A qualitative investigation of sport injury rehabilitation motivation from the perspective of the ATC-athlete dyad

It is estimated that over 50,000 sport injuries are sustained by NCAA athletes every year (Dick, Agel, & Marshall, 2007). Many of these injuries require rehabilitation, and proper adherence to a prescribed rehabilitation program has long been known to lead to better rehabilitation outcomes (Brewer, Van Raalte, Cornelius, Petitpas, Sklar, Pohlman, et al., 2000; Derscheid & Feiring, 1987; Heredia, Munoz, & Artaza, 2004). However, the mechanisms by which adherence to a rehabilitation program can be achieved are not yet well-understood, perhaps due to a lack of rich qualitative studies designed to explore the complexities of the rehabilitation process (Ohman, 2005). To begin to alleviate this shortcoming, the purpose of this study is to qualitatively investigate athletes’ motivation in the context of sport injury rehabilitation. More specifically, certified athletic trainers (ATCs) and NCAA athletes were observed during rehabilitation sessions and interviewed in a semistructured manner to determine how self-determination theory (SDT) constructs may affect adherence to sport injury rehabilitation programs. Data analysis revealed three influential categories: ATC-athlete relationship, athlete autonomy, and ATC competence. Two themes (trust, autonomy by necessity) were also uncovered and a negative case was identified. Findings coincide with prior research highlighting the importance of trust and the ATC-athlete relationship. Autonomy by necessity represents a novel finding within sport psychology literature. Implications for future research include examining the role of trust with the sport injury rehabilitation context relative to SDT and identifying specific behaviors ATCs can engage in to regulate their athletes’ motivation to adhere