Designing a Rehabilitation Program: Things to Think About
There are many different factors associated with injury and the rehabilitation process. It is not a linear and straight forward journey. Many of us could agree that we wish it was! Referral, adherence, and modeling are essential concepts to consider in the process when building a rehabilitation training program. However, there are other considerations that need to be included to support adherence, for example. Three different aspects of constructing a rehabilitation training program are discussed below and chances are some are not what necessarily come to mind. However, they are based on thinking about building a program that centers around the individual athlete as a person.
Cultural Awareness
The first and most essential aspect of constructing a rehabilitation training program is ensuring there is strong attention to cultural awareness when building and executing it. Ryba (2017) writes that the sociocultural domain is one of the factors constituting human psychological phenomena which means that a sport and performance professional (SPP) must account for it. Furthermore, cross-cultural differences exist across a wide range of variables in sport including but not limited to athlete identity, attributions of success and failure, coping style, goal orientations, participation motives, preferred coaching behaviors, regulation of emotions, responses to athletic retirement, and social physique anxiety (Hagan Jr. et al., 2019). Understanding these cross-cultural differences, in addition to athlete cultures, can provide orientation and also help prevent traumatizing the athlete. Bottom line. A program must come from a culturally-informed and trauma-pervention lens!
Accounts for Communication
Communication is included in this list of essential aspects because of how much communication happens, and it helps to acknowledge it upfront. There are different layers of communication. The first is communication between the different professionals supporting athletes recovering from injury, which is vital. The second layer is communication between professionals and the athlete. When thinking about the communication between professionals and athletes, its importance includes supporting athletes to take ownership of their rehabilitation experience and increasing adherence to a program in conjunction with a strong relationship (Brewer et al., 2007). All this communication supports the athlete’s journey, and taking a more collaborative approach may make that journey better for athletes.
Knowledge and Skillful Integration of Different Models and Theories
Many models may be used to guide a rehabilitation training program. With that said, they need to be wisely used in the context of the individual athletes and their cultural identity. While not every possibility is discussed, two are highlighted. Podlog et al. (2011) discuss how athletes returning from injury experience concerns about their sense of competence, autonomy, and relatedness, thus making self-determination theory (SDT) a helpful framework. Deci and Ryan (2012) describe SDT as a theory of human motivation and personality in social contexts that aims to differentiate motivation as being autonomous and controlled.
Another model is the phases of the injury and recovery process and what issues tend to arise in each. During the onset phase, athletes experience incapacitation and isolation in addition to issues surrounding injury severity, contractual and financial issues, child care, playing/performance, aspirations, incapacitation and isolation, weight gain, rehabilitations and setbacks, and identity loss (Evans et al., 2000; Evans et al., 2012). The rehabilitation and treatment recovery phase may be marked by a lack of rehabilitation progress and setbacks, contractual issues, playing expectancy, and financial demands (Evans et al., 2000; Evans et al., 2012). Within the returning to training and competition phase, athletes may be dealing with physical fitness, reinjury, and performance aspiration issues (Evans et al., 2000; Evans et al., 2012).
Understanding and applying SDT in conjunction with the phases of the injury and recovery process allows for a more nuanced plan, provides some structure, and can be explained to athletes to help them understand their experiences. Furthermore, it can be used to break down the program into more manageable pieces for the athlete. If these are not integrated well, however, an incongruence can arise, and it may make the program feel a bit awkward for the athlete and even the SPP.
Three people running against a blue background while the runners are blacked out due to the direction of the light.
take action today moment:
What other aspects would you add and why from either perspective, the SPP or the athlete? Take some time to really think about this topic and what it might have to do with adherence. To recover from injury, it is important to adhere to the injury recovery program. Many athletes just want to get back out there. No judgment about that! As a group, we tend to be passionate about our sports. Write down your thoughts. If you are recovering from injury, assess for yourself how your program is going and then provide feedback to your team of professionals.
References
Brewer, B. W., Van Raalte, J. L., & Retitpas, A. J. (2007). Patient-practitioner interactions in sport injury rehabiliation. In D. Pargman (Ed.), Psychological bases of sport injuries (3rd ed.) (pp. 79-94). Fitness Information Technology.
Deci, E. L., & Ryan, R. M. (2012). Self-determination theory. In P. A. M. Van Lange, A. W. Kruglanski, & E. T. Higgins (Eds.), Handbook of theories of social psychology (pp. 416–436). Sage Publications Ltd. https://doi.org/10.4135/9781446249215.n21
Evans, L., Hardy, L., & Fleming, S. (2000). Intervention strategies with injured athletes: An action research study. The Sport Psychologist, 14(2), 188-206.
Evans, L., Wadey, R., Hanton, S., & Mitchell, I. (2012). Stressors experienced by injured athletes. Journal of Sports Sciences, 30(9), 917-927. https://doi.org/10.1080/02640414.2012.682078
Hagan Jr., J. E., Schack, T., & Schinke, R. (2019). Sport psychology practice in Africa: Do culture-specific religion and spirituality matter?. Advances in Social Sciences Research Journal, 6(3), 183-197.doi: 10.14738/assrj.63.6209
Podlog, L., Dimmock, J., & Miller, J. (2011). A review of return to sport concerns following injury rehabilitation: Practitioner strategies for enhancing recovery outcomes. Physical Therapy in Sport, 12(1), 36-42. doi:10.1016/j.ptsp.2010.07.005
Ryba, T. V. (2017). Cultural sport psychology: A critical review of empirical advances. Current Opinion in Psychology, 16, 123-127. https://doi.org/10.1016/j.copsyc.2017.05.003