From the safety net to the injury prevention web: applying systems thinking to unravel injury prevention challenges and opportunities in Cirque du Soleil

Abstract

ObjectiveWe undertook this qualitative study within an international circus company—Cirque du Soleil—to explore the narrative of artists and the artistic team in regards to injuries and their prevention and to describe the prevention of injuries from a systems thinking lens.MethodsFocus groups (FG) with artists and semistructured individual interviews with the artistic team were conducted in six selected shows. The structure of the interviews and FGs concerned the themes: ‘injury’, ‘injury-related factors’ and ‘injury prevention’. Data were analysed through comparative data analysis based on Grounded Theory. Concept mapping and systems thinking approaches were used to design a map of participants’ views on how to prevent injuries.ResultsInjury was mainly described based on performance limitation. The factors mostly mentioned to be related to injury occurrence were physical load factors. Many of these factors were said to be connected and to influence each other. Injury prevention was mapped as a multilevel system, composed by artist-related factors (eg, technique and life style) and extrinsic factors (eg, touring conditions and equipment) that integrate different strategies and stakeholders.ConclusionOur study reinforces the importance of multilevel injury prevention approaches with shared responsibility and open communication among stakeholders.

In your shoes: A qualitative study on the perspectives of professional dancers and staff regarding dance injury and its prevention

“…However, a broader injury definition including pain and performance limitation might be more useful, allowing for early detection of health problems and potential injuries 23,24 . A wide‐ranging spectrum of how to define an injury was described by our participants, similar to the previous findings with elite athletes and circus artists 25,26 . This idea is also present in previous dance medicine studies, showing that pain and injury are part of the dancer's life and identity, 17,18,27 which has repercussions in terms of the underreporting of injuries.…”

“…23,24 A wide-ranging spectrum of how to define an injury was described by our participants, similar to the previous findings with elite athletes and circus artists. 25,26 This idea is also present in previous dance medicine studies, showing that pain and injury are part of the dancer's life and identity, 17,18,27 which has repercussions in terms of the underreporting of injuries. The common denominator of those descriptions was the clear and objective threshold "not being able to dance," which equals the concept of a time loss injury definition.…”

“…37,38 The need for teamwork indicates the importance of leadership 39 and an integrated staff engaged in a comprehensive care of athletes 40 and artists. 26 The literature has been advocating for a more integrative and collaborative workforce to deal with sports injury prevention. 41 However, no interventions targeting teamwork and communication have been described in the literature as a dedicated injury prevention intervention.…”

“…Ekstrand et al showed how leadership and communication are related to injury occurrence 37,38 . The need for teamwork indicates the importance of leadership 39 and an integrated staff engaged in a comprehensive care of athletes 40 and artists 26 . The literature has been advocating for a more integrative and collaborative workforce to deal with sports injury prevention 41 .…”

Taking the lead towards healthy performance: the requirement of leadership to elevate the health and performance teams in elite sports

“… 9 Likewise, it was shown in an artistic environment that the potential for targeting injury risk factors lies also outside the realm of medical care and sits in other departments within an organisation; for example, coaching, casting and artistic teams. 10 Therefore, it would only flow logically to assume that those who know how to manage and communicate effectively, and thus unlock the potential of their multidisciplinary teams, will do a better job in having the athletes ready to perform safely at their peak. So yes, effective leadership is important for health and performance.…”