Fear of Reinjury in Athletes: Implications for Rehabilitation

CONTEXT: A sports injury has both physical and psychological consequences for the athlete. A common postinjury psychological response is elevated fear of reinjury. OBJECTIVE: To provide an overview of the implications of fear of reinjury on the rehabilitation of athletes, including clinical methods to measure fear of reinjury; the impact of fear of reinjury on rehabilitation outcomes, including physical impairments, function, and return to sports rate; and potential interventions to address fear of reinjury during rehabilitation. EVIDENCE ACQUISITION: PubMed was searched for articles published in the past 16 years (1990-2016) relating to fear of reinjury in athletes. The reference lists of the retrieved articles were searched for additionally relevant articles. STUDY DESIGN: Clinical review. LEVEL OF EVIDENCE: Level 3. RESULTS: Fear of reinjury after a sports injury can negatively affect the recovery of physical impairments, reduce self-report function, and prevent a successful return to sport. Athletes with high fear of reinjury might benefit from a psychologically informed practice approach to improve rehabilitation outcomes. The application of psychologically informed practice would be to measure fear of reinjury in the injured athletes and provide interventions to reduce fear of reinjury to optimize rehabilitation outcomes. CONCLUSION: Fear of reinjury after a sports injury can lead to poor rehabilitation outcomes. Incorporating principles of psychologically informed practice into sports injury rehabilitation could improve rehabilitation outcomes for athletes with high fear of reinjury.