Is It Time to Focus on Psychological Readiness in Return to Play after ACL?

Is it time to target psychological readiness (or lack of readiness) in return to sports after Anterior Cruciate Ligament tears?

After an ACL injury, patients may experience strong emotions of tension and anxiety, fear of new injuries, reduced confidence, and low motivation

Inderhaug and colleagues found that…

These responses will inevitably affect both rehabilitation and the return-to-sport process

Psychological readiness has been found to be an important predictor of patients’ ability to resume sport, in fact a recent study reported it to be the most important component of a test battery when it came to predicting a return to pre-injury activity level

Further, there are indications that low psychological readiness might be associated with a higher risk of sustaining a second ACL injury upon returning to sport

An interesting observation is that physical and mental recovery does not always coincide

Patients might have regained sufficient function for sports participation, but still report high levels of fear and low psychological readiness. In such a situation their performance on tests of functional recovery (such as isokinetic strength tests and single-legged hop tests) will have little predictive value in whether they return to sport or not.

These patients might end up never attempting a return to play

Conversely, other patients may display no fear and high mental readiness for returning, irrespective of how physically ready they are!

These scenarios underline the importance of addressing both physical and psychological recovery—and using a test battery that includes evaluation of a combined physical and psychological readiness is therefore recommended. Full text here.

The findings of this study are truly inline with why we started Unbroken Athlete. 

Author

Dr. Catherine Logan, MD, MBA Catherine Logan, MD, MBA, MSPT, is a sports medicine orthopaedic surgeon specializing in complex knee and shoulder surgery at Colorado Sports Medicine and Orthopaedics (COSMO) in Denver, Colorado. As a former physical therapist & trainer, Dr. Logan provides a distinct expertise in sports injury, prevention, and surgical management.