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* Above figure provides some examples of open-ended questions used in MI <\/span> Applicability to Sports Physiotherapy:<\/b><\/p>\n Injuries are a common occurrence in the sporting environment. They result in a loss of playing time and impact team dynamics dramatically. As physiotherapists dealing with injured athletes, we are often presented with a degree of resistance when offering advice.\u00a0<\/span><\/p>\n These include but are not limited to the following statements:<\/span><\/p>\n Working<\/span> in this environment, physiotherapists tend to place the blame of poor adherence on the athlete. This leads to further resistance from the athlete and subsequent frustration for <\/span>\u00a0\u00a0\u00a0\u00a0\u00a0<\/span>physiotherapists, who feel a large degree of responsibility for the promotion of behaviour and lifestyle changes. This may result in miscommunication, preventing trust and rapport being established between the clinician and athlete. Distrust and disengagement can negatively impact the patient\/therapist relationship, potentially leading to the athlete withholding information about their injury or condition.\u00a0\u00a0<\/span><\/p>\n Improving the Therapist\/Athlete relationship:<\/b><\/p>\n Often there is an evident imbalance in the therapist\/athlete relationship, with the therapist assuming an authoritative role and minimal autonomy given to the patient in the clinical decision-making process. In recent years there has been a shift in the way physiotherapists communicate with patients. Evidence has shown that effective\u00a0communication skills are essential to patient care in athletic training and rehabilitation (3).\u00a0 Injured athletes often deal with a variety of psychological factors restricting their return to pre-injury performance (4). Factors such as maladaptive views about their injury, worry regarding prolonged loss of playing, and stress related to a perceived lack of competence can create barriers to the rehabilitation process. Recovery from physical pain and emotional distress, resulting from injury, requires the support of a trusted physiotherapist working in collaboration with the athlete towards a common goal. These impediments can be overcome through practitioner empathy and understanding, resulting in more comprehensive rehabilitation. One way this is achieved is through the use of a communication technique known as MI. Theoretically, MI strengthens the therapeutic relationship between the patient and therapist, which has been linked to improved rehabilitation results (5, 6). A collaborative approach between all those engaged in the athlete’s care is advocated, rather than one favouring a more dictated<\/span> \u00a0 \u00a0 <\/span>\u00a0approach in which the patient is the passive recipient of therapist instructions. Utilizing MI encourages shared clinical decision making between the therapist, team management and athlete, allowing for the provision of holistic athlete care. Although MI has been examined\u00a0from a physiotherapy perspective, other team personnel\u00a0such as the Coach, Team Physician, and Exercise Physiologist may find MI of significant value.<\/span><\/p>\n Integration into Clinical Practice:<\/b><\/p>\n Working as a side-line rugby physiotherapist a number of years ago, I commonly used authoritative communication approaches when addressing players. Overall, there was a lack of compassion<\/span> and understanding when players failed to meet expected requirements. Reasons for non-adherence were not tolerated, and players were blamed for being \u201clazy\u201d, showing a lack of commitment, or \u201cnot wanting it enough\u201d. Integrating MI into my clinical practice has been invaluable, I now view patients as being ambivalent, rather than non-adherent or lacking effort. Complex and difficult conversations with athletes have become significantly less strenuous to navigate, while subsequently dealing with any perceived resistance in a non-confrontational way. It has resulted in a higher level of job satisfaction and a marked decline in compassion fatigue.<\/span><\/p>\n Take home message:<\/b> <\/p>\n <\/p>\n Authors:<\/b><\/p>\n Denzil Jewell (BHsc Phty)<\/i><\/b> \u2013 Physiotherapist at Hillcrest Physiotherapy in Hamilton. Recently completed a Post Graduate Diploma in Health Science, majoring in Musculoskeletal Management.\u00a0<\/span><\/p>\n References:<\/b><\/p>\n
\n<\/span>Figure taken from (6), with permission.<\/span><\/p>\n\n
\n<\/span>MI promotes a focus on the athlete’s strengths, while increasing internal motivation for behaviour change. Through collaboration and recognition of autonomy, the athlete has the opportunity to actively participate in their rehabilitation.<\/span><\/p>\n![\"\"](\"https:\/\/blogs.bmj.com\/bjsm\/files\/2023\/02\/Denzil-Jewell-Motivational-Interviewing-Infographic-120x300.jpg\")
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