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Isabella Camarillo

Mrs. McCann

English 1302.203

24 April 2022

The Importance of Physiological Readiness in the Recovery of an Athlete's Injury

As athletes get injured, they can have many feelings and get broken down as they cannot

play their sport until they are recovered. One can feel like their world is ending and they have

nothing left to go on. From that, it is said that numerous aspects of recovery and health wise

appear when an athlete gets injured from an ACL tear. Many steps are to be taken slowly and to

go day by day so there will be no rush in recovery. The mind can have a strong input on whether

one is ready to return back to one’s field and that can take on a poll from someone who will have

a mindset of them never being the same. Once the fear of having a repeated injury (ACL tear) the

athlete may have a negative impact on the rehabilitation towards the recovery. In other words, as

an athlete gets injured from an ACL tear, the aspects of returning back will likely be based on

giving a full report both physiological and physical readiness for this can turn into a successive

recovery.

Understanding the Psychological Purpose

An athlete's psychological readiness can assist them in fully ensuring that they are well

and will not suffer another injury. It has been claimed that in the recovery of ACL injuries,

attention to the consequences of psychological wellness has not been paid as much as it should

be (Liew et al. 2). This is because there have been detrimental consequences of not spending

enough time looking into the psyche of many athletes. Researchers have been hesitant to
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acknowledge the wellness of psychology to further examine what can be a superior settlement in

rehabilitation since that discovery. Many research findings and assessments have found that the

components in psychological readiness with sports injuries have quite a distinct and crucial

element, implying that one cannot function without either (Liew et al. 2). In other words, once an

athlete has completed the completed recovery time for an ACL injury, they are exempt to return

to their original sport; however, the likelihood of getting hurt again and a lack of self confidence

may cause one to be reluctant to attend over.

As a result of that fear, it will be demonstrated that even without a psychological

evaluation of the athlete, the athlete may not be the same within themselves, and will have the

feeling of fullness in a somewhat more physical way. Psychological factors have a significant

impact on recovery regards to the effects of anterior cruciate ligament repair. Increased fear of

re-injury, kinesiophobia, or low self-efficacy make it difficult to return to sports following ACL

reconstruction (Chmielewski and George. 2). The psychological reaction to something like a

sports injury is generally the worst shortly after the event, yet it can have a better impact as

therapy progresses. Psychological difficulties may have an influence on the development

recovery results following ACL reconstruction. In the anxiety mode, kinesiophobia (fear of

movement/re-injury) and pain overthinking things are psychological constructs (Chmielewski

and George. 2) . When pain is regarded as a danger, kinesiophobia and pain catastrophizing

increase, leading to overuse, despair, and impairment.

Changes

It has been observed that as each wounded athlete progresses through their studies and

therapy, they become increasingly unique. The three factors are being investigated once more to

see what is affecting recovery. Many of the three objects that are being examined closely are
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thought to have a stronger connection than the items that mirror the various aspects (Liew et al.

3). More importantly, it was realized that the athlete's internal emotions have a greater impact on

the network than the other two elements: confidence and risk. As the studies are being taken

down with the questionnaires, many researchers are able to discover that athletes who have

recently injured themselves and are in the process of rehabilitation have many worries about the

future, which then can affect their psychological wellness. They are able to get more of an

understanding of what it is the athletes may be fearful of and what can be resolved due to this

problem. The chart with the questions gives an indication of where the athlete is at from the

beginning and the end during the study and more importantly how as the athlete changed with

their psychological readiness.

Step One (Questionnaire)

When stepping into the recovery unit there are certain questionnaires where researchers

ask athletes to see if they are ready to return to the sport. This can further assess in determining if

the athlete is at one hundred percent in their recovery. From that, there are many different

sections of different sources where they used somewhat of the same questionnaires to help the

recovery. The questionnaire called “ACL returns to sports after Injury” has the following 12

questions to check if the athlete has all three elements of physiological impact in returning back

to the sport (Slagers and van den Akker-Scheek 2). The three elements that indicate when an

athlete is ready to return are within their emotions, confidence in one’s performance, and

evaluation of risk. From this there is a total score on the response that was given and with any

high score gives an indication of a positive psychological response. Within the questions “The

Injury Psychological Readiness to Return” (I-PRRS) their scale had consisted of six items of one

hundred points to where it gets divided by the six items of ten points to calculate I-PRRS
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(Slagers and van den Akker-Scheek 2). The scores are there to consider if the athlete has a high

level of confidence of returning back to their sport. For instance, if the score comes out with a

score of 60 then it would indicate a high level of confidence and a score of 40 shows a

moderated level of confidence, whereas a score of 20 would show up as a very low level of

confidence.

Step Two (Challenges)

With the several questionnaires to indicate physiological readiness there is another side

where there is a test to truly see if the athlete is truly ready for returning back. The test, The

Tegner Activity Score, (TAS) helps determine if a certain body part is at one hundred percent

during their precipitation in the task of the test. The scores of TAS range from one to ten

depending on where the athlete is at (Slagers and van den Akker-Scheek 2). This activity comes

where the score is from zero through ten and from this can further assess the activity level

towards the athlete. And if succeeded the higher the scores were in TAS the higher activity it was

set to. This task was found to have very high outcomes towards people who have injuries from

ACLs. From this it helps give more of an understanding on just how both physiological and

physical readiness is both important and how they will need to work together in order for the

recovery to have a better outcome. While there is TAS the last test is going back to the

questionnaire test called Global Rating of Change, GRC, this test was to determine and identify

if the participants had improved (Slagers and van den Akker-Scheek 2). The way it progressed

was by asking the participant if they had a change in their confidence over the lasting two

months of resumption of their sport. As the response came back the response that had said to

have a very high confidence were labeled as improved; those who had come back with “about

the same” confidence were marked off as unchanged. This then comes back to the people who
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were said to have very low confidence were taken off the responsiveness analysis (Slagers and

van den Akker-Scheek 3).

Despite being given doctor's approval to revert back to sports and varying degrees of

symptomatic since surgery, the sportsmen inside this research never gained back workable

balance of lower extremity efficiency. These findings call into doubt the legitimacy of such

athletes' return to sport decisions, and the long-term deficiencies and their severity could clarify

the higher risk of “ACLR” reinjury described in the literature. The researchers assume that the

symmetrical activity ought to be the emphasis of comeback to sports criterion for a healthy

return to play following ACLR (Schilling and Radwan.10 ). A detailed review of an individual ’s

development can detect weaknesses and help lead the judgment of whether or not to resume

athletics safely .

Conclusion

When an athlete is injured, they may feel a range of emotions and become depressed

because they will not be able to return to their sport until they have fully recovered. It is possible

to feel as if your world is collapsing around you and you have nothing left to hold on to. When

an athlete's ACL is torn, there are a number of things to consider. Many steps should be made

gradually each day to avoid hastening the recovery process. The mind can have a significant

impact on whether or not someone is willing to enter their field, and this can take the form of a

poll from someone who believes they will never be the same again. Athlete's fear of sustaining

yet another injury The healing process could be hampered if the ACL is torn. In other words, if

an athlete endures an ACL tear, the elements of returning to the game will more than likely be

largely based on having a full review across both physical and physiological readiness, as this

can result to a long process of recovery if this is not considered to be checked up during the
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Rehabilitation. Even without a thorough understanding of psychology, one will never be able to

return to their sport.

Works Cited

Burland, Julie P, et al. “Decision to Return to Sport after Anterior Cruciate Ligament

Reconstruction, Part I: A Qualitative Investigation of Psychosocial Factors.” Journal of

Athletic Training, U.S. National Library of Medicine, 2018,

https://pubmed.ncbi.nlm.nih.gov/29505304/.

Chmielewski, Terese L., and Steven Z. George. “Fear Avoidance and Self-Efficacy at 4 Weeks

after ACL Reconstruction Are Associated with Early Impairment Resolution and

Readiness for Advanced Rehabilitation - Knee Surgery, Sports Traumatology,

Arthroscopy.” SpringerLink, Springer Berlin Heidelberg, 3 July 2018,

https://link.springer.com/article/10.1007/s00167-018-5048-6.

Huang, Hui, et al. “Reproducibility, Responsiveness and Validation of the Tampa Scale for

Kinesiophobia in Patients with ACL Injuries.” Health and Quality of Life Outcomes, 2019,

https://hqlo.biomedcentral.com/track/pdf/10.1186/s12955-019-1217-7.pdf.

Kitaguchi, Takuya, et al. “Importance of Functional Performance and Psychological Readiness

for Return to Preinjury Level of Sports 1 Year after ACL Reconstruction in Competitive Athletes

- Knee Surgery, Sports Traumatology, Arthroscopy.” SpringerLink, Springer Berlin Heidelberg, 2

Nov. 2019, https://link.springer.com/article/10.1007/s00167-019-05774-y.

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Liew, Bernard X. W., et al. “Understanding the Psychological Mechanisms of Return to Sports

Readiness after Anterior Cruciate Ligament Reconstruction.” PLOS ONE, Public Library

of Science, 2022,

https://journals.plos.org/plosone/article?id=10.1371%2Fjournal.pone.0266029.

Oleksy, Łukasz, et al. “Composite Score of Readiness (CSR) as Holistic Profiling of Functional

Deficits in Footballers Following ACL Reconstruction.” MDPI, Multidisciplinary Digital

Publishing Institute, 13 Aug. 2021, https://www.mdpi.com/2077-0383/10/16/3570/htm.

Schilling, Dave, and Ahmed Radwan. Are Athletes Ready to Return to Competitive Sports

Following ACL Reconstruction and Medical Clearance, 2020,

https://www.tandfonline.com/doi/pdf/10.1080/2331205X.020.1723822.

Slagers, Anton J., and Inge van den Akker-Scheek. “Responsiveness of the Anterior Cruciate

Ligament – Return to Sports after Injury (ACL-RSI) and Injury – Psychological Readiness

to Return to Sport (I-PRRS) Scales.” Taylor & Francis, 2019,

https://cogentoa.tandfonline.com/doi/full/10.1080/02640414.2019.1646023.