Return to sport
is both the ultimate goal of rehab
A source of
doubt and worry about the uncertainty of injured athlete’s abilities to return
to a level at or above where they performed prior to the injury
Approaches
It can be threat
·
Low confidence
·
Decreased adherence to rehab
·
Increase in pain
·
Display avoidance behaviors
·
Increases anxiety
·
Reduced motivation
It can be challenge
·
Positive attitude
·
High motivation
·
Excitement
·
Increased effort in rehab
·
Greater desire to return to
sport
·
Over adherence to rehab
·
Greater risk of reinjured due
to premature return
Stages of Return to Sport
1.
Initial Return to Sport
2.
Recovery confirmation
3.
Return of Physical &
Technical Abilities
4.
High Intensity Training
5.
Return to Competition
Initial Stage
·
Considered to be the most
difficult
·
Athlete quickly determines the
effectiveness of the rehabilitation
·
Entire stage should include a
series of tests of the healed area
·
Athlete’s expectation are:
·
They will perform at the same
level as prior to the injury
·
Pain will not be present
·
Discussion with the athlete are
needed to examine their expectations.
·
A concern of AT is that athlete
become “overzealous” in their approach to train and compete.
Recovery Confirmation
·
More psychological than
physical
·
Involves the athletes’
obtaining evidence from initial stage that the injury is healed and ready to
face the demands of the sport participation
·
This is considered the make or
break period
·
Athlete’s initial play will
confirm their attitudes and approaches
·
Success will lead to higher
levels of self-confidence and motivation
·
Injury does not swell, no pain,
full range of motion,
·
Self-confident and motivated
·
Not being successful will lead
to doubt if they will be able to return.
·
Swelling occurs, unexpected
pain, little range of motion, decrease strength
·
Highly anxious and depressed
Return of Physical & Technical Skills
·
High intensity training marks
the absolute conclusion of athlete’s identification that they are fully healed.
·
Re-establishment of their
regimen of physical conditioning and technical training
·
Major psychological concern is
their level of perceived preparedness:
-
Provide a safe,
-
progressive conditioning
program developed by the AT or physical trainer
Return to Competition
·
First post-injury competition
is key concern:
·
Athlete is usually more anxious
than at any other time
·
Initial uncertainty
·
Athlete may have a distorted
perception of the probability of the injury occurring again.
·
Need to discuss with the
athlete’s their attitude and feeling about the upcoming competition
·
Athlete should not be thinking
negatively
·
Athlete needs to redirect their
focus to their skills, game strategy, and goals.
Fear of Injury: A Major Concern
·
Perception that recovery is
incomplete,
·
returning to sport to soon,
·
impatient in returning to
sport,
·
lack of acceptance of the risk
of the sport,
·
low confidence,
·
highly anxious,
·
and preoccupied with being
re-injured
Prevention of Fear of Reinjury
·
Continue involving in the sport
during rehab
·
View rehab as a form of athlete
performance
·
Becoming involved with a coping
model
·
Performance imagery
·
Give the athlete time to
progressively regain their physical, psychological, and technical skills.
Treatment of Fear of Injury
·
Need to take a proactive
approach to alleviate the fear
·
Athlete needs to face a similar
situation as when the injured occurred.
·
Rational self-talk helps the
athlete refocus
·
Simulation practice
·
Relaxation techniques
·
Athlete establish
pre-competition and competition routines
Self-Determination Model & Return to Sport
Ryan & Deci
(2000) focused on:
·
Competence,
·
Autonomy, and
·
Relatedness in explaining the
athlete’s return to sport.
·
From the self-determination
perspective, the success of an athlete’s return to sport from injury is related
to meeting these psychological needs
Competency Issues
·
Athlete’s fear and concerns of
returning to sport
·
Loss of enjoyment because they
could not participate in the sport
·
Injury blocked their short
& long term goals
·
Letting down others, teammates,
and coaches
Issues
Competence Issues
- Fear
related to returning to sport
-
Injury blocked their sport goals
-
Overcoming their fear of reinjury
Relatedness Issues
- Feels
of separation from team
-
Support in re-entry into sport
-
Having role models
Autonomy Issues
Sense of personal control
- Pressure to
return to sport
Implications
Regarding the
assistance and management of athletes returning to sport following an injury:
Rehab environments
meet these three basic needs of the athlete by:
1.
Implementing goal-setting
2.
Giving the athlete choices when
to return to sport
3.
Provide role models
4.
Rehab progress should be safe
and successful
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