Prevalence of Posttraumatic Stress Disorder Symptoms Among Young Athletes After Anterior Cruciate Ligament Rupture

Abstract

Background:The risk of depression and the fear of reinjury were documented in recent investigations of patients after anterior cruciate ligament (ACL) ruptures. The extent of psychological trauma accompanying these injuries among young athletes, however, has never been assessed.Hypothesis:Posttraumatic stress disorder (PTSD) symptoms after ACL injury are present among young athletes with high athletic identities.Study DesignCase series; Level of evidence, 4.Methods:Patients ≤21 years of age who had suffered an acute ACL rupture were consecutively recruited at a tertiary care center. Patients completed the Horowitz Impact of Event Scale - Revised (IES-R) to analyze for PTSD symptomatology, the Athletic Identity Measurement Scale, and an athlete specialization instrument created at the authors’ institution.Results:A total of 24 patients were consecutively recruited. The mean patient age was 14.5 ± 2.7 years, and 50% of patients were male. More than 87.5% of patients experienced avoidance symptoms, 83.3% acknowledged symptoms of intrusion, and 75% had symptoms of hyperarousal. Patients aged 15 to 21 years incurred a higher severity of PTSD symptoms than younger patients (P = .033). Female patients experienced greater emotional trauma than male patients (P = .017). Finally, patients with high athletic identities experienced greater emotional trauma than those with lesser athletic identities, but this finding was not statistically significant (P = .14).Conclusion:Following ACL rupture, young athletes experience significant emotional trauma, including symptoms of avoidance, intrusion, and hyperarousal. High school and college athletes, female athletes, and patients with high athletic identities may be most susceptible.

Workload and Injury in Professional Soccer Players: Role of Injury Tissue Type and Injury Severity

“…In addition, although not discussed by Windt soreness [56], sleep quality [57], muscle architecture [58], and other stressors associated with competing at the elite level are also likely to affect an individual's injury risk and warrant further attention. Severe injuries remove players from match play for lengthy durations, often resulting in significant psychological distress for the athlete [59] and a reduction in the teams' performance [60] whilst also having financial implications for professional teams [6]. It is, therefore, important that we aim to understand if the severity of injury may share an association with the workload undertaken by soccer players.…”

Investigating correlates of athletic identity and sport-related injury outcomes: a scoping review

“…54 Despite anxiety symptoms being positively, although weakly, correlated to AI (r=0.14; 0.13; 0.21; 0.05, respectively, for the type of anxiety symptoms noted in the previous sentence), findings were not significant. Another study assessed athletes for symptoms of post-traumatic stress disorder (PTSD; eg, hyperarousal, avoidance and intrusive thoughts) 49 and compared PTSD scores between 'high' and 'low' AI groups prior to ACL reconstructive surgery. Group differences were not significant.…”

Post-traumatic stress disorder (PTSD) and other trauma-related mental disorders in elite athletes: a narrative review

“…For example, athletes experience clinically significant increased levels of PTSD symptomatology following a musculoskeletal injury 1. Younger athletes (eg, those in high school or college), female athletes and those who have a strong athletic identity may experience greater emotional trauma following injury, particularly ACL rupture 11. Musculoskeletal injuries are closely linked with specific symptoms of hyperarousal and avoidance behaviours, potentially compromising athletic performance, when repeatedly exposed to circumstances similar to the inciting event that led to their original injury 1 12.…”