Readiness to return : psychosocial factors and injury recovery

This thesis examined the associations between psychosocial factors, rate of recovery, and readiness to return to competition. The specific psychosocial variables measured were: social support, coping, daily hassles, and rehabilitation self-efficacy. Athletes and dancers (N= 35), ranging from club to elite level, who attended a sports medicine clinic for treatment grade 2 ankle sprains completed the questionnaires. For the purpose of examining associations between psychosocial variables and rate of recovery, athletes were categorised in to slow, on-time, and fast recovery groups by their physiotherapists. The questionnaire was administered on three occasions: after first physiotherapist appointment, middle of rehabilitation, and physiotherapists gave athletes permission to return to competition or performance. To ascertain whether differences between groups, and changes over time were significant, a series of mixed-design ANOVAs were conducted. Effect sizes, in addition top values, were reported and discussed. Number of daily hassles and use of coping skills reduced over the entire course rehabilitation, and social support remained stable. Rehabilitation self-efficacy and readiness return to competition increased over the rehabilitation period. A number of group main effects (medium to large effect sizes) were found for all emotion-focussed coping, self-efficacy, and readiness variables. No group differences for daily hassles or social support were found. In general, the fast recovery group reported higher self-efficacy and readiness and lower emotion-focused coping than the other two groups. Satisfaction with social support, psychological self-efficacy with rehabilitation, and physical readiness to return to competition were consistently and positively associated with psychological readiness throughout rehabilitation. No variable consistently correlated with physical readiness throughout the time phases of the study. The results suggest that some variance in rates of recovery and readiness may be accounted for by multiple psychosocial variables. The study also demonstrated that psychosocial, recovery, and readiness variables change over time. These findings suggest that research into athletic injury rehabilitation needs to take a multivariate approach and incorporate dynamic and temporal elements. Results of this thesis partially supported aspects of the biopsychosocial model of athletic injury rehabilitation. Sports medicine teams may need to take into consideration both physical and psychosocial factors when devising rehabilitation programs for recovering athletes