Summary

Young athletes who possess characteristics related to psychological resilience, and specifically the ability for positive cognitive reframing, may perceive their quality of life as less detrimentally impacted by injury.

Abstract

Background

Worsened quality of life (QOL) is commonly referenced as a primary consequence of anterior cruciate ligament (ACL) injury, especially for young athletes whose sport participation is impacted. However, QOL is a personal experience and therefore it is important to understand individual perspectives following ACL injury in this population.

Objective

To understand the factors influencing young athletes’ perceptions of QOL following an ACL rupture and prior to reconstructive surgery.

Methods

Using descriptive qualitative methodology, twenty young athletes who experienced an ACL tear and were awaiting primary ACL reconstructive surgery were purposively selected and interviewed using a semi-structured interview guide including vignette, word cloud, and visual analog scale activities. Interviews were piloted, conducted to saturation, and transcribed. Transcripts were coded by two independent researchers and organized into themes using thematic analysis.

Results

Young athletes shared common factors that made up their QOL; social connections and support, sport, health, and independence. However, participants’ perceptions of their current QOL were quite variable (13-95/100). Participants who were able to reframe their injury experience, by shifting focus to the positive and unaffected aspects of their lives (family/friends, general health) tended to have more favourable perceptions of their QOL following ACL injury than those who shifted focus to the losses associated with injury (loss of sport, social interaction).

Conclusions

Individual processes of adapting to and reframing the injury experience may have more to do with QOL following ACL injury than the actual injury itself. The process of reframing likely occurs at varying rates, and will be influenced by many socioenvironmental, individual, and structural factors. Identifying these factors may help target potential psychological interventions or supports likely to enhance athletes’ adaptation to injury. This could attenuate reductions in QOL following ACL injury as young athletes await their surgery date and may consequently improve overall outcomes.