(16) INFLUENCES OF ANTERIOR CRUCIATE LIGAMENT (ACL) INJURY MECHANISM ON PERCEIVED PAIN LEVELS AND KINESIOPHOBIA IN FEMALE ATHLETES

Purpose: Female athletes are most at-risk for injuries of the anterior cruciate ligament (ACL), particularly from non-contact change-of-direction movements that may incur concomitant injuries (e.g., medial collateral ligament, meniscus). Furthermore, ACL injuries tend to occur in female athletes’ supporting leg during twisting or turning movements. Nonetheless, pain associated with ACL injuries is multidimensional, involving physical sensations and psychological responses. Although the intensity of pain sensations should diminish during injury recovery, subjective experiences of pain may lead to feelings of uncertainty, doubt, and movement-related fears or kinesiophobia. Thus, the purpose of this study was to examine the perceived pain levels and kinesiophobia of female athletes based on ACL injury mechanism. Methods: Female athletes (N = 176) who had experienced an ACL injury were recruited to complete an online survey involving measures of kinesiophobia (Tampa Scale of Kinesiophobia-13), perceived pain levels at various timepoints (e.g., during injury incident, during rehabilitation), and demographic information (e.g., injury mechanism, concomitant injuries, injury site). Based on participants’ responses of ACL injury mechanism, they were categorized into contact (CON; n = 125) and non-contact groups (NON-CON; n = 51) before independent samples t-tests were conducted. Results: Post-ACL female athletes of the NON-CON group most often injured their non-dominant leg, while the CON group more commonly injured their dominant leg, t (174) = -2.83, p < 0.01, d = 0.47, and experienced concomitant injuries, t (174) = 2.72, p < 0.01, d = 0.45. Results also indicate that throughout the injury recovery process (i.e., pre-surgery, post-surgery, during rehabilitation), the CON athletes reported higher pain levels (M = 4.86, SD = 3.07) than the NON-CON athletes, t (174) = 3.17, p < 0.01, d = 0.53. However, there was no significant difference of pain levels between groups during the time of ACL injury incidence, t (174) = -0.40, p = 0.34. The comparison of kinesiophobia scores show a significant difference between groups, with NON-CON athletes reporting higher injury-related fears than CON athletes, t (174) = 3.17, p < 0.01, d = 0.51. Conclusions: Although female athletes who experience non-contact ACL injuries are likely do to so on their non-dominant leg, their perceived pain levels and risk for concomitant injuries are lower than those who injure from contact mechanisms. However, regardless of reported pain levels, non-contact ACL injuries led to increased fears of movement, pain, and reinjury in female athletes. Practical Applications: Considering these results, sports professionals may want to tailor injury recovery programs for female athletes based on the injury mechanism. Interventions such as targeted neuromuscular training for the non-dominant leg may help reduce non-contact ACL injuries, while also addressing psychological aspects of recovery such as kinesiophobia and pain-related fears. As post-ACL recovering athletes experience fluctuating pain levels, strength coaches, athletic trainers, and physical therapists may collaborate with sport psychology professionals to highlight pain management strategies to improve both physical and psychological recovery outcomes. Acknowledgements: This research was supported by the Association of Applied Sport Psychology Research Grant.