Athlete fear avoidance and pain interference are related to return to competition time following an acute injury in athletes

Context: Pain related fear and fear avoidance contribute to the development of chronic pain and longer rehabilitation times in the general population. Recent evidence suggests that fear avoidance might be associated with increased rehabilitation times in athletes with ACL reconstructions but there is little research on other injuries. Objective: The purpose of this study was to measure fear avoidance and return to competition times in athletes who have suffered an acute musculoskeletal injury. Participants: Thirty-five student-athletes (25 males, 10 females) participated in this study. Athletes competed in football, rugby, soccer, basketball, or hockey. Measures: Within 24 hours of suffering a musculoskeletal injury, participants completed a battery of questionnaires that assessed function, pain severity, interference and disability, depression, and psychosocial factors, which included (athlete) fear avoidance, catastrophizing and kinesiophobia. Return to competition was measured in days once the athlete returned to competition with no restrictions. Results: There was a significant improvement in pain and function from injury to return to competition. In addition, all participants experienced a decrease in pain disability, severity, and interference, as well as all psychosocial factors from injury onset to return to competition. Pearson correlations identified significant relationships between injury onset athlete fear avoidance, change in function, pain disability, pain interference, and depression, with return to competition. The regression analysis indicated a significant model, which accounted for 35.3% of the variance of return to competition times. Conclusion: It is possible that using injury onset measures of pain and athlete fear avoidance could predict rehabilitation times in athletes.