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kinesiophobia, anterior cruciate ligament injury, ACL injury, sports injury, rehabilitation, rehabilitation protocols, athletic therapy


The rehabilitation of an athlete after an anterior cruciate ligament (ACL) injury includes both physical and psychological barriers. One such psychological barrier is kinesiophobia, more commonly referred to as the fear of reinjury. All individuals experience some level of kinesiophobia, or fear of reinjury, related to the return to sport after ACL injury and reconstruction. Kinesiophobia can have a negative impact on an athlete’s short-term rehabilitation and long-term goals of return to sport. In many cases the fear of reinjury has been found to be one of the key reasons that an athlete does not return to sport or to their previous level of activity at all. Despite the advancements in graft technology for ACL reconstruction and the development of advanced return to sport protocols after surgery, successful return to sport rates are still considerably low. Many individuals do not return to their pre-injury level of activity despite regaining full physical knee function without any instability Purpose: The aim of this review is to expand on the effects of kinesiophobia on the successful return to sport following a reconstruction of the anterior cruciate ligament and to help determine risk factors, causes, and possible treatments to better the chance for successful return to sport after ACL injury. Although there has been significant research connecting the fear of reinjury (kinesiophobia) to negative rehabilitation outcomes following anterior cruciate ligament reconstruction, there has been very little research into the appropriate treatment of kinesiophobia and how to improve the low rates of successful return to sport. Conclusions: Rehabilitation and return to sport are both negatively impacted by psychological factors such as the fear of reinjury. Kinesiophobia has been found to increase with lengthened total time out of sport, increased time before surgery, and proximity in time to return to sport. Evidence has been found to support the use of psychological interventions/treatments targeting kinesiophobia and the fear of reinjury in the improvement of rehabilitation outcomes after ACL reconstruction. Further research should focus on the psychological aspect of rehabilitation after anterior cruciate ligament injury, and its impact on return to play as well as the inclusion of psychological intervention strategies in ACLR post-operative rehabilitation protocols.


Faculty of Applied Health and Community Studies (FAHCS)


2019 Canadian Athletic Therapists Association Certification Candidate Writing Award

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Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.