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Will our son reinjure his torn ACL?

Q: I have a feeling that our 17-year-old son is going to miss out on his senior year of high school football because he's afraid he'll reinjure the torn ACL he spent all summer rehabbing. We can't tell if we should push him back onto the field or just let it drop. His surgeon and Physical Therapist say he's ready to go back if he wants to.

A: Fear of reinjury is a natural reaction after an anterior cruciate ligament (ACL) injury in many high school and college athletes. In fact, a recent survey of over 150 football players showed that about one-third to one-half of players at both these levels of play don't return to the field.

And when asked why not, fear or reinjury was the number one reason followed by knee symptoms such as pain, stiffness, and swelling; perception that strength and/or speed were not enough for competitive play, and advice from others.

Emotional and psychologic factors for not returning to play after injury aren't discussed much in the sports world -- especially at the high school level. Knowing that this is a potential issue might make it easier to bring up in a conversation with your son. Sometimes it is the case that high school athletes develop other interests or just weren't settled enough on football to make it a high priority after injury. It's easier to make the decision to move on to other things when an injury gives the player the freedom to do so.

Reference: Kirk A. McCullough, MD, et al. Return to High School- and College-Level Football After Anterior Cruciate Ligament Reconstruction. A Multicenter Orthopaedic Outcomes Network (MOON) Cohort Study. In The American Journal of Sports Medicine. November 2012. Vol. 40. No. 11. Pp. 2523-2529.