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Why ‘best practice’ is not always best in sport
  1. Will Greenberg1,
  2. Jo Clubb2
  1. 1 Sports Performance, Buffalo Bills, Orchard Park, New York, USA
  2. 2 School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia
  1. Correspondence to Jo Clubb, School of Sport, Exercise and Rehabilitation, University of Technology Sydney, Sydney, NSW, Australia; jo.clubb{at}

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As sport and exercise medicine clinicians, we are constantly faced with challenging decisions. We contend with a diverse range of physical and psychological ailments, how to optimise rehabilitation, clear players to return to play and even the advancement of training to improve performance. Accordingly, clinicians often seek to provide evidence-based ‘best practice’.1 Monocausal thinking may drive the adoption of so-called ‘best practice’.2 However, while evidence-based solutions can provide a foundation for decision making, the quest for ‘best practice’ may often be misplaced given the complexity of both sports performance and injury manifestations.3 4

Problems arise in different contexts, requiring different responses. We may use the process of sense-making—defined as ‘how we make sense of the world so we can act in it’5—to understand and respond to such injury and performance dilemmas. A decision support framework from this field can benefit clinicians by guiding appropriate styles of thinking and responses to the array of problems faced.6

The Cynefin framework

Cynefin (pronounced ku-nev-in) is a conceptual framework used in industry, government and academia that aids decision making. It offers four principal decision-making domains that …

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  • Twitter @Coach_WillG, @JoClubbSportSci

  • Contributors WG and JC jointly conceived, drafted and revised the manuscript. Both authors have given approval of the final version to be published.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.