are also encouraged which further involves the athlete. There are no passive treatments carried outby the physiotherapist, which does not allow the athlete create an initial dependency on thetherapist.In the initial stages of an injury the athlete is highly susceptible to cognitive dependency due to thepreliminary psychological response. In order for rehabilitation to be a success there must beconsideration of both the physical and psychological training and preparation (Cox, 2002). Thereforeas physiotherapists we must recognise the psychological characteristics of an athlete that can lead tocognitive dependency if we are going to promote independence. Wiese-Bjornstal et al, (1995)
developed a model of an athlete’s psychological response which
takes into consideration cognitive
appraisal and the athlete’s emotional
and behavioural response to injury. Research indicates thatshock and disbelief are the main emotions experiences after the initial injury (Evans and Hardy,1999). Many of the emotions experiences after an injury are negative in nature (Tracey, 2003) withanger and frustration developing. Competitive athletes are seen to experience higher levels of
negativity surrounding the injury (Cox, 2002). According to one of the UK’s leading sportspsychologists’ Louise Eillis, (2010) professional athletes tend to ex
perience the same psychologicalresponse to that of a grieving individual after sustaining a serious injury. There is an associated lossof identity as many professional athletes have their self-identity tied to their sporting achievements(Cox, 2002). A loss of identity may lead to a decrease in self-efficacy. Albert Bandura (1982)describes self-efficacy as
“the belief in one’s capabilities to organize and execute the courses of action required to manage prospective situations”.
This decrease in self-efficacy may lead to acognitive dependency as the athlete
identity is altered. Cognitive dependency is described byBornstein et al, (1995) as
“the perception of the self as powerless and ineffectual, with the belief that
others are relatively powerful in t
he control of the outcomes of situations”.
Physiotherapists play anactive role in preventing the development of cognitive dependency in the professional athlete duringrehabilitation. This can be achieved through the use of cognitive therapy which can be carried out bya physiotherapist or a sports psychologist, which may be more common place among the majorprofessional sports clubs. Early patient education regarding the estimated recovery time, and thepathophysiology of the injury by either member of the sports medical team will assist towards amore positive cognitive appraisal, which will provide a better emotional and behavioral response topost-
operative rehabilitation. It is also important to diffuse the patient’s negative thoughts
surrounding their condition and put the injury into perspective. A professional athlete may becomevulnerable to catastrophising the injury due to severe sense of loss they experience, not only their