Psychological factors play an important role in the recovery of an injured athlete. Youth sports participation is associated with many positive indicators of mental health, like higher levels of confidence and social functioning. However, the injuries young athletes sustain can lead to many negative responses to injury, including depression, anxiety, PTSD, eating disorders, substance abuse, and loss of athletic identity. 

 

“Injury in elite athletes was a notable predictor of PTSD symptoms”, according to a study from Bateman and Morgan.

 

According to Leddy et al, ”51% of injured athletes met criteria for at least mild depression, with 12% meeting criteria for moderate depression postinjury”.

 

These mental health outcomes are relevant to orthopaedics because they influence recovery from injury. 

 

For example, patients with depression show increased levels of interleukin-1, which can lead to decreased bone formation and density. One year after ACL reconstruction surgery (ACLR), depressed patients had worse knee function than non depressed patients, according to a study from Garcia et al. 

 

Another study found that after ACLR, patients with higher levels of fear were 13 times more likely to tear their ACL again within two years after returning to sports than patients with lower self-reported fear levels.

 

Factors like depression, fear of reinjury, and unrealistic expectations can lead to suboptimal recovery from injury. However, an awareness of mental health’s impact on recovery can be part of the solution. Setting realistic expectations for post injury recovery can help mitigate some of these maladaptive responses. Additionally, factors like motivation, self esteem, and resilience are associated with favorable outcomes. 

 

The American Academy of Orthopedic Surgeries mentions mental health screenings, cognitive behavioral therapy, and multidisciplinary care of athletes as other potential approaches to sports injury recovery.