The association of psychological readiness to return to sport after anterior cruciate ligament reconstruction and hip and knee landing kinematics

Background: Anterior cruciate ligament tears have a negative psychological impact on athletes. Currently, it is not clear if psychological readiness to return to sport has an impact on an athlete's landing biomechanics. Thus the purpose of the study is to investigate whether there is an association of psychological readiness to return to sport and single-leg landing biomechanics. Methods: Athletes with an anterior cruciate ligament reconstruction (n = 18) completed the Anterior Cruciate Ligament-Return to Sport after Injury scale to measure psychological readiness to return to sport, knee strength testing, and a single-leg landing task. A multivariate linear regression model was built for the involved and uninvolved limb based on sagittal and frontal plane knee and hip range of motion. Significance was set at p < 0.05. Findings: Knee extensor/flexor strength testing showed significant differences (p < 0.05) between involved and uninvolved limbs. Nearly 40% of the variance in psychological readiness scores (p = 0.025) can be accounted for by the involved limb's frontal plane hip and knee range of motion. Knee frontal plane range of motion was the only significant factor, and the standardized coefficients indicate that greater knee frontal plane range of motion and lower hip frontal plane range of motion were associated with higher psychological readiness. No other associations were found between psychological readiness and sagittal or frontal plane sing-leg biomechanics of the involved or uninvolved limbs. Interpretation: Greater psychological readiness to return to sport is associated with the involved limb's frontal plane knee and hip range of motion during a single-leg landing biomechanics.