A clinical practice review of therapeutic movement-based anterior cruciate ligament reconstruction return to sports bridge program: the biological, biomechanical and behavioral rationale

Athletic Identity and Sport Injury Processes and Outcomes in Young Athletes: A Supplemental Narrative Review

Background: Identity formation, a primary developmental task of adolescence, may be particularly relevant to another commonly occurring event for young athletes-sport injury. Relationships between a subdimension of self-identity-athletic identity-and sport injury processes and outcomes have been documented in the general athlete population. The purpose of this supplemental narrative review is to explore the potential role of athletic identity in the risk of injury occurrence and responses to and consequences of injury among young athletes. Methods: Studies on athletic identity in relation to sport injury, with a focus on young athletes, were extracted from a recent scoping review and identified through an updated literature search from April 2020 through June 2024. A total of 23 studies were examined. Results: Across the studies reviewed, high levels of athletic identity were associated with a reluctance to report injury-related symptoms, a tendency to endorse attitudes and behaviors reflecting a willingness to play through pain and injury, intensified physical and psychological symptoms after injury, a disposition toward over-adhering to rehabilitation, high levels of postinjury coping skills, and better functional and return-to-sport outcomes after injury among young athletes. Conclusions: Athletic identity may, therefore, be a source of both strength and vulnerability in young athletes in terms of sport injury processes and outcomes.

Global knee function rating more strongly influences adolescent athletes that sustain a sports-related surgical ACL re-injury or contralateral ACL injury

PURPOSE

This study evaluated differences between adolescent athletes who sustained a surgical anterior cruciate ligament (ACL) re-injury, or contralateral ACL injury following return to sports bridge programme participation (Group 1) compared to those that did not (Group 2).

METHODS

At 19.9 ± 7 years of age, 198 athletes participated in this study. Groups were compared for time postsurgery, preprogramme and postprogramme Knee Outcome Survey Sports Activity Scale (KOS-SAS) and global rating of knee function (GRKF) during sports activities, postprogramme lower extremity physical function test performance and perceived sports performance compared to preinjury level.

RESULTS

By 6.0 ± 3.2 years postsurgery, 11 (5.6%) sustained another ACL injury. Group 1 was younger (17.3 ± 1.7 years vs. 20.1 ± 6.8 years, p < 0.001). Postprogramme re-evaluation revealed that Group 1 had a greater GRKF compared to their programme initiation GRKF than Group 2 (32.6 ± 38 vs. 20.0 ± 23, p = 0.04). Group 1 also had a greater mean preprogramme to postprogramme GRKF change than Group 2 (51.3 ± 31 vs. 35.5 ± 21, p = 0.02) (effect size = 0.73). More Group 1 subjects also had a GRKF difference that exceeded the overall mean than Group 2 (p = 0.04). Group 1 had moderately strong relationships between preprogramme and postprogramme GRKF score change and the postprogramme GRKF score (r = 0.65, p = 0.04) and between preprogramme and postprogramme KOS-SAS score change and postprogramme GRKF score (r = 0.60, p = 0.04).

CONCLUSION

Global rating scores had a stronger influence among adolescent athletes that sustained either surgical ACL re-injury or contralateral ACL injury. Since group physical function and neuromuscular control factors were similar, clinicians need to increase their awareness and understanding of other factors that may influence surgical ACL re-injury or contralateral ACL injury risk.

LEVEL OF EVIDENCE

Level III, retrospective cohort study.