How Does Fear Impact Return to Play after ACL Surgery?

Franklin D. Roosevelt said in his first inaugural address, “There is nothing to fear, but fear itself.”

Perhaps his words could inspire athletes bouncing back from devastating injuries.

The fear of re-injury and lack of confidence can have an enormous impact on anterior cruciate ligament surgery recovery and return to play after a sports injury.

This affects more than “Average Joes” and “Weekend Warriors.” Even high-profile professional athletes have struggled to physically and psychologically return to play after big knee injuries and surgery. Notable athletes include Chicago Bulls Guard Derrick Rose and Washington Redskins Quarterback Robert Griffin III.

A group of researchers examined how physical, psychosocial and functional recovery of patients reporting fear of re-injury or lack of confidence when returning to their sports and published their results in The American Journal of Sports Medicine. They followed 73 patients for one year. The researchers found:

  • 46 patients returned to their sport within one year after surgery.
  • 13 patients did not return to sports. An additional 14 patients didn’t return to sports because of their fear or lack of confidence.
  • The patients who did not return to sports because of fear or lack of confidence had these qualities, as compared with the patients who did return to sports:
    • Older age
    • Lower quadriceps strength/body weight

The researchers recommended making an assessment of fear of re-injury, quadriceps strength and self-reported function at six months as it “may help identify patients at risk for not returning to sports at one year and should be considered for inclusion in return-to-sport guidelines.”

View the full report here.