Five strategies to keep your athlete engaged and positive after ACL surgery

christino-043 (2)About the blogger: Melissa Christino, MD, is an orthopedic sports medicine fellow in Boston Children’s Hospital’s Sports Medicine Division.

Anterior cruciate ligament (ACL) tears in children and teens can be challenging injuries. While the surgery for ACL reconstruction generally involves minimal hospital time, patients must complete six to nine months of aggressive physical therapy to rehabilitate the injured leg, help optimize results and prevent re-injury.

Recovering from an ACL injury can be more devastating to a young athlete than the injury itself, and it is important for parents to be aware of the psychological consequences that may accompany their child’s physical injury. Having a positive attitude has been shown to significantly help with rehabilitation and surgical outcomes.

How might my child feel after an ACL injury?

While it’s impossible to pinpoint exactly what any athlete is experiencing during recovery from ACL surgery, there are some common patterns.

Young athletes can often feel isolated and depressed during this time. Not only are they missing months and months of their sports seasons, but they are also taken away from the camaraderie of their teammates, unable to participate in activities that bring them happiness and fulfillment and are uncertain of how they will be able to perform once they return to sports. It can also be very hard for a developing child or adolescent to fully commit to what seems like endless rehabilitation with long-term results.

Parents, coaches, friends and teammates can help young athletes through the recovery process.

Here are five ways that you can keep your athlete engaged and positive after ACL surgery:

1.)   Normalize Your Athlete’s Injury. Injuries are part of sports, and part of being an athlete is learning how to adjust to setbacks. An ACL injury can make a child feel like she is alone and that her athletic career is forever jeopardized.shutterstock_153903341

However, ACL injury in children and adolescents is very common. Athletes should be reassured that they are one of many who sustain this injury, and that they can recover and get back to activities if they desire to do so. Using famous examples such as NFL player Tom Brady and women’s soccer legend Brandi Chastain can help show kids that even the best athletes get ACL tears, and through hard work, they too can return to sports at a competitive level. Making kids feel like they are not alone in their injury and recovery can help them maintain a positive, can-do attitude.

2.)   Communicate With Your Athlete. Research has shown that injured athletes can experience mood disturbances, anger, depression, anxiety and decreased self-esteem. These negative feelings can result in poor coping responses such as avoidant behavior and can have negative effects on their commitment to rehabilitation and their overall surgical outcomes.

Keeping an open line of communication between parent and child regarding these issues is important. Parents should be encouraged to ask how their athlete is feeling about her injury and recovery. Acknowledging and discussing your athlete’s fears is the best way to prevent them from bottling up negative shutterstock_211350490emotions inside. In some cases, adolescents may prefer to seek emotional support from someone outside the family, such as a coach or friend, and this should also be encouraged.

If your athlete does show signs of significant depression or social withdrawal, it may be beneficial to seek the expertise of a sports psychologist, who can help her navigate through these complicated emotions.

3.)  Provide Emotional Encouragement. Many young athletes are very self-motivated, but it is hard to stay motivated all the time, particularly if there are setbacks during rehabilitation. Parents keeping a positive attitude and providing external motivation can help with this. Empowering your child and letting her know that she can have some control over her outcome is important and can reduce the feeling of helplessness.shutterstock_53401201

In addition, keeping her focused and dedicated to her physical therapy is important. This includes a solid commitment from you to make getting to physical therapy a priority. Parents can also help by engaging the physical therapist to set some short-term goals for their child. With short-term goals, athletes can experience a sense of accomplishment on a regular basis, which can help with self-motivation and optimism.

4.)  Promote Staying Involved with Teammates/Team. Particularly with adolescents, a large part of their overall identity can be derived from being an athlete. When their status as an athlete is threatened by injury, this can cause substantial distress. As a shutterstock_199100273result, some athletes may start to devalue their commitment to athletics as a defense mechanism. They try to protect themselves from the possibility of failure or decreased ability once they return to sports.

A good way to keep your child’s spirits up and still make her feel like she is an athlete is to encourage staying involved with team activities and/or teammates on a limited basis. This could involve anything from going to some practices or games, helping to manage the team or interacting on a social level. Being involved with her team will preserve an important sense of camaraderie and can have very positive psychological effects. Just remember, team involvement should not be at the expense of your athlete’s rehabilitation, as this should be the priority during the postoperative period. A healthy balance between team interactions, while maintaining a strong commitment to physical therapy, is ideal.

5.)  Encourage Other Strengths and Interests. If your child’s world revolves around sports and being an athlete, you can help her self-esteem by encouraging her to focus on some shutterstock_27835429of her other strengths and interests during recovery. As mentioned in #4, an athlete’s identity can be significantly threatened after an injury. Focusing on nurturing or developing other interests can give your child another domain where she can excel and find enjoyment. Whether it’s drawing, reading, singing or a hobby that your athlete enjoys, participating in gratifying activities outside of sports can help her feel better about herself overall.

Learn more about Boston Children’s ACL Program, which offers comprehensive services from injury prevention to treatment and rehabilitation.