course but stretched us to provide a more thorough and complete project.

Before starting the research project I felt confident in some areas such as study of literature but some parts were completely new to me such as completing an ethics form and the relevant forms to go along with it, conducting small scale research and analysing results to the degree required. I have learnt much from the process and if asked to complete something similar again would have a timeline and structure to support this.

In terms of my own teaching practice, although I expected physiotherapy would alleviate some of the psychological difficulties related to dance injury, it was not something as a dance teacher I felt in a position to recommend. That was for medical professionals. Although to a degree this is true part of my prior research suggested that medical professionals and dance teachers need to work much more closely together and enhance their awareness of negative psychology in treatment to prevent or reduce injuries (Kerr et al, 1994). Dance teaching is still a relatively new practice in secondary schools and as such schools need to be open to the new practices which may come with this new subject area. In my outside school teaching experience I would never question whether I should or should not recommend a medical treatment such as physiotherapy but somehow because we are primarily secondary school teachers  we feel nervous about perhaps recommending something that could be seen as outside our knowledge set. As my knowledge set has now been improved and backed up my the evidence from this project, however, I think it is important to feel confident in outlining the potential positives physiotherapy could have.

I acted professionally throughout this project and will continue to do so in both a research and teaching context. Teachers have a requirement to be continuously learning and improving and conducting research such as this provides opportunities both to improve as learners and as teachers with potential for research work to aid dance teaching in schools which is still undergoing great change.

 

Recommendations

There are three groups of people who I feel would gain value from this project: dancers, dance teachers/schools and physiotherapists. I would therefore make the following recommendations to each group:

Dancers – Dancers need to understand that, like sport, injuries are part and parcel of their lives but can have a damaging effect on both their physical ability to perform and their psychological ability to get better. Dancers should see physiotherapy is a potential treatment option which if sought quickly could support recovery by easing frustrations and stress around the injury and support dancers with exercises they can do to improve themselves on a daily basis. Although physiotherapists do not offer psychological services it cannot be denied that the work they do can be both motivating and progressive in terms of getting dancers back on track.

Dance Teachers – Need to understand that given we look after the whole wellbeing of the child recommending medical practices such as physiotherapy can have a positive impact on all aspects of the dancer’s recovery.  It is startling how negative injuries can make people feel  supported by both my own study an renowned researchers Mainwaring, Krasnow and Kerr who say “dancers’ reactions to injury involve initial negative affects that may become more positive as the injury heals”, therefore teachers (and schools) should feel confident in recommending physiotherapy as a treatment option.

Physiotherapists – Should be aware of the psychological impact their treatment can have and work closely with dancers and dance teachers/schools to limit any negative impact injuries might be having. My research would not suggest their practice needs to change in anyway but it is an additional positive effect that physiotherapists should be aware of when advertising treatment options.

 

Evaluation of impact

My initial research title was to: Explore the Impact of Intensive Physiotherapy on the Psychology of the Injured Dancer.

Overall the impact of the physiotherapy was that dancers felt less frustrated and down about theor injuries and more confident that things would improve. This suggests that without physiotherapy dancers would potentially continue to feel negatively and therefore not recovers o quickly or certainly not feel they could recover, negative psychology can subsequently lead to more serious mental health problems and so it is vital that dancers seek treatment as quickly as possible to negate potential negative side-effects.

It is important to note, however, that my study was completed with a small number of students over a relatively short period of time and further research would be necessary to clarify whether specific injuries were improved more or less, did the length or amount of physiotherapy sessions make a difference and to investigate the difference by perhaps using two groups – one getting physiotherapy treatment and one not.

However, this is an area which is gaining gravitas in the world of dance, a couple of recent reports highlighting the need for dance companies to be more in touch with potential difficulties arising from injuries and the importance of physiotherapists in countering problems. Entitled simply ‘Dancers Need More Physio Support’, author Helen Laws estimates that about 100 physiotherapists around the UK are now working with professional dancers but disappointingly only a handful of the larger companies have so far established adequate services and facilities for their dancers.

Recommendations arising from Laws report were:

  • more emphasis on assessing and improving dancers’ aerobic fitness levels, and providing advice on physiological and psychological issues
  • bringing in physiotherapists and counsellors to do more prevention and treatment work with dance groups and companies
  • providing direct access to treatment facilities and better access to gym equipment

Therefore my work, although small, could support this study still further to perhaps educate dance schools and companies on the importance of physiotherapy.

 

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