The effect of physiotherapist social support on injured athletes' rehabilitation

The overarching aim of the project is to examine the effect of physiotherapist social support on injured athletes' rehabilitation.
It is widely established that sport-related injury can be a stressful and traumatic experience that can have a detrimental effect on an athlete's ongoing health and well-being (Wadey et al., 2013). Although effective rehabilitation is key to athletes' successful recovery, the emotional turmoil, isolation, uncertainty, setbacks, unpredictability and slowness of recovery progress athletes' commonly experience can threaten their rehabilitation adherence (Brewer, 2007). Given that adherence is central to the successful rehabilitation of injured athletes, it is perhaps not surprising that over recent years strategies that potentially foster rehabilitation adherence have received increased research attention.
Of the strategies that can enhance injured athletes' rehabilitation adherence, social support is thought to have particular merit. Research that has explored the efficacy of social support in an injury context has shown it to be a significant coping resource during rehabilitation (e.g., Johnston & Carroll, 1998), with high levels of social support being associated with less psychological distress (Rees et al., 2010) and greater rehabilitation adherence (Duda et al., 1989). However, not all research has supported these beneficial effects. To elaborate, several studies suggest that social support can be ineffective, and even harmful at times with examples of poor rehabilitation guidance or lack of concern reported to be a hindrance to recovery (e.g., Udry et al., 1997).
In an effort to understand the somewhat inconsistent and counter-intuitive findings, researchers have highlighted the importance of discerning between the different functions and types of social support (Rees & Freeman, 2012). Indeed, as a line of enquiry research has already provided evidence for the differential effects of perceived and received social support on a number of injury outcomes (Mitchell et al., 2014). However, research has continued to overlook the importance of the effect of different support types on the role of, and effectiveness of social support in an injury context (Bianco, 2001). This is surprising given that, for example, emotional support might exert different effects than informational support during athletes' rehabilitation and support providers may differ in their ability to provide specific types of support (Wadey & Evans, 2011).
Arguably, one of the most important support providers for injured athletes during rehabilitation is the physiotherapist. In addition to being a key treatment provider, the physiotherapist fulfils a range of support roles for the athlete when they are detached from their teammates and coaches, exacerbating their perceptions of isolation and need for alternative sources of support (Podlog &Eklund, 2006). Physiotherapist support can therefore have important and wide-ranging effects, not only on the rehabilitation of injured athletes, but on their subsequent health and well-being.
Although research provides some evidence for the benefits of social support and the importance of the physiotherapist as a support provider, it has not examined the relationship between physiotherapist social support and injured athletes' rehabilitation, or determined the differential effects of support functions and types on support effectiveness. The purpose of the proposed project is to address this oversight by examining whether athletes' perceptions of support functions, types and responsiveness of the physiotherapist influence athlete well-being, belief and adherence to rehabilitation, and actual recovery outcome.