Abstract
Unrestricted participation in sports activities and return to the pre-injury level is often reported as an indicator of the success of ACL reconstruction. The athletes’ choice not to return to their pre-injury level may depend on the knee function, but some times, social reasons or psychological hindrances such as fear of re-injury may influence their return to sports. The aim of this study was to investigate whether fear of re-injury due to movement is of significance for returning to previous level of activity in patients who have undergone anterior cruciate ligament reconstruction. The Tampa Scale of Kinesiophobia (TSK), the Knee Injury and Osteoarthritis Outcome Score (KOOS) and some general questions were mailed to 87 patients who underwent ACL reconstruction 3–4 years before the study was conducted. Sixty-two patients (74%) answered the questionnaires (34 men and 28 women). Fifty-three percent of the patients returned to their pre-injury activity level. The patients who did not return to their pre-injury activity level had more fear of re-injury, which was reflected in the TSK. In addition, high fear of re-injury was correlated with low knee-related quality of life. Fear of re-injury must be considered in the rehabilitation and evaluation of the effects of an ACL reconstruction.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Bak K, Jorgensen U, Ekstrand J, Scavenius M (1999) Results of reconstruction of acute ruptures of the anterior cruciate ligament with an iliotibial band autograft. Knee Surg Sports Traumatol Arthrosc 7(2):111–117
Bjordal JM, Arnly F, Hannestad B, Strand T (1997) Epidemiology of anterior cruciate ligament injuries in soccer. Am J Sports Med 25(3):341–345
Deehan DJ, Salmon LJ, Webb VJ, Davies A, Pinczewski LA (2000) Endoscopic reconstruction of the anterior cruciate ligament with an ipsilateral patellar tendon autograft. A prospective longitudinal five-year study. J Bone Joint Surg Br 82(7):984–991
Hamada M, Shino K, Horibe S, Mitsuoka T, Miyama T, Toritsuka Y (2000) Preoperative anterior knee laxity did not influence postoperative stability restored by anterior cruciate ligament reconstruction. Arthroscopy 16(5):477–482
Johnson U (1997) Coping strategies among long-term injured competitive athletes. A study of 81 men and women in team and individual sports. Scand J Med Sci Sports 7(6):367–372
Kori SH, Miller RP, Todd DD (1990) Kinisophobia: a new view of chronic pain behavior. Pain Manag (Januari/Februari):35–43
Kvist J (2004) Rehabilitation following anterior cruciate ligament injury: current recommendations for sports participation. Sports Med 34(4):269–280
Lundberg M, Styf J, Carlsson S (2004) A psychometric evaluation of the Tampa scale for kinesiophobia—from a physiotherapeutic perspective. Physiother Theory Pract 20:121–133
Mainwaring LM (1999) Restoration of self: a model for the psychological response of athletes to severe knee injuries. Can J Rehabil 3(12):145–156
Mikkelsen C, Werner S, Eriksson E (2000) Closed kinetic chain alone compared to combined open and closed kinetic chain exercises for quadriceps strengthening after anterior cruciate ligament reconstruction with respect to return to sports: a prospective matched follow-up study. Knee Surg Sports Traumatol Arthrosc 8(6):337–342
Roos EM, Roos HP, Lohmander LS, Ekdahl C, Beynnon BD (1998) Knee Injury and Osteoarthritis Outcome Score (KOOS)—development of a self-administered outcome measure. J Orthop Sports Phys Ther 28(2):88–96
Ross MD, Irrgang JJ, Denegar CR, McCloy CM, Unangst ET (2002) The relationship between participation restrictions and selected clinical measures following anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 10(1):10–19
Webb JM, Corry IS, Clingeleffer AJ Pinczewski LA (1998) Endoscopic reconstruction for isolated anterior cruciate ligament rupture. J Bone Joint Surg Br 80(2):288–294
Vlaeyen JW, Linton SJ (2000). Fear-avoidance and its consequences in chronic musculoskeletal pain: a state of the art. Pain 85(3):317–332
Vlaeyen JW, Kole-Snijders AM, Boeren RG, van Eek H (1995) Fear of movement/(re)injury in chronic low back pain and its relation to behavioral performance. Pain 62(3):363–372
Acknowledgements
The authors especially thank Inger Eriksson for valuable help with the study administration. This work was supported by the Faculty of Health Sciences, Linköping University.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Kvist, J., Ek, A., Sporrstedt, K. et al. Fear of re-injury: a hindrance for returning to sports after anterior cruciate ligament reconstruction. Knee Surg Sports Traumatol Arthrosc 13, 393–397 (2005). https://doi.org/10.1007/s00167-004-0591-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00167-004-0591-8