Nobody says to you “come back in six months and we’ll see how you’re doing”: a qualitative interview study exploring young adults’ experiences of sport-related knee injury

Abstract

Background: Regular exercise is vital for overall health, and key to the maintenance of joint health. However, whilst people are encouraged to participate in sport and exercise, many are unaware that they could be at risk of developing post-traumatic osteoarthritis (PTOA) in the years following sport-related injury. Younger adults (< 40 years) with PTOA can experience declining quality of life, comorbid health conditions, and symptoms that place a chronic burden on health services. Conserving knee health through careful self-management in the latency period between injury and the onset of PTOA may help to delay disease progression. In this regard, the development of self-management interventions can be facilitated by understanding the post-injury experiences of young adults and their attitudes towards joint health. Methods: Semi-structured interviews were conducted with 13 young adults following a sport-related knee injury to explore their experiences of injury, and their attitudes and perceptions of self-managing knee health. The interviews were audio-recorded, transcribed and analysed systematically using an inductive approach. Results: Four themes pertaining to participants' experiences were identified: [1] perceptions of current care provision; [2] long-term impact of knee injury; [3] motivation to conserve knee health; and [4] opportunities for supplementary support. The expression "Nobody says to you 'come back in six months and we'll see how you're doing'" personifies the long-term impact of knee injury on young adults and a paucity of care provision. Conclusion: Participants did not perceive that they had adequate care in the aftermath of knee injury, leading to a sense of frustration and uncertainty. This had implications for continued participation in sport and exercise, negatively impacting their athletic identity and sense of wellbeing. Activity tracking, symptom monitoring, advice provision and peer support were identified as tools to enable individuals to self-manage knee health.

“I think we need to empower people to manage it better themselves”: A qualitative interview study exploring UK healthcare practitioners’ perspectives on treating young adults following a sport-related knee injury

“…The role of peer support in enhancing psychosocial wellbeing has also been widely recognised, as individuals with knee-related symptoms have been shown to find solace or inspiration in others who have had similar experiences (9). In a recent study by this research group, this sense of connectedness was sought from teammates who had previously experienced knee injury or from social media platforms, which included positive stories of rehabilitation and creative strategies for managing symptoms (29). The key for young adults with knee difficulties was that they were able to access information to suit their specific needs and preferences (29).…”

“…In a recent study by this research group, this sense of connectedness was sought from teammates who had previously experienced knee injury or from social media platforms, which included positive stories of rehabilitation and creative strategies for managing symptoms (29). The key for young adults with knee difficulties was that they were able to access information to suit their specific needs and preferences (29). Thus, satisfying the informational and supportive needs of individuals may facilitate self-management of joint health.…”

Booster visits in the management of the acute musculoskeletal injuries: Transforming care to improve outcomes–A perspective review

“…The patients were describing a type of booster visit which could assist after the current standard of care was complete, to safely transition to preinjury levels of activity. Finally, Watkins et al 42 specifically explored the attitudes and perceptions of self‐managing knee health in young adults following acute knee injury. One of the four primary themes identified by the patients when interviewed was opportunities for supplementary support.…”

“…One of the four primary themes identified by the patients when interviewed was opportunities for supplementary support. These preferences included intermittent follow up visits for a defined period of time after discharge or additional support with supplemental care and activity after discharge but collectively the construct was best summarized by the quote “Nobody says to you come back in 6 months and we'll see how you're doing.” 42 Collectively, these qualitative manuscripts articulated a common theme, that additional formal physical therapy visits after clearance to return to activity are preferred to potentially assist with increasing physical activity, assisting with transition to return to activity and potentially reducing long term impact of acute injury.…”