Returning to sport after an ACL surgery is about a lot more than your physical condition. It’s a huge mental challenge. To make it back to the activities you love, you have to know how to overcome fear and doubt after ACL surgery.
The truth is that fear of re-injury or hesitation puts you at an even greater risk for complications. You need to be confident in yourself and your knee to safely return to activity.
But that’s easier said than done.
When you must re-learn to walk and undergo the often extreme pain that comes with knee surgery, it can be hard to get past that.
I returned to professional soccer after ACL and meniscus surgery. I’ve had two meniscus surgeries since then and came back to soccer each time. My injuries did not hold me back, but they certainly have been mentally challenging.
Here are some of my top tips for overcoming fear and doubt after ACL surgery, or any other major injury.
Envision the Future You Want
If you let your thoughts spiral, they will. Take active steps to control them. Instead of thinking about “what if I get hurt again” or “what if my knee doesn’t hold up” think about “what if I make it past this!”
Picture the future you want. Picture yourself doing the activity again. Envision that you’ll be strong enough, you’ll be ready enough.
Yes, bad thoughts and worries will come up. That’s natural, especially early on when you’re in a TON of pain or can barely walk. But take control and visualize the positive.
A few tips to help manage this fear and doubt after ACL surgery:
- Write it down. Write it as a list or story. Describe the scene.
- Meditate/ visualize. Really picture it. Visualize yourself doing the action safely and successfully.
- Talk it out loud with others. Say it to other people. Exude confidence.
Positive Self Talk
This goes hand in hand with the other tip, but use positive self-talk. Be the “good wolf” for yourself. Tell yourself you can do it. Tell yourself you’re getting stronger. Don’t tear yourself down or beat yourself up when rehab doesn’t go how you want. Be your biggest cheerleader.
Some self-talk phrases to think about include:
- I can do this.
- I am mentally and physically strong
- I will make it back to [activity]
- This is just a setback, I can get through it
- I will do everything I can to prepare my mind and body
Watch Your Highlights
One of the most motivating, encouraging things I did was revisit my best moments in sports during my rehab. Yes, this was hard sometimes. There were times in my recovery when I couldn’t do this because it was too discouraging. But when I needed some extra confidence, I looked back at the player I was before the surgery.
When you’re struggling physically, you can start to feel disconnected from the athlete you were before. That can seem like someone else, not like “it’s really you.” Whenever I began to feel like I wouldn’t be good anymore, or there was no way I could come back, I’d flip on some highlights.
Watching my old highlight clips and action shots helped build my confidence. It reminded me what I was capable of, it made me hungry to get back to her.
The visual aspect of seeing yourself doing what you want to do again is powerful. But if you don’t have a game film, lean on your friends, family, or teammates. Talk with them about some of your best memories or moments. Sometimes it’s also really nice and encouraging to hear about your qualities or top moments from another source.
One Step at a Time
I’ve mentioned this before when talking about how to stay motivated, but it’s really a golden rule for ACL recovery: focus on one step at a time.
When you’re fresh out of surgery, you’ll have a hard time envisioning playing your sport again. That’s normal. So instead, think about taking your first step. Then about walking without crutches or a brace. Then about bending and straightening your leg all the way. And so forth.
Put one foot in front of the other (literally). Set small goals and focus on the one right in front of you. This helps you stay focused and prevents mental spiraling. But it also builds confidence. As you find yourself checking off your mini goals each day, week, month, etc. you’ll gain back the confidence that you can make it all of the way back.
Accept the Uncontrollables
What if I get injured again? What if my knee doesn’t feel the same? The truth is that those, and your other worries, are possible. You could do everything right, and still not get the outcome you want. Or you could face various challenges along the way no matter what you do.
Accepting the possibilities and risks is part of overcoming your fear. The fear, doubt, and anxiety comes from not having full control. You can never fully control how your rehab goes or if you can return to sport safely. There’s no guarantee that things will work out. Accept that. Acknowledge the uncontrollables, and then let them go.
While there’s always a risk and always a chance, that doesn’t make you powerless. Adhering to your rehab and working on your mentality dramatically decreases the risk. Let go of all the aspects you can’t control and focus on what you can.
Find Balance
All of ACL recovery, but especially return to sport, is a delicate balance. If you push too far too fast, you end up with issues and increase the risk of a re-tear. But if you don’t push hard enough, you won’t progress or ever feel comfortable.
While your physical therapist and surgeon do their best to guide you, finding this balance is really up to you. You must challenge yourself enough to feel a little uncomfortable and scared, but not so much that it’s dangerous for your body.
Find balance in that sweet spot that pushes you to progress. This is the only way to physically and mentally recover to the point where you can play sports. ACL rehab gets scary sometimes, that’s normal. You have to get comfortable being uncomfortable and feeling a little fear. The key is to ensure that it’s safe and logical progression.
Don’t Rely on a Brace
Every doctor has a different protocol for wearing braces. While I had a compression sleeve, I never wore a brace after surgery. My surgeon did not find evidence for a brace to be strong enough. She also felt it often made people too dependent and afraid to fully come back. Instead, she told me I would not ever progress to the next step until I was 100% ready.
But many people do have a brace. Even if your doctor prescribes you a brace, you must be careful not to become dependent on it. Oftentimes, people struggle to feel confident without the brace.
Since I never wore one, I didn’t have this experience. To avoid it, I recommend removing the brace as soon as the doctor tells you that you can. If they say you can start to walk without it, immediately remove it for walking, etc. Furthermore, do not progress through rehab if you can’t do the previous thing without a brace. If you still have to wear a brace to walk, then you shouldn’t be jogging, for example.
Gradual Return to Sport
Generally, your physio and surgeon don’t just release you to sport without progression after ACL surgery. But unless you play college sports, your PT is quite limited in actually helping you return to sports. That’s why you must take it upon yourself to build back into the sport.
The only way to get comfortable and build confidence is to progress with balance as I described. Well, sports are incredibly complex and include several facets. With your PT, you can build back your speed, strength, agility, etc, but you can’t really work on game-like situations most of the time. It’s up to you to integrate yourself back into your sport based on your medical team’s guidance.
I found it incredibly helpful to start working with a team as soon as I could sprint and cut. Of course, I was not playing with contact. At first, I did only the technical drills with a team. Then, I played as a non-contact neutral. I trained in small groups with controlled contact, and then full contact in practice. After several weeks and this slow progression, I played a friendly match.
Take Your Time After ACL Surgery
The bottom line is that ACL recovery is an extremely difficult process. It’s as much mental as it is physical, if not more. You have to build back confidence while dealing with fear and doubt after ACL surgery. I certainly did, but the tips above are what helped my mentality the most.