The Role of Psychosocial Variables in Successful Return to Sport After Anterior Cruciate Ligament Reconstruction

Paper ID : 1743-SPORTCONGRESS

Authors

Omid Norouzi * No

Abstract

Introduction: This review aims to examine and synthesize current evidence regarding the influence of psychosocial variables—including psychological, social, and environmental factors—on successful return to sport outcomes following Anterior Cruciate Ligament Reconstruction (ACLR). The primary focus is to understand why many athletes who achieve physical recovery benchmarks fail to return to their pre-injury performance levels. Methods: A comprehensive narrative synthesis of literature was conducted, incorporating evidence from longitudinal studies, cross-sectional research, and systematic reviews from sports medicine and psychology databases. The analysis specifically investigated psychosocial factors including fear of re-injury (kinesiophobia), self-efficacy, rehabilitation motivation, perceived social support, and psychological readiness in post-ACLR athletes. Results: The findings consistently identify psychosocial variables as significant predictors of return to sport outcomes. Fear of re-injury emerges as the most prevalent psychological barrier, frequently resulting in protective movement patterns and compromised performance. Additional negative factors include low self-efficacy, pain catastrophizing, and lack of psychological readiness. Conversely, positive psychosocial factors such as high motivation, resilience, and strong perceived support from coaches, family, and healthcare providers demonstrate significant correlation with successful rehabilitation adherence and confident return to competition. Conclusion: The evidence confirms that successful return to sport after ACLR transcends physical recovery and is substantially mediated by psychosocial factors. The conventional rehabilitation model, predominantly focused on physical metrics, proves inadequate in addressing the complex biopsychosocial nature of recovery. A paradigm shift integrating standardized psychosocial assessments and targeted interventions—including cognitive-behavioral therapy, graded exposure, and support system education—is imperative. This integrated approach is essential for bridging the gap between physical recovery and psychological readiness, ultimately optimizing return-to-sport outcomes and ensuring sustainable athletic participation post-reconstruction.

Keywords

A nterior Cruciate Ligament Reconstruction, Return to Sport, Psychosocial Factors, Kinesiophobia

Status: Abstract Accepted (Poster Presentation)