Physical, psychological, and environmental shifts experienced during the young athlete journey after ACL reconstruction

• Published in: Physical therapy in sport 2024-11, Vol.70, p.44-52
• Main Authors: Zwolski, Christin M., Paterno, Mark V., Rethorn, Timothy J., Thomas, Staci M., Quatman-Yates, Catherine C., Schmitt, Laura C.
• Format: Article
• Language: English
• Subjects: Adolescent; Anterior Cruciate Ligament Injuries - surgery; Anterior Cruciate Ligament Reconstruction; Athletes; Athletes - psychology; Built Environment; Child development; Coronaviruses; COVID-19; Data analysis; Data collection; Environment; Exercise; Female; Humans; Interviews; Interviews as Topic; Life transitions; Ligaments; Male; Mental Health; Motivation; Pediatrics; Psychological aspects; Qualitative Research; Rehabilitation; Return to Sport; Self Concept; Social networks; Social Support; Software; Sports medicine
• ISSN: 1466-853X; 1873-1600; 1873-1600
• DOI: 10.1016/j.ptsp.2024.08.005

The purpose of this study was to explore self-perceived changes in athlete journey trajectory, or shifts, after ACLR that facilitate or hinder physical activity participation among youth. Ten participants were included in this study at a median of 5.9 years after adolescent ACLR. Using an interpretive phenomenological methodology, semi-structured interviews with each participant were recorded and transcribed verbatim. Data collection focused on participants’ lived experiences of reintegration to physical activity after ACLR. Thematic analyses were guided by the procedures of the constant comparative method. Nineteen distinct shifts were identified from participants’ perspectives, categorized into the main classification scheme of 1) environmental shifts (extrinsic demands, built environment, social network), 2) psychological shifts (expectations, motivation, meaning of sports, accountability, priorities, athlete identity, mental health, confidence, knowledge, character, participation mentality), and 3) physical shifts (movement competence, sport participation, physical activity, normalization, knee health). Factors perceived to induce shifts were categorized as natural, injury-driven, or life transition-driven. In the years following adolescent ACLR, young athletes experience physical, psychological, and environment shifts that impact physical activity participation. These findings provide important insight for future work that aims to optimize physical activity outcomes after an injury-related disruption in the athlete journey. •Young athletes perceive significant “shifts” to impact physical activity after ACLR.•Examples include shifts in one's social network, athlete identity, and knee health.•Shifts are perceived to occur naturally, or brought on by injury or life transition.•Results provide important insight for physical activity interventions after ACLR.