
Questions like this have plagued those of us that work in the
sports medicine realm for years. What
makes the difference between athlete A and B and how can you, as a clinician
help to improve the odds of a safe return to sport? All too often, the one component that is
missed is the psychological component. For
many, it is an uncomfortable aspect of care to address. It is too touchy feely. Yet, how can you address the “whole” athlete
if you don’t address?

What the authors found was at 12 months, only 56 athletes or
31% had returned to their pre-injury level of sports participation. The most significant psychological factors
contributing to inability to return to pre-injury levels were: psychological readiness,
fear of re-injury, sport locus control and the athlete’s pre-operative estimate
of the number of months it would take to return to sport. As ground breaking as this study is, it is
nothing new to those of us who treat these patients every day. Yet it also highlights some very key take aways.
One key take away for me is the role of the rehab
provider. If they are not personally
vested in assisting the athlete achieving success, if they approach it with
apathy, then they are doing the athlete a serious disservice. As a provider, our role is as an educator and
coach, with emphasis in this case on coach.
Coaching is not passive. It is methodical
in approach, motivational and inspiring and purposefully driven to the end goal
all while also being empathetic to the patient.

About the
author: Trent Nessler, PT, DPT, MPT.
Trent is a practicing physical therapist with 14 years in sports
medicine and orthopedics. He has a
bachelors in exercise physiology, masters in physical therapy and doctorate in
physical therapy with focus in biomechanics and motor learning. He author of a textbook “Dynamic Movement Assessment™: Prevent Injury and Enhance
Performance”, is associate editor of the International Journal of Athletic
Therapy and Training, Member of the USA Cheer Safety Council and
founder/developer of the Dynamic
Movement Assessment™.
Reference:
1.
Ardern C, Taylor N, Feller J, Whitehead T, Webster E. Psychological
Responses Matter in Returning to Preinjury Level of Sport After Anterior
Cruciate Ligament Reconstruction Surgery.
Am J Sports Med. 41:1549-1558.
2013.
2.
Brophy R, Schmitz L, Wright R, Dunn W, Parker R, Andrish J, McCarty E,
Spindler K. Return to Play and Future ACL Injury Risk After ACL Reconstruction in Soccer
Athletes From a Multicenter Orthopaedic Outcomes Network (MOON) Group. Am j sports med. 40:2517-2522, 2012.
3.
Holm I, Oiestad B, Risberg M, Gunderson R, Aune A. No
Difference in Prevalence of Osteoarthritis or Function After Open Versus
Endoscopic Technique for Anterior Cruciate Ligament Reconstruction: 12 Year
Follow-up Report of Randomized Controlled Trial. Am j sports med. 40:2492-2498, 2012
4.
McCullough K, Phelps K, Spindler K, Matava M, Dunn W, Parker R, Reinke
E. Return
to High School – and College-Level Football After Anterior Cruciate Ligament
Reconstruction: A Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study. Am j sports med. 40:2523-2529, 2012
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