Deciding when to return to sport following an ACL injury can be extremely challenging. Athletes must contend not only with the physical consequences, but also with the psychological ones. While readiness tests take various factors into account, it’s unclear how these factors might be linked. In a study published in The American Journal of Sports Medicine, researchers from Norway report on the association they found between psychological readiness to return to sport and tibial displacement.
The study enrolled 132 patients aged 16 or older nine to twelve months after ACL reconstruction surgery. At baseline, patients completed a project-specific activity questionnaire and the ACL-Return to Sport After Injury scale evaluation. Knee laxity was assessed using the Lachman test, a KT-1000 arthrometer, and the pivot-shift test. Patients were followed-up two years after surgery.
Data revealed small but significant negative associations between measurements of anterior tibial displacement and psychological readiness to return to sport: patients showing greater displacement on the Lachman test and in KT-1000 arthrometer measurements reported lower psychological readiness.
No significant associations were observed between laxity determined by the pivot-shift test and psychological readiness . And there were no differences in ACL-RSI scores between patients with stable knees and those with slightly increased or residual laxity.
Thirty-six percent of patients returned to their preinjury level of sport two years after surgery. Factors that predicted this return included higher age, higher psychological readiness, and less anterior tibial displacement.
Although the association between psychological readiness and knee laxity was low, the results offer support for incorporating psychological readiness and clinical findings into return-to-sport assessments following ACL reconstruction.