Serious Injuries – Breaking bad news – Have you mastered it??

Breaking bad news

Ever thought you may need specific help to inform injury severity to the athlete? Most physiotherapists in collaboration with their Sports Medicine Physicians discuss the likely scenario’s. Should we be seeking some professional guidance on how best to do this on a case by case basis? The physiotherapist often spend the most one on one time with athletes and may be best placed to notice changes in their mental well-being.

Case Study

The athlete at the center of this case study was a young professional rugby union player who had suffered a complete rupture of his right Achilles’ tendon mid-season. The sport psychology consultant (“Practitioner B”) was initially contacted by the athlete’s rugby club, for the purposes of providing advice to their medical team (Chief Medical Officer, Club General Practitioner, Chief Physiotherapist, Strength and Conditioning Coach and Lead Soft Tissue Therapist) regarding how to best communicate the diagnosis, prognosis and associated plans for rehabilitation to the injured individual. They explained that the player had, in their words, “over-identification” issues (e.g., Miller and Kerr, 2003). They felt that the injury and the associated recovery would present a great challenge to the athlete, hence requesting Practitioner B’s support at this time. The medical team were recommending surgical repair of the tendon, which would, they said, involve around 6 months recovery. They were however, unable to provide certainty over the individual’s future in the sport.

Practitioner B acknowledged that the medical team would be more familiar with the player, and as such would be able to best determine the most effective communication strategy. However, general advice on “breaking bad news” (e.g., Baile et al., 2000) was provided, which involves a six-step strategy for disclosing unfavorable information. With this strategy in mind, the practitioner advised the medical team to ensure that an open and honest dialog was maintained with the athlete at all times, whilst being mindful not to generate any false hope regarding a return to play at professional level. In addition, it was also recommended that the athlete be provided with as many opportunities as possible to exercise control over the situation (decision-making etc.) and the option of remaining as involved with the team as he wanted during his rehabilitation.

Blurred lines: Performance Enhancement, Common Mental Disorders and Referral in the U.K. Athletic Population

Claire-Marie Roberts,1,* Andrea L. Faull,1 and David Tod2

Published by Ashley Stiven

Ashley Stiven is a physiotherapist with more than 20 years of experience. He has helped and worked with numerous professional athletes and sports teams.

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