attend the rehabilitation session of an injured colleague in order to provide him or her
with some advice or encouragement In general, social support serves as a buffer against
the emotional distress typically caused by injuries. A good example here is the support
given to each other by two injured French international athletes—the soccer star Robert
Pires (Arsenal), who had been out of action for seven months between April and October
2002 due to a cruciate knee injury, and Thomas Castaignède (Saracens), the rugby player
who was out for two years due to a ruptured Achilles tendon, before resuming in autumn
2002, Pires visited Castaignède in hospital in Paris and Castaignède visited Pires in
London during their long spells of rehabilitation: “When you’re injured, there’s a certain
level where there’s not much you can say, it’s just a question of being there” (cited in
Fotheringham, 2002b, p. 2).
How effective are these psychological techniques when applied to the rehabilitation of
injured athletes? Although research evidence on this issue is sparse, some evaluative data
are available. To explain, levleva and Orlick (1991) studied thirty-two athletes who had
attended a sports medicine clinic for rehabilitation treatment for knee and ankle injuries.
Results showed that the techniques which were most strongly associated with fast healing
were positive self-talk (see also Chapter 4), goal-setting and certain kinds of mental
imagery. In a similar study, Davis (1991) evaluated the effects of using relaxation and
imagery exercises with collegiate swimmers and football players. Results indicated that
there was a 52 per cent reduction in injuries to the swimmers and a 33 per cent reduction
in injuries to the football players. More recently, Evans, Hardy and Fleming (2000) used
a longitudinal case study approach with three injured rugby players who were each
receiving treatment for serious injuries. Results showed that the perceived efficacy of the
psychological techniques used depended on the stage at which they were applied. For
example, whereas emotional support was perceived as being important to the athletes in
the initial stages of rehabilitation, task support was seen as being more useful in the
middle to late stages of this process. An interesting feature of this study was that the
researchers tackled the neglected question of re-entry for injured athletes. Briefly, they
found that two key determinants of successful re-entry were gaining confidence in the
injured body part and gaining confidence in overall fitness. Unfortunately, despite the
apparent efficacy of many psychological techniques in injury rehabilitation settings, few
researchers have explored the possible theoretical mechanisms that underlie these effects.
However, one possible mechanism in this regard is self-efficacy. Put simply, these
techniques may work simply because they strengthen athletes’ sense of personal control
over their physical condition. As yet, however, this proposition has not been tested
systematically. Even in the absence of theoretical clarity, it is evident from the preceding
evidence that effective injury rehabilitation is a collaborative enterprise involving the
treatment specialist, the athlete, other health-related professionals (e.g., a physiotherapist,
a psychologist), the coach and other significant members of the athlete’s life and family.
Indeed, research suggests that the importance of these team-members may vary with the
stage of athletic rehabilitation in question. For example, Gilbourne and Taylor (1998)
suggested that early in the treatment phase, the medical staff and the physiotherapist play
a significant role. Later in the recovery process, however, the coach of the injured athlete
may assume a special significance as the performer begins to contemplate the possibility
of participation in the sport once again.
Sport and exercise psychology: A critical introduction 262