Skip to main content

Advertisement

SpringerLink
Log in

Psychobiology and the Athlete with Anterior Cruciate Ligament (ACL) Injury

  • Review Article
  • Published:
Sports Medicine Aims and scope Submit manuscript

Abstract

Over the past decade, research has increasingly highlighted the need for psychological aspects associated with sporting injury to be considered in treatment programmes. However, contemporary practice continues to focus on the treatment of the physical injury. The purpose of this article is to summarise research and contemporary thoughts on the psychological aspects associated with sporting injury. The potential for incorporating both physical and psychological aspects into the treatment of injury is discussed with special reference to the anterior cruciate ligament (ACL) injury. Specifically, the potential importance of athlete involvement throughout the treatment programme is discussed. Additionally, the physical and psychological measures that are available to the sports medicine team to measure rehabilitation outcome are critically evaluated. The limitations of psychological measures of the athlete’s perception of outcome are outlined. Evidence for the utility of the performance profile technique is critically evaluated. The technique provides valid and reliable measures of the idiosyncratic responses of athletes to injury to provide a framework for effective treatment for optimised outcome.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Renstrom P. Sports traumatology today: a review of current sports injury problems. Ann Chir Gynaecol 1991; 80 (2): 81–93

    PubMed  CAS  Google Scholar 

  2. Crossman J. Psychological rehabilitation from sports injuries. Sports Med 1997; 23 (5): 333–9

    Article  PubMed  CAS  Google Scholar 

  3. Ryde D. The role of the physician in sports injury prevention: some psychological factors in sports injuries. J Sports Med Phys Fitness 1977; 17: 187–94

    Google Scholar 

  4. May JR, Sieb GE. Athletic injuries: psychosocial factors in the onset, sequelae, rehabilitation and prevention. In: May JR, Asken MJ, editors. Sports psychology. New York: PMA Publishing, 1987: 157–85

    Google Scholar 

  5. Gordon S, Milios D, Grove JR. Psychological aspects of the recovery process from sport injury: the perspective of sport physiotherapists. Aust J Sci Med Sport 1991; 23: 53–60

    Google Scholar 

  6. Lynch GP. Athletic injuries and the practising sport psychologist: practical guidelines for assisting athletes. Sport Psychol 1988; 2: 161–7

    Google Scholar 

  7. Pedersen P. The grief response and injury: a special challenge for athletes and athletic trainers. Athletic Train 1986; 21: 312–4

    Google Scholar 

  8. Rotella RJ, Heyman SR. Stress, injury, and the psychological rehabilitation of athletes. In: Williams JM, editor. Applied sport psychology: personal growth to peak performance. 2nd ed. Mountain View (CA): Mayfield, 1993: 338–55

    Google Scholar 

  9. Brown TJ, Stroudmire AG. Normal and pathological grief. JAMA 1983; 250: 378–82

    Article  PubMed  CAS  Google Scholar 

  10. Kubler-Ross E. On death and dying. New York: Macmillan, 1969

    Google Scholar 

  11. Shontz FC. The psychological aspects of physical illness and disability. New York: Macmillan, 1975

    Google Scholar 

  12. Astle SJ. The experience of loss in athletes. J Sports Med Phys Fitness 1986; 26: 279–84

    PubMed  CAS  Google Scholar 

  13. Rotella RJ. The psychological care of the injured athlete. In: Bunker LK, Rotella RJ, Reilly AS, editors. Sport psychology: psychological considerations in maximizing sport performance. Ann Arbor (MI): McNaughton and Gunn, 1985: 273–87

    Google Scholar 

  14. McDonald SA, Hardy CJ. Affective response patterns of the injured athlete: an exploratory analysis. Sport Psychol 1990; 4: 261–74

    Google Scholar 

  15. Uemukai K. Affective responses and the changes in athletes due to injury. In: Serpa S, Alves J, Ferreira V, et al., editors. Proceedings of the 8th World Congress of Sport Psychology; 1993 Jul: Lisbon. Lisbon: International Society of Sport Psychology, 1993: 500–3

    Google Scholar 

  16. Brewer BW. Review and critique of models of psychological adjustment to athletic injury. J Appl Sport Psychol 1994; 6: 87–100

    Article  Google Scholar 

  17. Pearson L, Jones G. Emotional effects of sports injuries: implications for physiotherapists. Physiotherapy 1992; 78: 762–70

    Article  Google Scholar 

  18. Wiese DM, Weiss MR. Psychological rehabilitation and physical injury: implications for the sports medicine team. Sport Psychol 1987; 1: 318–30

    Google Scholar 

  19. Rose J, Jevne RF. Psychosocial processes associated with athletic injuries. Sport Psychol 1993; 7: 309–28

    Google Scholar 

  20. Yukelson D. Psychology of sports and the injured athlete. In: Bernhardt DB, editor. Clinics in physical therapy. New York: Churchill Livingstone, 1986: 173–95

    Google Scholar 

  21. McNair DM, Lorr M, Droppleman LE. Profile of mood states manual. San Diego: Educational and Industrial Testing Service, 1971

    Google Scholar 

  22. Lorr M, McNair DM. Profile of mood states: bi-polar form. San Diego: Educational and Industrial Testing Service, 1988

    Google Scholar 

  23. Smith AM, Scott SG, O’Fallon WM, et al. Emotional responses of athletes to injury. Mayo Clin Proc 1990; 65: 38–50

    PubMed  CAS  Google Scholar 

  24. Butler DL, Noyes FR, Grood ES. Ligamentous restraints to anterior-posterior drawer in the human knee: a biomechanical study. J Bone Joint Surg 1980; 62A: 259–70

    PubMed  CAS  Google Scholar 

  25. Tibone JE, Antich TJ, Fanton GS, et al. Functional analysis of the anterior cruciate ligament instability. Am J Sports Med 1986; 14: 276–84

    Article  PubMed  CAS  Google Scholar 

  26. Sanderson F. Psychology and injury. In: Reilly T, editor. Science and soccer. London: E & FN Spon, 1996: 65–180

    Google Scholar 

  27. Wojtys EM. The ACL deficient knee. Rosemont (IL): American Academy of Orthopaedic Surgeons, 1994

    Google Scholar 

  28. Noyes FR, Matthews DS, Mooar PA, et al. The symptomatic anterior cruciate deficient knee: Pt II. The results of rehabilitation, activity modification, and counseling on functional disability. J Bone Joint Surg 1983; 65A: 163–74

    PubMed  CAS  Google Scholar 

  29. Bach BR, Friedman MJ, Howell SM, et al. Anterior cruciate ligament: sugical principles and techniques. Proceedings of the 63rd Annual Meeting of the American Academy of Orthopedic Surgeons; 1996 Feb: Atlanta (GA). American Academy of Orthopedic Surgeons, 1996

    Google Scholar 

  30. Rees D. ACL reconstructions: possible modes of failure. Proceedings of the Football Association, Royal College of Surgeons [Edinburgh] 6th Joint Conference on Sport Injury; 1994 Jul 2–3: Telford, UK

  31. Reid DC. Sports injury assessment and rehabilitation. New York: Churchill Livingstone, 1992

    Google Scholar 

  32. Howe JG, Johnson RJ, Kaplan MJ, et al. Anterior cruciate ligament reconstruction using quadriceps patella tendon graft: Pt 1. Long term follow up. Am J Sports Med 1991; 19: 447–57

    Article  PubMed  CAS  Google Scholar 

  33. Hurwitz DE, Andriacchi TP, Bush-Joseph CA, et al. Functional adaptations in patients with ACL-deficient knees. Exerc Sport Sci Rev 1997; 25: 1–20

    Article  PubMed  CAS  Google Scholar 

  34. Holden DL, Jackson DW. Treatment selection in acute anterior cruciate ligament tears. Orthop Clin North Am 1985; 16: 99–109

    PubMed  CAS  Google Scholar 

  35. Gleeson N, Mercer T, Morris K, et al. Influence of a fatigue task on electromechanical delay in the knee flexors of soccer players [abstract]. Med Sci Sports Exerc 1997; 29: S281

    Google Scholar 

  36. Gleeson N, Mercer T, Reilly T, et al. The influence of acute endurance activity on leg neuromuscular and musculoskeletal performance. Med Sci Sports Exerc 1998; 30: 596–608

    Article  PubMed  CAS  Google Scholar 

  37. Deci EL, Ryan RM. Intrinsic motivation and self determination in human behaviour. New York: Plenum Press, 1995

    Google Scholar 

  38. Tegner Y, Lysholm J. Rating systems in the evaluation of knee ligament injuries. Clin Orthopaed 1985; 172: 143–7

    Google Scholar 

  39. Noyes FR, McGinniss GH, Grood ES. The variable functional disability of the anterior cruciate ligament deficient knee. Orthop Clin North Am 1985; 16: 47

    PubMed  CAS  Google Scholar 

  40. Anderson AF, Federspiel CF, Snyder RB. Evaluation of knee ligament rating systems. Am J Knee Surg 1993; 6: 67–73

    Google Scholar 

  41. Mayor RB, Rogers WH, Roos N, et al. Measurement of functional outcome of anterior cruciate ligament reconstructive surgery: an analysis of rating scales. Proceedings of the 63rd Annual Meeting of the American Academy of Orthopaedic Surgeons; 1996 Feb: Atlanta (GA). American Academy of Orthopaedic Surgeons, 1996: 89

    Google Scholar 

  42. Sgaglione NA, Del Pizzo W, Fox JM, et al. Critical analysis of knee ligament rating systems. Am J Sports Med 1995; 23: 660–7

    Article  PubMed  CAS  Google Scholar 

  43. Noyes FR, Barber SD, Mooar LA. A rationale for assessing sports activity levels and limitations in knee disorders. Clin Orthop 1989; 246: 239–49

    Google Scholar 

  44. Morrey MA. Predicting injury recovery is a function of affect in pain perception in athletes who have undergone anteriorcruciate ligament reconstructive surgery: an exploratory study [abstract]. J Appl Sport Psychol 1996; 8: S38

    Google Scholar 

  45. LaMott EE. Longitudinal assessment of physical and psychological response to injury: in the context of the Wiese-Bjornstal and Smith response to injury model [abstract]. J Appl Sport Psychol 1996; 8: S39

    Google Scholar 

  46. Butler RJ. Psychological preparation of Olympic boxers. In: Kremer J, Crawford W, editors. The psychology of sport: theory and practice. Leicester: British Psychological Society, 1989: 74–84

    Google Scholar 

  47. Kelly GA. The psychology of personal constructs. New York: Norton, 1955

    Google Scholar 

  48. Butler RJ, Hardy L. The performance profile: theory and application. Sport Psychol 1992; 6: 253–64

    Google Scholar 

  49. Butler RJ. Sports psychology in action. Oxford: Butterworth Heinemann, 1996

    Google Scholar 

  50. Jones G. The role of performance profiling in cognitive behavioural interventions in sport. Sport Psychol 1993; 7: 160–72

    Google Scholar 

  51. Butler RJ, Smith M, Irwin I. The performance profile in practice. J Appl Sport Psychol 1993; 5: 48–63

    Article  Google Scholar 

  52. Hardy L, Parfitt G. The development of a model for the provision of psychological support to a national squad. Sport Psychol 1994; 8: 126–42

    Google Scholar 

  53. Doyle J, Parfitt G, Gleeson N, et al. The reproducibility and single-measurement reliability of the performance profile technique. J Sport Exerc Psychol 1997; 19: S47

    Google Scholar 

  54. Doyle J, Parfitt G. Performance profiling and predictive validity. J Appl Sport Psychol 1996; 8: 160–70

    Article  Google Scholar 

  55. Doyle J, Parfitt G. Performance profiling and construct validity. Sport Psychol 1997; 11: 411–25

    Google Scholar 

  56. Shambrook CJ, Bull SJ. Towards a further understanding of adherence to psychological skills training. Proceedings of the 9th European Congress on Sport Psychology; 1995 Jul 4–9: Brussels. European Federation of Sports Psychology (FEPSAC), 1995: 966–73

    Google Scholar 

  57. Shambrook CJ, Bull SJ. The impact of programme individualization and programme structuring on post-workshop imagery training adherence levels. J Sports Sci 1997; 15: 103

    Google Scholar 

  58. Dale GA, Wrisberg CA. The use of a performance profile technique in a team setting: getting the athletes and coach on the ‘same page’. Sport Psychol 1996; 10: 261–77

    Google Scholar 

  59. McCoy MM. The reconstruction of emotion. In: Bannister D, editor. New perspectives in personal construct theory. London: Academic Press, 1977: 93–124

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. School of Sport, Health and Physical Education Sciences, University of Wales, Bangor, Victoria Drive, Bangor, Gwynedd, LL57 2EN, Wales, UK

    Jo Doyle &  Nigel P. Gleeson

  2. National Centre for Sports Injury Surgery, Robert Jones and Agnes Hunt Orthopaedic and District Hospital NHS Trust, Oswestry, Shropshire, England

    Dai Rees

Authors
  1. Jo Doyle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Nigel P. Gleeson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Dai Rees
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nigel P. Gleeson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Doyle, J., Gleeson, N.P. & Rees, D. Psychobiology and the Athlete with Anterior Cruciate Ligament (ACL) Injury. Sports Med 26, 379–393 (1998). https://doi.org/10.2165/00007256-199826060-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00007256-199826060-00002

Keywords

Search

Navigation