Singapore Airlines: Business, Marketing and Operations

capital of Singapore airways Business, Marketing and OperationsThis strikeup national is stupidd on Singapore Airlines (SIA), in this vitrine study the project has discuss almost the SIAs Business, Marketing and operational system, what are the changes is the SIAs lining in future, how this flight path companionship has changed its dodge and how this respiratory tract from a blue country- deposit with a population of around three m feverishion volume, on an island no larger than the Isle of Man, earn a reputation for being the virtu e rattlingy constant m nonpareily-making air duct in the world, in spite of the various world-wide recessions.The c over study besides discuss about, how the Singapore Airline retained employees and the customers. marvel 1 Evaluate SIAs Business, Marketing and Operational Strategies and assess their effectiveness in relation to the competition?Over the last decade Singapore Airline has grown from a local air passage into adept of the worlds leading rider and cargo carriers. In an attempt to survive, many of the organization which is working in the same business tried to break and investigate the approaches or strategy which are exploitation by Singapore Airlines (SIA, 2007). Fin solelyy it became clear and compreh barricadeible that SIA are to a greater extent agonistical beca work of its business and operations strategy.The foresighted chooseation growth of a business fancy to provide and of importtain shareowner value is c e genuinelyed the business strategy.So, this pick of the piece of music contains the business, market and operation strategy of Singapore Airlines.As we all roll in the hay the SIAs has developed a stead for being an fabrication innovator as well as doing things in a different way than its competitors who are in the same industry line, for example, As the study says SIA was the graduation airline to introduce free drinks, a choice of meals and free headsets back in the 1970 s. Not unaccompanied this, the Singapore airlines are the send-off who start a dickens grade broadcast to install Kris World, that is a bleak in-flight entertainment scheme, for passengers in all three classes of its Megatop B747s. KrisWorld provides around 22 channels of video entertainment, around dozen digital audio channels, around ten Nintendo video games (Nintendo was best cognize for console industry and famous for home video game), and always spiffy the destination information and provides a telephone at each seat. By using this innovative ideas and creativity techniques the SIAs has done wonder in this airline business and earn a reputation for being the solely about self-consistent money-making airline in the world.Not besides if this, SIAs has done many changes in the history of airline and they provide numerous innovative ideas and doing things differently than its competitors.SIAs is the one who spend lot of millions in site to install KrisWorld movies by doing this they had stipulation an amazing entertainment to their customers while traveling and this lead to make them a different from their competitors and by adding this KrisWorld they are the low one to do so and this emblems of strategy helper them a lot in becoming a number one in these business.SIA is the first in the market for armorer and performer of the mostly innovative run low teletext currents service (KrisNews) and also for an interactive in-flight shopping service for its aircrafts. These creative and innovative developments by SIA, in the end won numerous awards for the best air lines.SIA was the first airline which bought a collection of finest chefs from all over the world to serve best in-flight homework for its passengers as well as it was the first airline which tried to achieve the wants of individual passengers by launch the special meal service with tran variance and better options plus the unique in-flight meal service which is specially introduc ed for young flyers and en adequated them to choose their desired meals up to 24 hours before the flight departure. anyways that, SIA started to update its menus monthly and however hebdomadary to create an impression among its haunt travelers and also to keep route of flyers tastes. These were the main line of attack for SIA to make do among its competitors in the market and also to shore up its business strategy1.The main success of SIAs is Singapores Changi airport, Changi is situated in eastern end of the Singapore. Changi airport is one of the world busiest airportQUESTION 2 Using change heed models evaluate how the company has changed in strategic terms.QUESTION 3 What challenges is SIA confront in the future. What should SIAs business and operations strategies be for the future and why? ply justification for your exhortations.As we make do that SIAs is the one of the leading airport in the world just now due to the large number of competitors in the world. SIAs hol d to maintain their top ranking in the future by maintaining their operations and business strategy and by ontogeny more innovative ideas.The challenges which a SIA facing in future is mainly due to their competitors, as we all know in airline business the profit is very slight and its mainly because of growing airline industry, passengers induct many choices to select the scurvy fare flight, so they must provide the better facility in a lower price that may affect their capital turnover.niche is also the one of the factor for affecting consequently in future. corresponding in recession, in that location is a reduction in number of fliers.In future on that point is my advance air throwes/crew because of the competition and so the availability of the best crew is very important. in that respect are more challenges that airline industry is facing ilk escalating costs and stiff competitions.As this part of the paper contains that which type of business as well as operations strategies should SIAs makes for their future and which makes them different from there competitors.Before going to this we must know about the operations strategy, operations strategy is the total guide of ratiocination make the management which leads to the long-term growth for any type of operations, it is the long term process. Basically operations strategy is the method or tools that help us producing substantiallys and services to the consumers. Operations basically deal with the producing or delivering of substantiallys.This paper study discuss the competitive strategies of Porter, In 1980s Porter has argued that there is two types of competitive advantages which can be shared with either a broad or narrow competitive scope to create 4 well known business strategies 2Cost lead, specialisation, pore low-cost, and concentrate differentiationThe Porters four competitive strategies are shown in table down the stairs-Competitive AdvantageLower Cost specialismCost attract orshipDifferentiation broad tar trainLow cost focusedFocuseddifferentiation narrow tar cleaveCost leadership technique or strategy is normally used by the companies for generally generating the profit even though the low price of the product or the services offered.In this strategy company mainly focused on the decreasing of price and retaining their old customer and generating the new one, so by applying this rule to the airline business SIAs convey to take some initiative for lowing there prices in spite of that providing the skilful facility to their passengers. By doing this the SIA is always be a head from its competitor in present as well in future because doing this the high, medium and even low class passenger relieve oneself attractive towards it and SIAs leave behind make even more profit than earlier.Differentiation strategy, in this strategy a companys offers a service that consumers perceived it as a different and seduce to endure a high descend or cost for that .So, SAI founder to innovate some new facilities like new entertainment programs while travelling and some advance engineering features with some extra cost, and it must be different as well as a new thing for passengers so that they are ready to pay a high amount for it. Or do oblation the old facilities but offered it in that manner that passengers are ready to pay a high amount. This type of innovation or creativity make them different from there competitor and good for future also.Focus Differentiation strategy focus on a narrow sector and in spite of appearance that sector, they are attempting to achieve either a price advantage or differentiation. The principle is that the sector which is focusing must be better served by entirely focusing on it.So, SIAs must use this strategy for be a top in their business by focusing in a undersized small sector and offered better services to the passengers and thusly they will definitely be a head in the airline business.Reflection on Career Goals Becoming an OphthalmologistReflection on Career Goals Becoming an Ophthalmologist1. disport provide leaven of activities and achievements which indicate your commitment to a assister in this military capability and/or which lose led to the development of dexteritys germane(predicate) to a calling in this specialty.(250 spoken language)My devotion for becoming an ophthalmologist stemmed from working in DARUL-HIKMAT DARUL-SHIFA, a munificence essence hospital in Pakistan, which I make up tended to(p) biannually since first twelvemonth in medical school. There I detect how a small procedure brings a remarkable remediatement in the quality of a affected roles life.Out of my own interest, I undertook 2 ophthalmology electives. I was allow to observe practice on an incredible elective at MOORFIELDS EYE HOSPITAL. It was a with child(p) have got and further motivated me to ram ophthalmologist. I achieved characteristic in Ophthalmology during my MBBS.As a Foundation year doctor, I regularly attended kernel clinics and domains in my free time. I did a hebdomad of a TASTER SESSION and managed to arrange a SPECIAL faculty in ophthalmology during my GP rotation.I have do several global intros and have published in peer reviewed journals.I have excellent hand to eye coordination and dexterity. I am fitting in Objective Subjective Refraction.The gang of medicinal drug and mental process, along with the modification of cerebral and fine motor skills necessary has drawn me to the specialty. It is the only specialty that has satisfied me to practice medicine at the highest level. Sight is the most cherished of senses for many people, and to be in a status to im hear and redo sight, as well as frustrate eye disease, gives me great pleasure.I am a dedicated, hardworking, and energetic person. In addition, I have passed RCO exams and my pick up in ENT, neurosurgery, diabetics and oncology make me a great candidate.2. Please provide expand of outstanding achievements outside the field of medicine. (250 haggling)I have regularly set up clinical courses for the subaltern doctors and GP since 2008. The courses consist of ECG description day Pain Management Course Eye ENT day. This involves a great deal of organizational and managerial skills. This has also given over me experience of developing a successful business plans and dealing with the finances, which will be very beneficial for me, in the future, to set up new services in the NHS. Following additional demand, I have setup a company with a name of AR MEDICS to organise courses more widely.We won the first prize of 5000 in South Asian Federation (SAF) Quiz competition, 2004.As Sports Coordinator at Medical College, I improve the Sports Society and wrote its new rules and regulations. For the first time in its 25 year history, I arranged sports fixtures with a nonher(prenominal) universities and introduced new sports. This change college s ports reputation remarkably. I was the captain of the basketball police squad and was awarded Colours. I learned to cope under pressure and meliorate my leadership decision-making skills.I enjoy hiking mountaineering. I have hiked up to the base coterie of Nanga Parbat- the worlds 7th highest peak- and won first prize.3. Clinical visit What experience of clinical take stock do you have? Please state distinctly where and when this was undertaken and indicate specifically your role. (250 words)Evaluation of Glaucoma Management Services M Amjad, R Job, S Walker. 01/02/2009 at Leighton Hospital.I initiated the study and conjecture the pro-forma and equanimous data, which was presented in the Divisional Audit Meeting. I made recommendations to improve the system. I indeed re-audited to complete the cycle of the audit.. My material was later presented as card at the Royal College of GP one-year Congress Nov 2009.A pilot Glaucoma care pathway was initiated from my recommendati ons., and Glaucoma Medisoft was installed to document and print clinic letters instantly. Improved documentation was made available for the GPManagement of lid CA M. Amjad, S Raja. 01/09/2008 at Blackpool Victoria Hospital.Once again, I initiated the literary productions research, formulated a pro-forma, compile data, and analysed it. I presented this in the departmental audit see.An Audit of Ophthalmology Emergencies presenting in AE M Amjad, W Khan. 30/03/2007 at Blackpool Victoria Hospital.I researched the literature, formulated a pro-forma, collected, and analysed data. My conclusions were presented in the Divisional Audit meeting.Management of Corneal Abrasion in AE M Amjad, W Khan. 01/04/2007 at Blackpool Victoria Hospital.Again, I researched literature, formulated the pro-forma, collected, and analysed data, all for a presentation in the Divisional Audit meeting. Guidelines from Kings College Hospital have now been taken up inn the AE department.Management of Gastro-oesop hageal CA sestet years audit M Amjad, MU Javed. 01/03/2007 at Blackpool Victoria Hospital.I researched literature, formulated a pro-forma, collected, and analysed data. A presentation was made at the North westside Regional Meeting for Upper-GI Carcinoma.Major Limb Amputation, Environmental Study M. Amjad, MU Javed, G Riding. 01/06/2007 at Blackpool Victoria Hospital.I designed pro-forma, reviewed literature, collected and analysed data for a presentation in the Divisional Audit Meeting.2. Managing Teams Please provide show of leadership skills, managing and/or working in teams. You may give examples from some(prenominal) inside and outside medicine. (250 words)I was elected as a Sports Coordinator at Medical College in my final year, which was a great honour and position of responsibility. In order to make this successful, I take awayed a good team and representatives from each year, whom I appointed. Working through the team and using my leadership skills, I was able to make significant changes. I reformed the Sports Society and devised its rules and regulations. For the first time since its foundation, I arranged fixtures with other universities and introduced new sports. I took on board ideas from team members and organized sponsors and a plan to generate funds. Our efforts ameliorate the colleges sports reputation.This was because of the good management, delegation of responsibilities to team members and proper use of the recourses generated. I also captained the basketball team and was awarded Colours. This experience not only improved my team working and leadership skills, but also improved my ability to perform under pressure and make clear decisions.5.Teaching work through What experience do you have of delivering article of faith? (250 words)I have attended the How to Teach Course, in order to learn new teaching skills and develope a methodology.I have been regularly organizing and coordinating a full day study course for junior trainee doc tors and GPs on ECG interpretation Pain Management Eye and ENT day since 2008. The feedbacks has been excellent and the courses are very popular.I regularly delivered formal lectures to foundation and AE doctors on the use of kitty lamp and management of acute eye problems. The feedback has always been good and higher than that given to my peers.I organized formal teaching and mock OSCE for final year Manchester medical students.In addition, I regularly present and attend the weekly landal teaching to keep up-to-date with advances indoors the specialty. My compose feedbacks from the sessions have been very encouraging. I enjoy teaching and endeavour to continue it.6. seek Please provide evidence of research whether past or in progress. If you have undertaken or are undertaking a research project, delight give details and indicate your involvement. (250 words)I worked as a junior Research Fellow Gastroenterology under Prof M Umer in consecrate Family Hospital. I was involved in two projects, twain presented as poster and also published CHRONIC HEPATITIS-C RESPONSE TO ANTI-VIRAL COMBINATION THERAPYA future study of 200 patients. The objective was to study the response of chronic hepatitis-C patients to compounding antiviral therapy. I reviewed the literature, collected and analyzed data using SPSS. The results showed that combination therapy with interferon and ribavirin for CAH-C helps to handle the disease as well as to improve the symptoms of the patients.SYMPTOMATOLOGY OF CHRONIC HEPATITIS-CA case control study involving 1000 patients. The subroutine was to study the common symptoms in patients with Chronic Hepatitis-C. I formulated the pro-forma, collected data and analyzed using SPSS. This was my first experience in research. Moreover, it was presented internationally. It gave me a lot of confidence and motivation. I learned the skills needed to search the literature, design a research project and to statistically analyze the results. It als o improved my colloquy and presentation skills.Recently I was involved in two small studies and presented them as poster in RCO annual congresses. They are The furbish up of GDX in the management of new glaucoma referrals and Post-operative optical complications after acoustic neuroma surgery7. Additional Achievements Please office any prizes, awards and other distinctions (include specialty and fling distinction) which you may have. Please indicate undergraduate or postgraduate award, the prize body and date awarded. (250 words)Grade A+ in MBBS Examinations, Rawalpindi Medical College, Jun 2005Distinction in Ophthalmology (MBBS Exams), Rawalpindi Medical College, Apr 2004 Distinction in Forensic Medicines Toxicology (MBBS Exams), Rawalpindi Medical College, Jan 2001 Awarded specious Medals for best in academics, commandment Board, Jan 2000Won Merit Scholarship for 5 years, Education Board, Jan 19998. Presentations In this section please provide details of your most appl icable presentations at local level (state whether departmental, hospital or trust). Please give a statement about your individualised contribution to the work. (250 words)I have initiated these projects and presented the using PowerPoint at different meetings.Morbidity and mortality meeting. Presented in divisional meeting. 2009Negative dysphotopsia Long-term study and possible explanation for passing(a) symptoms. Oral presentation in daybook Club, Leighton Hospital 2008.Management of Eyelid CA M. Amjad, S Raja Presented in departmental audit meeting in Sept 2008Major Limb Amputation, Environmental Study M. Amjad, MU Javed, G Riding Presented in departmental audit meeting in Jun 2007An Audit of Ophthalmology Emergencies presenting in AE M Amjad, W Khan Presented in departmental audit meeting in Apr 2007Management of Corneal Abrasion in emailprotected Amjad, W Khan Presented in trust annual review meeting in Mar 2007Management of Gastro-oesophageal CA six years audit M Amjad, MU Javed Feb 20079. Presentations In this section please provide details of your most relevant presentations at regional and/or national level. Please give a statement about your personal contribution to the work. (250 words)I have initiated, written and presented the catching work.Patient with previously undiagnosed Autoimmune Hypophysistis (AH) presenting with bilateral continual cystoid macular oedema secondary to Intermediate uveitis. M. Amjad, A Sachdev, V KotamarhiSubmitted for Poster presentation at Royal College Ophthlmology Annual Congress, 2010.Post operative complications affecting look after acoustic neuroma surgery. A. Garrick, M. Amjad, I Marsh, C Noonan.Submitted for Poster presentation at Royal College Ophthalmology Annual Congress, 2010. Restructuring and Innovating the Glaucoma Services. Role of Primary and Tertiary Care. M. Amjad, R Job, A Asghar, S Walker.Poster presentation at Royal College of GP Annual National Conference, Glasgow, 2009.The impact of GDX in th e management of new glaucoma referral. M. Amjad, R Job, S WalkerPoster presentation at North of England Ophthalmology Society, aloneensford UK, June 2009. Patients perspective of new Intra-vitreal Anti-VEGF handling V. Kotamarthi, M. AmjadPoster presentation at Royal College Ophthalmology Annual Congress, Birmingham 2009.Chiari disfiguration with the symptom of photopsiae as the only ocular symptom and no ocular signs. M. Amjad, V. KotamarthiPoster presentation at The tenth Congress of transnational eyepiece Inflammation Society, Prague. May 2009Value of Ultrasound in detecting pathology in vitreous haemorrhage. T. El-kashab, M. AmjadOral presentation The 10th Congress of International ocular Inflammation Society, Prague. May 2009A Case of Idiopathic Sclerochoroidal Calcification associated with Primary absolved Angle Glaucoma. M. Amjad, T. El-kashab, R Job, A NeedhamPoster presentation at The 10th Congress of International Ocular Inflammation Society, Prague. May 2009Communica tion and interpersonal skills Please give a recent example that demonstrates that you possess these skills. (150 words max)A 59 year old gentleman was referred over the pass with a six month history of leftover temporal ache. All the examinations and airs were normal, except for a disc gibbosity on his left side. I informed my consultant and devised a plan. Then, I liaised with the ENT and on call radiologist to review the patient. I kept the patient and his partner informed about all the progress throughout this time. After arranging an urgent scan, which showed a mass compressing his orbit, I arranged for the admission and booked theatre for removal of the mass compressing orbit. As the focal point of communication amongst concerned groups, I enabled us to work as a large team, efficiently and in effect, to save the patients eye from future complications. My ability to say and delegate facilitated the effective success of a multi-disciplinary team approach to patient care.In itiative Please give a recent example that demonstrates initiative. (150 words max)In October 2008, I attended a busy eye camp in Pakistan. During my stay, I was astonished to find that operations are call off on-table by the surgeons due to high IOP. Only high endangerment patients were having their IOP check over due to high patient turnover. This resulted in a huge elope of resources. After discussion with the management, I took the initiative to provide a ascendant to this problem. After research and discussions with senior doctors visiting the camp, I proposed to use a puff tonometer to check IOP of all patients undergoing surgery. This method doesnt require extraordinary skill to use, hence it is effective in a busy camp. This proposal was recognized by the supervisors. It had been a great success with surgical cancellations dropping by more than 95%. I received a letter of thanks. fashioning such a difference in patient care makes me proud. musical theme 2Describe how you realised that you wanted to become an Ophthalmologist? EditMy divine guidance for becoming an ophthalmologist stemmed from working in DARUL-HIKMAT DARUL-SHIFA, a kind-heartedness eye hospital in Pakistan, which I have attended biannually since my first year in medical school. There I observed how a small procedure brings a remarkable improvement in the quality of a patients life.Out of interest, I undertook 2 ophthalmology electives and I was privileged in observing practice on an incredible elective at MOORFIELDS EYE HOSPITAL. It was a great experience and further motivated me to become ophthalmologist.Achieving a Distinction in Ophthalmology during my MBBS, I joined Rawalians Research assembly during my final year in medical school, where I published two research papers. Since then I have been actively involved in audits and clinical studies. I have presented 14 papers in international and national conferences. In addition, I have several published articles in many journals .Most notably during the Haematology, I was involved in randomized control trials. As a Foundation year doctor, I regularly attended eye clinics and theatres in my free time. I did a week of a TASTER SESSION and managed to arrange a SPECIAL MODULE in ophthalmology during GP rotation.I have excellent hand to eye coordination and dexterity. I am get bynt in Objective Subjective Refraction. In my recent job I have done 53 Phacoemulsifications,6 squint Surgeries, 23 IV injections, and 64 argon YAG laser procedures.The combination of medicine and surgery, the variety of cerebral and fine motor skills necessary has drawn me to the specialty. It is the only specialty that has satisfied me at the highest level. Sight for many is the most valued of senses and to be in a position to improve and restore eyesight, and prevent eye disease gives me great pleasure. I am dedicated, hardworking, and energetic person. In addition, I have passed RCO exams and my experience in ENT, neurosurgery, dia betics and oncology will make me a great candidate.What do you think are the main have it offs in work out global blindness by 2020? Edit Approximately 314 million people universal live with low vision and blindness. 90% of these blind people live in low-income countries. 80% of blindness is avoidable. Without effective, study intervention, the number of blind people worldwide has been projected to increase to 76 million by 2020.The major causes of blindness in the world are cataract (50%), refractive errors (15-30%), Trachoma, Onchocerciasis, Glaucoma, Diabetic Retinopathy, be on Related macular degeneration. According to WHO, restorations of sight and blindness prevention strategies are among the most cost-effective and gratifying interventions in health care.In 1999, WHO launched VISION 2020 The veracious to Sight. It is a joint programme of the World health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB) with an international members hip of NGOs, professional associations, eye care institutions and corporations.It aims for control of avoidable blindness by 2020 to achieve the aim the following issues need to be addressed. HR development adequate and meaningful information of all eye care personnel is a signalise factor. Apart from ophthalmologists, the ophthalmic nurse, ophthalmic medical assistants and especially refractionsists should be recruited and educate appropriately. Infrastructure Equipments development facilities should be equipped according to the tasks. Local entrerpreaunership should be encouraged to participate to take down cost and enhance sustainability. Awareness Education of local community community participation is vital and this can be achieved by creating awareness in the public about the diseases and the facilities available to treat and prevent them. Funding regular and new funding sources should be explored. away(p) medicine, what personal attributes make you a good candidate for a career in Ophthalmology? EditI possess combination of qualities through which I have not only achieved over and preceding(prenominal) the required competencies mentioned in the RCOphth program for ST1 and F2 but also a good working relationship with the colleagues to prove as a good and successful ophthalmologist. I maintain good rapport with patients. During my foundation nurture, I had experience of caring for terminally ill patients, breaking bad news and discussing the patients care and resuscitation status with their family, which I was able to do in an empathetic and sensitive manner. I am actively involved in audits, and publications to maintain good medical practice aboard the tough demands of clinical work. This requires refinement of my time management and organizational skills. I believe in sharing the skills and experiences, which I do by not only involving myself in teaching but also in kindness and voluntary work. I possess qualities of a good team leader and a n effective team player, which I have gained through my clinical and non-clinical experiences. I prioritize work and this helps me in make do when working under pressure. I am making most of the opportunities to gain experience and refine my personal skills and will do my best to become a good ophthalmologist.Injuries in Sports and Exercise Case StudiesInjuries in Sports and Exercise Case StudiesPDG.Understanding reproach in Sport and Exercise Settings Self-Selected Case StudiesIntroductionIn this case study we shall consider three jockstraps who are superficially similar and have presented with injuries as a result of their sport. The athletes will be referred to as Mr.A, Mr. B and Mr. C. Each is in their twenties and are golf club standard runners. Mr.A brutish during a planning run and sustained an sexual inversion trauma to his left ankle. Mr. B presented with a pre-patella bursitis of his right knee and Mr. C could not compete because of weighty metatarsalgia.Mechan ism and pathophysiology of speckIf we consider the etiology and mechanisms of each disgrace we can see that although they are largely sports related and, to a tip sports specific, each is fundamentally different in terms of presentation, cause, treatment and outcome. permit us consider Mr. A. who fell during training. He was a modest club runner who ran sporadically for personal enjoyment. He sustained an acute inversion daub which resulted in a partial tear of the lateral malleolar ligament. This ligament effectively joins the Tibia to the talus and calcareous and is largely responsible for the lateral constancy of the joint. (Clemente C D 1975). There was ready pain and subcutaneous swelling and, although he could weight bear immediately after the injury, Mr.A could only passing play with great pain. Lateral distortion of the joint was extremely painful. The fundamental aetiology of the injury was a sudden inversion stress to the ankle which was greater than the ligament co uld withstand and this resulted in rupture of some of the collagen fibres of the lateral ligament together with the implicit in(p) joint capsule. This allowed substantial bleeding to track into the surrounding tissues which, together with both extravasation of synovial fluid and accumulation of tissue oedema, led to the clinically apparent swelling over the lateral malleolus.Mr. B, by stemma, was a fiercely competitive sub- elite runner who noticed his injury developing more behind over a period of about ten days. He was preparing for a race and had increased his tally schedule both in military capability and distance covered. Initially he was aware of a discomfort in the anterior aspect of his knee which felt superficial. This was apparent at the end of his training sessions and persisted for a few hours while travelling home. As the training sessions intensified, the pain grew more persistent until it occurred throughout his rill session. Although it was a nuisance, it was not severe. By the end of ten days it had become very severe to the point that there was demonstrable swelling over the lower rod of the patella which was tender to the feign and constantly painful. The mechanism of this injury is veritable(prenominal) of the overuse injury seen with overtraining. It is believed to arise initially from micro tears within the body of the patella ligament which become inflamed and the constant stresses involved with training do not let the injury heal sufficiently and the inflammation becomes accumulative to the point that histology would show inflammatory changes occurring throughout the ligament and this, in turn, causes clang on the surrounding structures. (Hewett T E et al. 1999)This is manifest as a constant progressively painful swelling localised in the region of the patella ligament and is aggravated by movement of the knee joint. It is tender to the touch and limits exercise.Mr. C was a club runner of modest ability, but with an over opt imistic appreciation of his own ability, who trained with the elite runners at the club. He frequently complained of minor injuries that were blamed for his particular lack of exertion in races. On this occasion he presented with pains in his forefoot over the metatarsal heads which was very specific and occurred when the toes were flexed but not when they were extended (an unphysiological finding). He could run, but complained bitterly of forefoot pain after the race and could be seen hobbling off the track and around the changing rooms after the race. Examination of his foot was altogether unremarkable and no consistent physical abnormality could be found. It was discernible that Mr. C vociferously blamed this problem for his inability to perform well. No physical diagnosis was made but the aetiology of his complaint was purview to be a psychoincarnate manifestation of his anxiety relating to his inability to cause the better runners at the club. This equated to a mechanism o f cognitive distortion and self-denial together with a compensatory conversion symptom complex to rationalise his unequal transaction. (Patel D R et al. 2000)In short(p) we see three competitive runners with common presentations of injury, but three very different mechanisms of pathophysiology and aetiology. Each will require a different approach to treatment and will follow a very different illness trajectory.Psychology of sports injuryThere are a number of different theoretical concepts (with differing full stops of security of evidence base) that can be usefully employed in describing sporting motivation and are then relevant to the incidence of sporting injury. (Wigfield A et al. 2000)The literature on these subjects is very extensive and beyond the scope of this essay to consider in any degree of detail. Reversal theory (Apter M J 2001) is commonly utilised in this regard and can describe relationships between the personality characteristics and motivational stimuli. Para telic dominant athletes commonly enter the paratelic motivational state and are typically arousal seekers and engage in high assay and highly competitive sports (viz Mr. B )(Cogan N A et al. 1998)Mr.A, by contrast is the typical telic dominant athlete who tend to be arousal avoiders, who plan and consider their training carefully and prefer low intensity experiences. (Kerr J H et al. 1999)Let us start this consideration of the psychology of sports injury with an sagaciousness of Mr. C who presents with a primarily psychological complaintMr. C has an overtly psychosomatic presentation. This can be conveniently described in terms of reversal theory (Apter M J 2001).and the paratelic concept (Murgatroyd S et al. 1978). There are aspects of the metamotivational states described in the theory which are relevant to Mr. Cs perception of his motives for continued participation in running even when he was clearly failing to achieve his set targets.If appears that Mr. C has developed a vari ation of a paratelic protective framework with somatic constructs. He needs the high arousal gratification of the paratelic dominant athlete by lining up on the starting line with the elite athletes, but has developed his idiosyncratic phenomenological frame as a coping mechanism which allows him a sensation of unassailabletyty from his perception of failure with a series of somatic excuses for his failure to perform. (Kerr J H 2001)One psychological technique that has been demonstrated to work in this type of case is a form of cognitive behaviour therapy which allows a realisation of the implications of an action to be re-evaluated by the client. (Fowler D et al. 1995) This was combined with a strategy of the setting of in small stages short term goals. This effectively allowed the client to consider his need to unrealistically compare himself with the elite athletes and to allow him to achieve progressive attainable targets, thereby recognising and capitalising on achievement ra ther than ruminating on poor past performance comparisons with other (better) athletes. (Pain M et al. 2004). The idea is that by setting and achieving some short term goals, the client can focus on the present, make small progressive steps, and recognise new achievements, instead of ruminating on past performance level. (Hall H K et al. 2001). Complicity by the clinician in agreeing that his symptoms may actually be physical can be on the whole counterproductive in this type of case (see on)Injury managementThe object of management of any injury is clearly to maximise the degree of recovery possible and to limit and end disability that may occur as a result of the injury. In broad terms we can consider the immediate (first aid) treatment and the posterior longer term management as separate issues. (Hergenroeder A C 2003)In the case of Mr.As acute injury the essential elements of treatment (once the diagnosis has been confidently made) should be to prevent further tissue constip ation and bleeding by immobilisation of the joint (splinting), prompt cooling to reduce the tissue reaction to the injury, analgesia to relieve the pain (but with the caveat that pain quietus should not be an indication to stress the joint) and pressure to minimise blood and tissue fluid accumulation. The longer term considerations should be that weight heraldic bearing should be kept to a minimum for about 7-10 days. Mobilisation should then dumbfound in a graded fashion over about four to six weeks. Running on flat surfaces could realistically begin (possibly with an ankle support) after that time. Mobilisation (both active and passive) is necessary to ensure that the fibroblastic activity of the ligament repair mechanism does not restrict movement of the joint to the degree that the long term restriction of movement becomes a problem. (Orchard J 2003)Mr.A would be well advised to avoid running on uneven surfaces for a period of many months and to undertake a course of physiot herapy involving modalities such as wobble board training to improve his proprioceptive capabilities. (Lephart S M et al. 1997) Because of the injury, Mr.A should always regard himself as more prone to get a recurrence if he were to have another fall.Mr. B should be treated in a distinctly different way. There is no acute first aid treatment as such, as the faultfinding factor here is to recognise that the injury is the result of overuse of a joint. Rest, or in some cases simply a reduction in the training schedule, is often all that is needed to allow the condition to resolve.(Krivickas L S 1997)There is some evidence to suggest that the use of NSAIAs may help to reduce the inflammatory reaction and thereby increase the hie of recovery but their use must be undertaken with caution because of the desire of runners to consider that the analgesic properties of the NSAIA group can be equated with evidence of curtailment of the pathophysiology of the lesion, and therefore they can s tart to increase their training schedule opinion that the inflammation has settled because the knee is pain free. (Nickander R et al. 2005)Some clinicians would recommend the use of steroid injections in the paratendon tissues. It has to be noted that this is contentious because of the happen of tendon damage if the steroid is injected into the wrong area.Mr. C requires no immediate physical treatment. Indeed on an intuitive basis, physical treatment could be considered counterproductive as it could be viewed as reinforcing his aberrant adaptive and compensatory mechanisms by colluding in the physical nature of his pathology. By entrenching his position, the clinician could be actually exacerbate the problem. Once confidently diagnosed, Mr. C should be promptly referred to a skilled sports psychologist for treatment along the lines that we have outlined above.Lecture to clubThe first serious examination of sports injuries as a specific entity was carried out by William Haddon in 1962 (Haddon W et al. 1962). The growth in interest since then has been exponential. In terms of general observation about sports related injuries we can observe that it is generally accepted that one of the common predictive factors for an injury is a history of previous injury. (Watson A W 2001) ( Lee A J et al. 2001) Various studies have reported increased odds ranging from 1.6 to 9.4. (Chalmers D J 2002). In order to accommodate this information it is clearly important to know the other risk factors involvedThe practical problem is that in order to assemble a coherent evidence base on this issue it is vital to have well designed and robust trials to consider. In short, there are very few of these. (Parkkari J et al. 2001). A critical synopsis of the literature on the subject reveals that there is a surprising famine of evidence for any significant preventative measure for sports injury. Part of the cerebrate for this is that if there is anecdotal evidence that a procedure re duces the risk of injury then it is likely that a substantial proportion of participants will already be using it. This makes double blind trials almost impossible. Van Mechelen ran a trial of the prophylactic value of warming up and down only to find that over 90% of participants were using the technique already. (van Mechelen et al. 1993)It is clearly of questionable ethical possibility, quite apart from a practical possibility to get a control group of athletes not to warm up just to see if they are more likely to get injured.The management of sports injuries is therefore largely a combination of intuition based on anatomic and physiological principles, guided by experience and validated by what scientific evidence base there is on the subject.The three case studies presented above have all occurred in similar status club runners for completely different reasons. 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