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Understanding Fear after an Anterior Cruciate Ligament Injury: A Qualitative Thematic Analysis Using the Common-Sense Model

Author

Listed:
  • Cameron Little

    (Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia)

  • Andrew P. Lavender

    (Institute of Health and Wellbeing, Federation University Australia, Ballarat, VIC 3350, Australia)

  • Cobie Starcevich

    (Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia)

  • Christopher Mesagno

    (Institute for Health and Sport, Victoria University, Melbourne, VIC 3011, Australia)

  • Tim Mitchell

    (Pain Options, Perth, WA 6151, Australia)

  • Rodney Whiteley

    (Aspetar Sports Medicine Hospital, Doha 29222, Qatar)

  • Hanieh Bakhshayesh

    (Curtin School of Electrical Engineering, Computing and Mathematical Sciences, Curtin University, Perth, WA 6102, Australia)

  • Darren Beales

    (Curtin enAble Institute and Curtin School of Allied Health, Curtin University, Perth, WA 6102, Australia)

Abstract

Fear is a significant factor affecting successful return to sport following an anterior cruciate ligament (ACL) injury. However, there is a lack of understanding of the emotional drivers of fear and how fear beliefs are formed. This study qualitatively explored the contextual and emotional underpinnings of fear and how these beliefs were formed, with reference to the Common-Sense Model of Self-Regulation. Face-to-face online interviews were conducted with ACL-injured participants ( n = 18, 72% female) with a mean age of 28 years (range 18–50 years). Participants were either 1 year post ACL reconstruction surgery ( n = 16) or at least 1 year post injury without surgery ( n = 2) and scored above average on a modified Tampa Scale of Kinesiophobia. Four participants were playing state-level sport or higher. Five themes emerged describing factors contributing to fear: ‘External messages’, ‘Difficulty of the ACL rehabilitation journey’, ‘Threat to identity and independence’, ‘Socioeconomic factors’, and ‘Ongoing psychological barriers’. A sixth theme, ‘Positive coping strategies’, provided insight into influences that could reduce fear and resolve negative behaviors. This study identified a broad range of contextual biopsychosocial factors which contribute to fear, supporting the notion that ACL injuries should not be treated through a purely physical lens. Furthermore, aligning the themes to the common-sense model provided a conceptual framework conveying the inter-related, emergent nature of the identified themes. The framework provides clinicians with a means to understanding fear after an ACL injury. This could guide assessment and patient education.

Suggested Citation

  • Cameron Little & Andrew P. Lavender & Cobie Starcevich & Christopher Mesagno & Tim Mitchell & Rodney Whiteley & Hanieh Bakhshayesh & Darren Beales, 2023. "Understanding Fear after an Anterior Cruciate Ligament Injury: A Qualitative Thematic Analysis Using the Common-Sense Model," IJERPH, MDPI, vol. 20(4), pages 1-17, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:4:p:2920-:d:1060966
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    References listed on IDEAS

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    1. Orbell, Sheina & Johnston, Marie & Rowley, David & Espley, Arthur & Davey, Peter, 1998. "Cognitive representations of illness and functional and affective adjustment following surgery for osteoarthritis," Social Science & Medicine, Elsevier, vol. 47(1), pages 93-102, July.
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