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The capacity of the human body to adapt and flourish in a wide range of environmental conditions is well recognised. Indeed, it is this ability to effectively adapt physiologically, psychologically and genetically that makes us successful as a species. Significant attention has been given to the long-term adaptation to environmental factors, for example, the ‘mismatch hypothesis’ of evolutionary medicine.1 Of particular note, however, is the capacity to make rapid changes at neurophysiological and behavioural levels in response to alterations in environmental constraints. The ability to effectively modify responses under a broad spectrum of conditions is central to effective sporting performance and to long-term health outcomes. Simply speaking, the ability of humans to respond to a variety of challenges is what makes us stand out.
The traditional dogma that injury or illness results from the failure to attain a single ‘ideal’ (specific movement pattern, nutritional status and anatomical alignment) has been challenged.2 The multifactorial nature of the majority of conditions has resulted in a general acceptance that a reductionist approach is often inadequate to describe the nuanced clinical presentation of many sporting injuries.3 The dynamic and frequently non-linear relationship between risk factors and injury incidence is, perhaps, better understood in relation to the ability of the individual to adapt to various challenges.
Different constraints, different strategies, same outcome
Adaptations are subject to a range of neuromechanical, contextual and emotional factors. It is reasonable to suggest that some adaptations may be beneficial in terms of injury or illness predisposition while other maladaptive responses may increase susceptibility. Referring to the consequences of repeated participation in sports with or without injury, Meeuwisse et al4 noted that ‘adaptations occur that alter risk and affect aetiology in a dynamic, recursive fashion’. As such, two individuals under the same environmental constraints may carry out the same …
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