Return to sport: clinicians should seek inspiration from Barack Obama

Dr Gledhill, along with co-authors Dale Forsdyke and Tom Goom – a senior lecturer in sports injury management at York St John University and a physio at the Physio Rooms in Falmer, East Sussex, respectively – set out a four-pronged strategy to boost rehabilitation adherence. 

‘Patients have to be their own agent of change; we cannot do it for them,’ they note, arguing that injuries commonly affect patients’ ‘emotional integrity’.

As a result, injured patients may not be totally honest with the clinicians treating them as ‘their ability to make rational decisions can be compromised’.

I’m asking you to believe – not in my ability to create change, but in yours [former US president Barack Obama]

‘We know that patients’ home and clinic-based adherence rates are often poor. Helping to improve adherence is important as it is associated with better return to sport outcomes.’

In order to overcome such obstacles, Dr Gledhill and his colleagues suggest using a ‘psychologically’ informed approach with patients, based on sound evidence.

Summary of the key four stages

Strategy 1: form strong relationships and provide high-quality social support

A strong relationship is characterised by clinicians providing clear, honest and understandable information. This can create a sense of ‘shared goal commitment’ and help to empower patients to ‘make informed decisions regarding their rehabilitation behaviours’

Strategy 2: encourage patients to maintain the ‘social side of sport’

Clinicians could schedule rehabilitation sessions at the pitch side or near where the patient’s team is playing, for example

Strategy 3: support patients' autonomy

Everyone will have worked with athletes who expect us to ‘make them better’, the authors state. Encouraging patients to be more autonomous could help them be less passive

Strategy 4: use goal-setting techniques

Offer goals that relate to individual sessions, promote progression through the various stages of a return to sport and supply lifestyle goals

The article concludes: ‘By being a source of high-quality social support, supporting the patient’s autonomy, making effective use of goal setting and encouraging relatedness satisfaction, clinicians can enhance patients’ beliefs in their ability to be their own agent of change.’

To see the article, visit: http://dx.doi.org/10.1136/bjsports-2020-102245