![]() ![]() Fear avoidance behaviors can also be indicative of high psychological distress, which has further been associated with poor clinical outcomes. An individual motivated by fear typically avoids both painful experiences and activities. Fear of pain is an important feature of the emotional reaction in that it can bring out two different forms of coping responses: confrontation or avoidance. ![]() 12- 13 According to the fear avoidance model (FAM) of exaggerated pain perception proposed by Lethem et al 14, pain perception involves both a sensory and an emotional reaction component. 11 Behavior that is guided by kinesiophobia has the potential to negatively impact outcomes for patients with pain. Kinesiophobia has been defined as an “excessive, irrational, and debilitating fear of physical movement and activity resulting from a feeling of vulnerability to painful injury or re‐injury.” 11 The fear associated with kinesiophobia can be heightened in injuries due to trauma. Inversely, a positive psychological response to injury and rehabilitation correlates with a more rapid return to sport within a year. 5- 10 This fear of re‐injury is an example of how a negative psychological state can hinder an outcome. 5- 10 Athletes that sustain traumatic injuries may never return to their sport due to fear of re‐injury. However, current research shows that the psychological component of these injuries can be more predictive of return to play than physical outcome measures. Previous attention has been paid to physical outcome measures for return to sport. Therefore, prognostic factors that may positively or negatively affect the rehabilitation process and ultimately return to sport must be recognized. 3- 4 This is problematic due to the variables associated with making a safe return to play decision. 2 While lower extremity fractures are common in soccer, research regarding prognosis and outcomes for high impact fractures is lacking. 1 In fact, the majority of injuries that soccer players experience are high impact traumas, with slide tackles being the most common lower extremity fracture mechanism. There is a high prevalence of fractures in Division I college sports, especially in athletes participating in contact sports such as soccer. ![]()
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