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Fear of reinjury kept athletes from returning to play after ACL reconstruction
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The number of football players who resumed play after anterior cruciate ligament reconstruction was less than expected and may be attributed to psychological fears of reinjury, according to recent study data.
Researchers conducted a retrospective analysis of 147 football players, including 68 high school and 26 college athletes recruited from the Multicenter Orthopaedic Outcomes Network, who had undergone anterior cruciate ligament (ACL) reconstruction in 2002 and 2003. Patients responded to questions about their ACL tear, their participation before surgery and factors pertaining to their return to play.
Return rates for the two groups were similar: 63% of high school players compared with 69% of collegiate athletes. When assessing their performance upon return at a minimum of 2 years postsurgery, across high school and college football players, 43% reported playing at the same level as before their injuries, 27% said they did not perform at the same pre-ACL injury level, and 30% were unable to return.
Among the reasons for not returning, 53% of high school and 50% of college players listed fear of reinjury, while other interests, including other sports, jobs and family, topped the responses at 67% and 75% for high school and college players, respectively. High school players reported that their position on the field did not have an effect on their ability to return to play (P=.76), although 41% of “skill position” players returned to their pre-injury performance level compared with 50% among “nonskill position” players.
“While the surgical and rehabilitation components of ACL [reconstruction] have undergone extensive study and evaluation,” the researchers concluded, “the psychological component of return to play, in particular fear of reinjury, is frequently underestimated and likely plays a critical role in preventing athletes from returning to play.”
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