ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2025
Athletic identity-fear avoidance relationships of high musculoskeletal injury risk adolescent athletes during return to sport rehabilitation: a pilot study.
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAdolescent athletes who sustain a musculoskeletal sports injury are at high re-injury risk. Fear avoidance (FA) during return to sport (RTS) rehabilitation may be concerning either when "too high" (excessive fear) or "too low" (excessive confidence). Research suggests that adolescent athletes with an athletic identity (AI) ≤ 25th percentile ("low" AI") are 1.5 × more likely to sustain an initial injury, while those scoring >25th percentile ("higher" AI) are 2.3 × more likely to sustain subsequent injury. This study evaluated adolescent athlete AI and FA relationships during RTS rehabilitation. MATERIALS AND
methodsFrom 159 consecutive patients, 60 (32 females, 28 males) adolescent athletes (mean = 16.9 ± 3 years of age) completed the 7-item Athletic Identity Measurement Scale, the 10-item Athletic Fear Avoidance Questionnaire (AFAQ), and the AFAQ with two additional movement-related fear and pain questions (AFAQ +). Comparisons were made between low AI (≤ 25th percentile) and higher AI (> 25th percentile) groups and between low FA (≤ 50th percentile) and higher FA (> 50th percentile) groups.
resultsAthletes with "low" AI had greater FA than those with "higher" AI (AFAQ + scores of 30.2 ± 10 vs. 24.8 ± 7, p = 0.02; AFAQ scores of 24.4 ± 8 vs. 20.2 ± 6, p = 0.03). Athletes scoring > 50th percentile on the AFAQ (high FA) had lower AI social identity (18.2 ± 3 vs. 19.5 ± 3, p = 0.04) and exclusivity (8 ± 4 vs. 9.8 ± 4, p = 0.03) subscale scores compared to athletes scoring ≤ 50th percentile. Athletes scoring > 50th percentile on the AFAQ + (higher FA) also had lower AI social identity (18 ± 3 vs. 19.5 ± 3, p = 0.02) and exclusivity (7.6 ± 4 vs. 10.1 ± 4, p = 0.005) subscale scores than athletes scoring ≤ 50th percentile.
conclusionAdolescent athletes with "low" AI had higher FA, while those with "higher" AI had lower FA. Athletes with higher FA also had lower AI social identity and exclusivity subscale scores. Identification of an effective AI and FA balance may help better determine safe RTS timing, however further research is needed. LEVEL OF EVIDENCE: II, Prospective cohort study.
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