The Relationship Between Disability and Fear Avoidance in Athletes with Acute Musculoskeletal Injuries




Rack, Bennett

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Advances in injury management and rehabilitation have helped reduce the physical recovery time needed for many athletes to return to sport. However, psychological readiness to return to sport should also be addressed and if left untreated has the potential to negatively affect return to activity. Increases in kinesiophobia have often been observed in a chronic injury population with little understanding of its potential impact on an acute injury population. The purpose of this study was two-fold: 1.) to examine the relationship between kinesiophobia and disability in athletes with acute musculoskeletal injuries and 2.) to describe potential psychological factors that contribute to the development of kinesiophobia in athletes if a relationship is established. Methods: Twenty-five NCAA collegiate athletes (10 females, 11 males; age = 20.1±1.5) who incurred an acute musculoskeletal injury resulting in a loss of playing/practice time or alterations in participation status in conditioning, practice or game participated in this study. Participants completed a study packet that included a demographic questionnaire and 4 psychometrically sound instruments: 1.) Visual Analog Scale (VAS), 2.) Pain Catastrophizing Scale (PCS), 3.) Tampa Scale of Kinesiophobia (TSK-17), and the Disablement in the Physically Active Scale (DPA). Results: The TSK-17 scores explained 37.6% of the variance in DPA scores. (r=.613, R2=.376, p=.001). VAS scores were only moderately related to TSK-17 scores (r=.373, R2=.141, p=.020), but were highly related to DPA scores accounting for 52.2% of the DPA score variance (r=.723, R2=.522, p<.001). VAS and PCS scores were not significantly able to explain variance in the TSK-17 scores (r=.467, R2=.226, F (2,22) = 3.214, p=.060). The combination of VAS, PCS, and TSK-17 explained 68.7% of variance in DPA scores (r=.829, R2=.687, F(3,21)=15.33, p<.001) Conclusion: The results suggest that kinesiophobia is present in an acute population, but cannot be entirely explained by the Fear Avoidance Model psychological constructs. However, The TSK-17 and VAS are useful tools to help practitioners understand an athlete’s disablement levels. Future research in this area is warranted to understand kinesiophobia in acute musculoskeletal injuries.



Kinesiophobia, Disability, Catastrophizing, Acute, Athlete, Self-efficacy


Rack, B. (2014). <i>The relationship between disability and fear avoidance in athletes with acute musculoskeletal injuries</i> (Unpublished thesis). Texas State University, San Marcos, Texas.


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