Psychological Aspects of Anterior Cruciate Ligament Injuries

Abstract

1Impairment-based evaluation has, until recently, been the mainstay of orthopaedic 2 research in anterior cruciate ligament (ACL) reconstruction. However, participation-3 based outcomes, in particular returning to sport, have lately garnered increased 4 research attention. This is important because returning to sport is typically a main 5 concern of injured athletes. Recent meta-analyses have demonstrated that the return to 6 sport rate after ACL reconstruction is disappointingly low, and that a range of 7 contextual factors including age, sex, sport participation level and psychological 8 factors may affect the return to sport rate. Moderate to large effect sizes have been 9 demonstrated for greater psychological readiness to return to sport, and lower fear of 10 re-injury favouring returning to the pre-injury level sport after ACL reconstruction. 11Understanding the relationship between psychological factors and returning to sport is 12 essential in light of the fact that most athletes recover good physical function after 13 surgery, and many athletes with good knee function do not return to sport. 14 Psychological factors are potentially modifiable with appropriate intervention, yet 15 these factors are not systematically addressed in routine post-operative rehabilitation. 16This review summarises the recent evidence for the relationship between 17 psychological factors and ACL injury, including recovery from injury and returning 18 to sport. 19 3

2016 Consensus statement on return to sport from the First World Congress in Sports Physical Therapy, Bern

“…Biopsychosocial model of RTS after injury 151. Examples of physical, psychological and social factors that may influence RTS are listed (reproduced with permission).…”

Update on functional recovery process for the injured athlete: return to sport continuum redefined

“…This model is endowed with its complexity8 and should be biopsychosocial,9 in which an optimal result (ie, accelerated RTP erf with low reinjury risk) can only be obtained by adopting a multifactorial interdisciplinary approach, which requires teamwork between specialists of the medical and performance departments. It is essential that each step is undertaken in succession per criterion-based progression7 and that each step be fully complete.…”

“…There is a substantial agreement that it is important to establish objective criteria for safe RTS, and that an extensive test protocol should be adopted,10 11 based on the biopsychosocial model 9. The testing process should be embedded in functional recovery for RTS and prevention of reinjury and RTP erf .…”

Role of Religious Beliefs and Practices on the Mental Health of Athletes with Anterior Cruciate Ligament Injury

“…Anterior cruciate ligament sprain or tear is one of the most common knee injuries. Despite the extensive researches related to the medical and physical aspects following ACL reconstruction, in certain conditions, the normalized objective of knee status do not correspond to the capacity to perform the sport, specifically when psychological rebound is not attained (Ardern et al, 2016). Psychological variables have been significantly associated with various aspects of ACL reconstruction recovery.…”