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More than fear of reinjury – a multidimensional experience of reinjury concerns: a sytematic review with qualitative evidence synthesis of athletes’ experience and interpretation of “reinjury concerns” after anterior cruciate ligament injury

Review written by Dr Christina Le info

Key Points

  1. Athletes’ experiences of reinjury concerns are multifaceted, dynamic, and shaped by individual beliefs and contexts.
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BACKGROUND & OBJECTIVE

Imagine having a conversation with your patient who is just about to return to sports following an anterior cruciate ligament (ACL) injury. They have met all of your testing criteria, but they’re also sharing that they’re scared of hurting their knee again. Unfortunately, this scenario is all too common (1).

Fear of reinjury is often used as a catch-all term for a wide variety of psychological and behavioral responses like kinesiophobia, fear avoidance, re-injury anxiety, or low confidence (2), but these terms mean slightly different things that likely require different management approaches. Adding to the confusion, the construct of fear of reinjury largely originates from chronic pain populations (3,4), and no previous research has determined if fear of reinjury is an appropriate term for ACL-injured populations.

In this study, “reinjury concerns” is used to capture the cognitions, emotions, and behaviors associated with the threat of reinjury. The objective was to explore what “reinjury concerns” means to athletes recovering from an ACL injury.

Fear of reinjury is often used as a catch-all term for a wide variety of psychological and behavioral responses like kinesiophobia, fear avoidance, re-injury anxiety, or low confidence.
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As clinicians, we should consider using the term “reinjury concerns” instead of “fear of reinjury” as this previous concept is narrow in its breadth, suggesting that fear is either present or not.

METHODS

This study was a systematic review and qualitative evidence synthesis. The authors used an interpretivist lens (aiming to understand how people create and interpret meaning) within a constructivist approach (viewing reality as socially constructed through experiences).

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