Fear of Reinjury Is the Leading Reason for Failure to Return to Competitive Sport

Many of our patients are athletes, and a goal is to help these athletes return to their preinjury level of activity or sport. The focus of injury management and recovery is often on physical treatments, but there are modifiable factors that can improve patient outcomes independent of surgical technique. 

Tell me about the study: 

Andrew J Sheean, et al. Psychological Readiness to Return to Sport: Fear of Reinjury Is the Leading Reason for Failure to Return to Competitive Sport and Is Modifiable. Arthroscopy. 2023 Aug;39(8):1775-1778. 

What do we often ignore? 

Psychological readiness to return to sport. 

In what populations can we do better? 

In athletes, particularly in teenagers, chronic, clinical depression is a prevalent. In addition, in non-clinically-depressed patients (or in patients who are situationally depressed because of injury), the ability to deal with stressors may still influence clinical outcomes. 

What significant psychological traits have been identified? 

Self-efficacy; locus of control; resilience; catastrophizing; kinesiophobia; and fear of reinjury. 

What is the leading reason for failure to return to competitive sport, reduced activity levels after sports injury, and greater reinjury rates? 

Fear of reinjury 

Can we do something? 

Authors in this study report traits may overlap and may be modifiable. Thus, like strength and functional testing, we should evaluate for signs or symptoms of depression, and we should measure psychological readiness to return to sport. 

With awareness, we can intervene or refer as indicated. Psychological readiness to return to sport represents an underexamined domain in which we can help our patients achieve best outcomes.