Adherence to sports injury rehabilitation programmes.

Many studies have shown that low adherence is a common problem in treatment programmes. Adherence to sports injury rehabilitation is dependent on the personality characteristics of athletes operating in conjunction with particular aspects of their rehabilitation settings and the quality of interactions developed between athletes and their therapists. Any attempt to view treatment adherence as a unitary construct is doomed to fail; a complex construct demands a multidimensional outlook. Taking into account the challenges that injured athletes face during their rehabilitation, strategies can be designed to promote adherence. Self-confidence is the key to enhanced rehabilitation adherence, and the strategies are organised within that framework. Competence strategies include education, treatment efficacy, tailoring, and relapse prevention training. Control strategies include dissociation, self-monitoring, decision-balance sheet, and pain deconditioning. Commitment strategies include shaping, contracting, threats, goal-setting, and social support. Because of the dearth of empirical data on the specific issue of adherence to sports injury rehabilitation programmes, it is necessary to extrapolate from various other areas of treatment adherence (e.g. cardiac rehabilitation). Treatment dropout does not seem to be inevitable, but is in fact preventable. The task for the sports medicine professional is to recognise and acknowledge the salient features of their clients and the rehabilitation demands on them and then to utilise various strategies to enhance the likelihood of treatment adherence.