Nothing more than a charlatan

Thursday, October 3 2019

 

The “Expert” Football Physio / Sport Scientist:

 

I'm going to cut straight to the chase for this piece as I know we are all time-crunched these days: It is generally perceived that certain people are termed “experts” in professional football. Let me dispel some expert myths right now on the so-called expert physio/sport scientist/S&C.

 

You are not an expert just because:

YOU work in the Premier League

YOU have treated/ worked with a famous person

YOU have a big following on social media

YOU are published in a scientific journal

YOU are part of the “clique” “cool gang” or mafia as I like to call you. Needless to say, I have never been in the cool gang.

YOU are a social climber and will only talk to someone if you want something from them.

YOU always voice your opinion on social media as the only way to do something right

YOU are invited to speak at international conferences because YOU either:

  • Work in the Premier League
  • Treated a famous person
  • Published an article
  • Have a big social media following
  • Spoke at another conference etc. - you get my point right!!

 

First things first, if you are any of the above - get over yourself!!!

The above points might be very desirable to some people, but they are certainly not pre-requisites of what constitutes being assigned the “expert” tag.

 

You are only an expert if you work in the Premier League *emoji face* joke!

Let’s take working in the Premier League as an example. And let me be very, very clear here – it is the athlete who is the expert, not the support staff, be you a physio or sport scientist, no matter how good you might think you are - sorry to burst your bubble!! The recruitment process for a player (and associated pay package) couldn’t be any further from the recruitment of the support staff (and hence is reflected in their salary too).

 

Social Media Bullies:

I know plenty of physios/sport scientists/S&C’s who “piggyback” on the success of the athletes/club they work with and then become very vocal on social media because they assume that their opinion carries more weight because they hide behind a Premier League badge or superstar athlete. It’s as if the club or athlete owe all their success due to their “expert” practice. Complete and utter nonsense - again get over yourself.

 

I am a published author - seriously!!!

I know plenty of physios and sport scientists who have published articles in journals and thereafter assume that they are an authority in this field. For example, I know of a physio who considers himself an expert because he works in the Premier League and was part of a group who wrote a clinical piece on return to play decisions – thereafter he announced in his Twitter bio that he was an expert, again absolute poppycock. Furthermore, I read the piece and wasn’t all that overly impressed if I’m honest.

 

Expertism by Association:

There is a perception that the higher the status of the league or the more successful the athlete you work with is, then, the better a physio you are, and in some instances, I would imagine this to be true. However, this type of perception is more akin to “expertism by association” rather than a true measure of how efficacious that practitioner is. For example, a physio who works with Manchester United is assumed to be better than a physio who works for one of the lower league clubs such as Carlisle. Funny that because I know the physio at Carlisle and he is certainly without a shadow of a doubt one of the best in the business. However, this is a very shallow method for judging a person’s capability of how good they are as a physio/sport scientist /S&C. There are so many confounding factors, twists and turns in life, good and bad luck as well as timing which play a role where we all end up in our journey.

 

Learner or charlatan (expert) - Which one are you?

What makes someone an “expert” in their field? The quick answer is nothing. Nobody and I do mean nobody, is an expert in this field. How could they be? Seriously, how would you measure it? In my humble opinion, you have two types of people, those who think of themselves as lifelong learners and those who are delusional enough to believe they are experts in their field…. the charlatans!

 

Anyway, let’s get back to what the academics think constitutes expert practice.

 

A Reflective Practitioner:

This type of person according to Boud et al (1985) is able to reflect with purpose on their experiences, actions, emotions, feelings and responses in order to learn from them with the ultimate aim of challenging their understanding of themselves, their attitudes and behaviours to expose any biases they may have (Patterson & Chapman, 2013). The sequelae of such reflective practice may help improve patient care, bridge the theory-practice gap and fuel further critical thinking to promote ongoing changes in practice (Duffy, 2007).

 

Professional Craft Knowledge:

Benner (1984) argues that nothing trumps professional experience as the gold standard for “expert” practice - not even speaking at a conference or having thousands of followers on Twitter - imagine that?! Although she admits, it is very difficult to define what an expert is because this type of person operates on a deeper level. She believes that the expert clinician utilises evidence-based practice as merely another tool in the toolbox, a bit like k-tape, exercise or manual therapy or NICE guidelines for that matter. Again, I would argue against Benner’s choice of using the term “expert”, and this could be replaced with “learner”. Professional craft knowledge is reserved for those practitioners who are very experienced in their profession, who have seen the good, the bad and the ugly, and again who have reflected on and learned from all their experiences.

 

A novice practitioner, on the other hand, has “propositional knowledge” that is knowledge they have gained from books or courses but lack the real-life practical experience to inform their practice. They rely on and quote heavily, especially on social media platforms “scientific theoretic knowledge” because their personal practice is limited and inflexible. As their exposure to industry-specific scenarios increases (for example in professional football) as does their experiential practical knowledge (professional craft knowledge) and therefore they are able to lean on their propositional knowledge and anecdotal experience to make better decisions for the patient/athlete (Benner, 1984).

 

On the spot: Research action Research practitioner

The other defining aspect of an experienced practitioner is that they are able to reflect-in-practice, that is while the scenario is occurring which is in contrast to the novice practitioner who will be more likely to reflect-on-practice, i.e. reflecting on the event after it has occurred (Schon, 1983). This type of practitioner is able to carry out on the spot: research action research – they can generate a new understanding of the situation and change the situation there and then. They are able to consciously attend to the task in hand. In my humble opinion, the practitioner who is striving for best practice will be one who utilises both reflection in and on practice. The practitioners who view themselves as lifelong students, learners, reflectors, not those who think of themselves as experts just because of who they work for, what they have written or how many followers they have. But what do I know? I’m just a learner!

 

The Intuitive Practitioner:

This type of person uses intuition which is difficult to verbalise and has no rationale process – it’s simply a hunch!!! Again, you need quite a bit of experience to operate at this level. Your decision-making ability becomes fluid and effortless and not so cognitive anymore. Dreyfus & Dreyfus (1986) also refer to an “intuitive grasp” where the practitioner uses pattern recognition to inform their decision making. In essence, the practitioner compares their current experience with their past practice to make the right decision.

 

 

Metacognition:

This occurs when you are able to reflect on your reflection, be critical about your own thoughts. This type of clinician can act as their own supervisor and question whether they are dealing with the situation effectively (Rolfe, 2011).

 

Being a good listener:

My whole aim in life now is to be a better listener, did I really listen to the other person, did I understand their fears, expectations and aspirations. If I have listened well, I can put that person at the centre of the rehab journey and build from there.

 

Conclusion:

Is it correct to assume that someone is an “expert” in the field of sport and exercise medicine just because of who they work for, who they know or what they have written? In my opinion, this criteria defines what a “bureaucratic expert” is and nothing more than that. They hide behind smoke and mirrors, badges and athletes, journals and conferences.

If it's that important to you to be perceived as an “expert” in your field, then stop hiding, develop your own skillset as a practitioner and qualities as a good person. Listen more and stop telling people what to do on Twitter, realise that it is just your opinion that you are offering. Make your job your passion, reflect on your behaviour and become a nicer person. The more experience you have, the more you will realise that there are many occasions where current evidence does not advocate a particular practice. And, it is in these challenging situations of uncertainty – which you will constantly face within professional sport – that you, as a lifelong reflective learner, rather than who you work for, will help most.

 

Reference List:

Benner, P. (1984). From novice to expert. Reading MA: Addison-Wesley.

Boud, D., Keogh, R., & Walker, D (eds) (1985). Reflection: Turning experience into learning. London: Kogan Page.

Duffy, A. (2007). “A concept analysis of reflective practice: determining it’s value to nurses.” British Journal of Nursing, 16(22), 1400-1407.

Dreyfuss, H. & Dreyfuss S. (1986). Mind over machine. Oxford. Blackwell.

Higgs, J & Titchen, A. (2000). “Knowledge & Reasoning. Higgs & Jones (Eds.), Clinical reasoning in the health professions. Oxford: Butterworth Heinemann.

Jones, M. & Rivett, D (2004). Introduction to clinical reasoning. In M. Jones, & D. Rivett (Eds.), Clinical reasoning for manual therapists. London: Butterworth Heinemann.

Moon, J. (2004). “A handbook of reflective and experiential learning, theory & practice”. London: Routledge.

Paterson, C. & Chapman, J. (2013) “Enhancing skills of critical reflection to evidence learning in professional practice. Phys Ther in Sport. 133-138.

Rolfe, G. (2011). “Knowledge and practice. In G. Rolfe, M. Jasper & D. Freshwater (Eds.), Critical reflection in practice. Generating knowledge for care (pp.11-29) Palgrave MacMillan.

Schon, D. (1983). “The reflective practitioner: How professionals think in action. London: Temple Smith.

 

 

 

Ben Dinnery

Ben Dinnery

@BenDinnery

Ben is football’s leading injury specialist. The ‘go-to’ guru for big hitters like Sky Sports, ESPN and NBC Sports when they need data. Or the BBC, talkSPORT and the broadsheets when a quote is required. His unique insight has helped provide a better understanding of what is really happening in the treatment rooms.


Johnny Wilson

Johnny Wilson

@johnny_wilson5

Johnny is a respected physiotherapist and sports scientist, specialising in football injuries and rehab. Johnny has headed up the medical departments at Chesterfield, Scunthorpe and Notts County. Overseeing everything from player-specific training loads to pre-signing medicals. He has a proven record working with elite athletes in Private Practice and is regularly called upon throughout Europe to deliver presentations on the latest rehab innovations.


Matt Nesbitt

Matt Nesbitt On TipTV

@MattNesbitt16

Matt's short, unremarkable football career was ended by his own bad driving. His long, distinguished career as a football tipster was ended by his own good advice. Because bookmakers don’t like a winner. First, they closed his accounts. Then his members’ accounts. Then his tipping service. And now they employ him as a consultant. Funny old game.


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