MEDICINE IN SPORT SPORTS PSYCHOLOGY CONFIDENCE IN THE THERAPIST.

is a useful tool in improving rehabilitation adherence (19) n Therapists are already reporting frequent use of goal-setting (15, 21, 22) n Although therapists are frequently using goal setting, it is often utilised in an unstructured and unorganised way (23) n Existing research tends to suggest that despite frequent use of goal setting, many therapists feel that further training in using goal setting in practice could be useful (15, 21, 22).

WHY SET SYSTEMATIC GOALS DURING REHABILITATION? Goal setting is vital and very effective because it is something that athletes can measure themselves and see how they are doing (23). According to Hardy, Jones, and Gould (24), goals should identify specific targets that lie within the performer’s control. Goals should also be set in a staircase format, ie. easy and attainable short-term goals leading towards harder and challenging medium and long-term goals (25). When applied to sport injury rehabilitation, a flexible approach to goal setting should be applied (26), as injury rehabilitation process is hardly ever a linear progression towards the desired outcome. In fact, the rehabilitation process itself is a complex process and consists of a range of physical, psychological, and emotional needs. At all times the medical professionals working with injured athletes should keep in mind that each individual athlete and his/her injury are unique. Therefore in order for a goal setting programme to be successful, therapists should ensure that any planned interventions meet the athlete’s needs.

TYPES OF GOALS FOR REHABILITATION When planning rehabilitation goal setting, both the therapist and the athlete should be aware of the different types of rehabilitation goals. According to Taylor and Taylor (7) at its best, a rehabilitation goal setting programme incorporates all areas of rehabilitation. The aim of such goal setting should be to identify clear objectives for the rehabilitation through physical, psychological, and performance goals.

1) Physical rehabilitation goals Physical goals can enable a clear direction for the physical aspects of recovery. The process for setting physical goals should begin with a

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IN ORDER TO BUILD A SUCCESSFUL REHABILITATION RELATIONSHIP, AN ATHLETE NEEDS TO HAVE TRUST AND

conversation between the therapist and the athlete in which crucial physical aspects of rehabilitation are discussed and explained. This should be followed by setting clear goals for each of the components of physical recovery: range of motion, strength, stability, stamina, flexibility, and any other relevant physical parameters (7).

2) Psychological rehabilitation goals Addressing psychological aspects of the recovery process should be done in a similar manner to physical aspects. Often issues associated with motivation, self-confidence, focus, and anxiety (re-injury) should be discussed and included in the goal setting. One of the most effective ways to initiate psychological rehabilitation goals is through rehabilitation profiling (7).

3) Performance goals

An injury and the subsequent rehabilitation period should not be treated as a layoff from training and a time when an athlete will fall behind in their development. On the contrary, rehabilitation, if managed and utilised effectively, can be a time in which substantial performance gains can be made in areas which, during regular training, might have not received priority. According to Taylor and Taylor (7) the four primary areas for performance goals are technical and tactical development, physical conditioning, mental training, and return-to-form. In addition, well planned and structured rehabilitation goal setting will also consider physical, psychological, and performance goals for different levels of rehabilitation. These include: goals in relation to the ultimate level of recovery (long-term goals), goals for different stages of rehabilitation (medium-term goals), and daily goals (short-term goals). In addition, goals in relation to their lifestyle should also be considered and set, as often existing lifestyle (ie. sleep, diet, alcohol and drug use, relationships, work and school commitments) can either assist or hinder rehabilitation adherence and ultimately have an effect on the outcome.

PRINCIPLES OF REHABILITATION GOAL SETTING Gould (27) put forward six main guidelines for setting effective goal setting for rehabilitation. First, goals should be challenging, realistic, and

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