Who ‘owns’ the injury or illness? Who ‘owns’ performance? Applying systems thinking to integrate health and performance in elite sport

Systems thinking frameworks have gained attention in both modelling athlete performance and injury prevention in sports medicine.1–3 We believe that these fields may contribute valuably and interdependently within a larger high performance system.1 The purpose of this editorial is to explain how ‘injury’ and ‘performance’ interact within a system-based framework3 and to provide three practical implications of an integrated performance system. The basic premise underpinning any systems model is that parts of a system are inter-related, and the objective of the whole system defines the function of each part. Therefore, the interaction between parts cannot be reduced to a number of linear cause and effect relations.1 The influence of a part on the outcome of the whole system depends on the state of the other parts. Any change to a part of the system can affect the objectives of the whole system as …

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