A longitudinal examination of athletes' emotional and cognitive responses to anterior cruciate ligament injury

Clin J Sport Med. 1999 Apr;9(2):63-9. doi: 10.1097/00042752-199904000-00004.


Objective: To determine the emotional and cognitive impact of injury and surgery on physical recovery in injured athletes.

Design: A prospective longitudinal study comparing the psychosocial and physical recovery of competitive and recreational athletes.

Setting: Tertiary-care sports medicine center.

Participants: Twenty-seven athletes (15 men and 12 women) who required anterior cruciate ligament (ACL) reconstruction surgery.

Interventions: A repeated-measures design used to compare the psychosocial and physical changes for 6 months after ACL surgery.

Main outcome measures: Emotional (mood) and cognitive (coping) functions and physical recovery (range of motion, physician-rated level of recovery, and physician permission to return to sport).

Results: There was a significant time-effect difference in mood, with a greater mood disturbance and recovery rate for competitive athletes than recreational athletes. Differences in mood and pain coping were significant at 2 weeks and 2 months after surgery.

Conclusion: Athletes experience significant mood changes throughout rehabilitation, which may hinder rehabilitation early in the process. Longer-term rehabilitation was not impacted by mood or pain coping. Future studies might focus on examining the process over a longer time period (1-2 years after surgery). Physicians should be aware of these findings and appropriately counsel and motivate athletes toward more favorable positive psychological and physical outcomes.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adaptation, Psychological
  • Adolescent
  • Adult
  • Affect
  • Analysis of Variance
  • Anterior Cruciate Ligament / surgery
  • Anterior Cruciate Ligament Injuries*
  • Athletic Injuries / psychology*
  • Athletic Injuries / rehabilitation
  • Athletic Injuries / surgery
  • Chi-Square Distribution
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Longitudinal Studies
  • Male
  • Pain Measurement
  • Prognosis
  • Prospective Studies
  • Range of Motion, Articular / physiology
  • Sick Role*
  • Surveys and Questionnaires
  • Wounds, Nonpenetrating / psychology*
  • Wounds, Nonpenetrating / rehabilitation
  • Wounds, Nonpenetrating / surgery