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‘I’m asking you to believe—not in my ability to create change, but in yours’: four strategies to enhance patients’ rehabilitation adherence
  1. Adam Gledhill1,
  2. Dale Forsdyke2,
  3. Tom Goom3
  1. 1 Carnegie School of Sport, Leeds Beckett University, Leeds, West Yorkshire, UK
  2. 2 School of Sport, York St John University, York, UK
  3. 3 The Physio Rooms, Falmer, UK
  1. Correspondence to Dr Adam Gledhill, Carnegie School of Sport, Leeds Beckett University, Leeds LS6 3QS, West Yorkshire, UK; adam.gledhill{at}

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‘I’m asking you to believe—not in my ability to create change, but in yours.’ Former US President Barack Obama provides a poignant message for sport and exercise medicine clinicians that relates to rehabilitation adherence (‘adherence’ in this paper): patients have to be their own agent of change; we can not do it for them.

At a time when patients can experience negative psychosocial and emotional responses to injury, their emotional integrity (eg, the honesty of information they share with their treating clinicians) and their ability to make rational decisions can be compromised.1 Think about your own practice; how many times have you had a conversation similar to that in box 1. We know that patients’ home and clinic-based adherence rates are often poor.2 Helping to improve adherence is important as it is associated with better return to sport (RTS) outcomes.3 Therefore, the aims of this editorial are to (a) provide psychologically informed suggestions that can enhance adherence and (b) based on principles of best evidence-synthesis, provide theoretical or empirical underpinning to these suggestions.

Box 1

Example conversation between clinician and patient

Clinician: ‘Hi there. How are you doing today?’

Patient: ‘Good, thanks’

Clinician: ‘That’s great! Has the injury improved?’

Patient: <Dies a little bit inside> ‘No, not really’

Clinician: ‘Oh, that’s too bad. …

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  • Twitter @gleds13, @forsdyke_dale

  • Contributors AG, DF and TG produced the initial concept of the editorial. All authors contributed to the theoretical and applied considerations within the editorial. AG collated all ideas and produced the final version of the editorial, which was then critically revised by DF and TG to ensure meaningfulness for applied sports medicine practitioners.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests AG serves as an Associate Editor with BJSM.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.