Explore pain perception and pain self-efficacy in acrobats in the context of holistic management: a scoping review.

Abstract

Background: Within the acrobatic community, there is a strong belief that pain, defined as “an unpleasant sensory and emotional experience associated with; or resembling that associated with actual or potential tissue damage”, is normal when training and performing. Acrobats are subject to extraordinary physical and psychological demands, sometimes leading to pain and injury, which has an impact on their performance and well-being.

Objective: This research aimed to explore the physical and psychological factors that influence pain perception and pain self-efficacy and identify best practices which will inform pain management in acrobats. This research will be useful to summarise the existing literature evidence in this area which could inform future research projects around holistic pain management.

Design: A literature search of ProQuest and Web of Science databases was undertaken for the period between 2012 to 2023, using the search terms “pain”, “pain perception” and “self-efficacy” in those who practised the following acrobatic disciplines: circus performers, gymnasts, and cheerleaders.

Results: 28 studies were identified to form the key findings of this review. This research found that pain in acrobats could be identified as either injury-related or performance-related. Risk factors for pain included internal, external, and psychological factors. Some acrobats believe in “no pain, no gain,” which implies a high self-efficacy, that is the ability to continue training despite the pain. The findings suggest that a holistic pain management approach, involving multiple stakeholders, may incorporate the following components: 1) maintaining a healthy physical condition, 2) reviewing training load, 3) managing stress, 4) differentiating pain, and 5) sharing available resources. A positive relationship with coaches and teachers is key in the early identification and treatment of pain.

Conclusion: In conclusion, this scoping review offered insight into pain behaviours and explored best practices around holistic pain management in acrobats. To manage pain, it is recommended to address the following: general health, training loads, stress, pain self-identification and signpost to resources. These strategies could help reduce pain incidents and promote career longevity.