Millions of pounds of corporate and charity money are being channelled into sport in the UK for people with combat injuries; but do we know that this money is being spent in the best way? Do we know what really works in recovery and why?
In my last blog I talked specifically about motorsport but in this one I’m going to discuss sport and extreme challenges more generally. Involvement in sport as a part of rehabilitation for combat injury is mainstream these days. There are numerous inspirational and moving accounts of young people being saved from near death on the battlefield and then going on to achieve the extraordinary. Excelling in athletics, climbing mountains, rowing the Atlantic and tackling extreme off-road racing are all examples. This is a positive development on many levels, for the individuals finding a new purpose in life, because of the many people who are inspired by these stories and for the challenge to negative views of people with disability in society.
So all good? Not necessarily.
In my last blog I told you about Nick Caddick’s (2014) review of the literature on the impact of sport and physical activity on the well-being of combat veterans. There is clear evidence of the benefits and effectiveness of sport in rehabilitation; as well as providing pleasurable experiences, social and psychological well-being are improved. There are also some words of caution from Nick however. Not all injured veterans want to be involved in competitive and elite sport and those with Post-Traumatic Stress Disorder (PTSD) may prefer non-competitive, relaxing activities. Some sports may exclude veterans who do not have the time and money to train and travel extensively. Also, a point I made in my previous blog, an injured veteran may have many and complex needs that are not met purely through being involved in sport. For some employment might be the main objective of transition.
I’m going to give you two examples of what can, and indeed, should be happening to explore these questions by telling you about some research into the use of surfing in recovery from PTSD, using very different methodological approaches.
In the UK qualitative research has been undertaken by Nick Caddick, who published the literature review previously mentioned (Caddick 2014). He studied veterans who live with the symptoms of PTSD over a long period of time when they were involved in surfing with Surf Action, a charity in Cornwall. He talked to the veterans to record their stories and spent time joining in with their surfing. This research is soon to be published and I’ll give you more details and the references in later blogs. Nick has kindly let me have sight of the papers in press and all I can say at this point is, this is excellent qualitative research and surfing has demonstrable benefits.
In the United States an occupational therapist has been delivering ‘Ocean Therapy’ for veterans from the conflicts in Iraq and Afghanistan with PTSD to facilitate their transition to civilian life (Rogers et al 2014). She used quantitative methods in a small study and demonstrated that a 5 week surfing programme had a positive impact on PTSD and depression symptom severity. Although Nick and colleagues reject medical model concepts of PTSD, there are many similarities in their findings. The interaction with the ocean was found to be an important part of developing coping strategies; storytelling and relationship building were key positive factors in the efficacy of the programme. The veterans developed a new kind of brotherhood with its own language and culture, similar to being in the military which aided transition. There were aspects of surfing that appealed to male participants, which is also a benefit of motorsport that I mentioned last week. Rogers et al (2014) concluded that surfing and other high impact sports could be incorporated into occupational therapy programmes with veterans and that more research is needed.
There have been a couple of themes developing in these discussions about what works for recovery from combat injury: having an extreme challenge and close interaction with the natural environment. This leads me to tell you about two challenges undertaken just this week. The first by Philip ‘Barney’ Gillespie who was the co-driver in the race car ‘Joy’ that completed the Dakar Rally in 2013 with Race2Recovery. Barney is a lower limb amputee as a result of being blown up in Afghanistan and has climbed five mountain peaks in five days with a group of friends to raise money for ABF The Soldiers’ Charity. This would be a challenge of endurance for anyone, but add walking on a prosthetic limb into the mix, this is a true man v. mountain achievement. Well done Barney and team.
The second is Flying for Heroes; a team of injured veterans who are flying Para Trikes across Kenya with the support of Land Rover. They have learnt to fly for this adventure, so they face a physical and mental challenge in the awesome natural, but potentially dangerous, Kenyan landscape. They are raising money for Help for Heroes and, in doing so, moving forward in their own recovery journey. In their words; ‘learning to fly is an exciting, enlightening and enriching experience’. Follow their blog here for updates and amazing photographs:
To sum up:
Sport, physical activity and extreme challenges do aid recovery from combat injury, but it needs to be the right activity at the right time and other support is vital. Research can be done to show what works and why. We can see, for example that surfing is a helpful activity for veterans who live with PTSD. We don’t necessarily need high tech, state-of-the art gymnasiums! People could be doing more activities in the ‘Green Gym’ or ‘Blue Gym’. See the work of Mick Collins (2014) for more discussion about the need to be connected with our natural environment and the deep transformation of the self that can happen from overcoming extreme challenges. Occupational therapists have a lot of expertise to enhance these programmes and to capitalise on the benefits provided by the activity to assist transition. Finally, more research is needed using different methodologies to show us what really works and where the money should be spent.
Social media links:
@Flying4Heroes @HelpforHeroes @InvictusLondon @LandRover @NickCaddick1 @Race2Recovery
@Row2Recovery @Soldierscharity @Surf Action
Caddick N & Smith B (2014), ‘The impact of sport and physical activity on the well-being of combat veterans; A systematic review.’ Psychology of Sport and Exercise 15, 9-18.
Collins M (2014), The Unselfish Spirit. Permanent Publications, Hampshire.
Rogers C, Mallinson T, Peppers D (2014), ‘High-Intensity Sports for Posttraumatic Stress Disorder and Depression: Feasibility Study of Ocean Therapy With Veterans of Operation Enduring Freedom and Operation Iraqi Freedom’, American Journal of Occupational Therapy 68, 395-404.