An Exploration of Sports Rehabilitators' and Athletic Rehabilitation Therapists' Views on Fear of Reinjury After Anterior Cruciate Ligament Reconstruction

Background: Research involving long-term follow-up of patients after successful anterior cruciate ligament reconstruction (ACLR) has shown that return-to-sport rates are not as good as would be expected despite many patients' having normal knee-function scores. The psychological component, specifically fear of reinjury, plays a critical role in determining patients' return to play and is frequently underestimated. Little is known about the recognition and intervention from the therapist's perspective. Aim: To gain a greater understanding of the views of sports rehabilitators and athletic rehabilitation therapists on recognition of fear of reinjury in clients after ACLR. Method and Design: A qualitative approach, consisting of semistructured interviews with a purposive sample of 8 participants, sports rehabilitators, or athletic rehabilitation therapists. This population has been largely unexamined in this context in previous research. Main Findings: Thematic analysis yielded 2 main themes: communication and education. Participants discussed the importance of communication in the client-therapist relationship and how it is used in addressing misinformation and fear of reinjury. All participants used education in outlining the rehabilitation pathway and dealing with those providing social support around the client. Issues emerged relating to therapists' recognition of observable signs of fear of reinjury in the clinical setting. Overall, participants thought that fear of reinjury was not a barrier to return to play after ACLR. Conclusion: There is a need for more education of therapists on recognizing fear of reinjury and the appropriate use of psychological intervention skills as a method for dealing with this throughout the rehabilitation process.