Gymnasts' experiences and perception of a cruciate ligament injury

Gymnastics is a high injury risk sport including difficult technique. A cruciate ligament injury is common, though there are no evidence-based guidelines for return to gymnastics. The gymnasts' experiences may add specificity to a guideline. Therefore, the aim of the present study was to describe the gymnasts' experiences and perception of a cruciate ligament injury.

An embedded mixed methods design. Semi-structured interviews in 14 gymnasts between March and August 2018. The gymnasts represented a variation in age, sex, discipline, level of gymnastics, re- ruptures, associated injuries and return to gymnastics. The Knee Injury and Osteoarthritis Outcome Score, compared with age matched cruciate ligament injured gymnasts in the Swedish National Knee Ligament Registry, and the Tegner's Activity Score were supplements to the interviews. The interviews covered injury occasion, rehabilitation, return to gymnastics and current experience of the knee joint and were analyzed using qualitative content analysis with an inductive approach.

The Knee Injury and Osteoarthritis Outcome Score was consistent with the Swedish National Knee Ligament Registry and showed low levels in the subscales Quality of Life and sports/recreation. One third reported Tegner's Score <6 supporting low levels in Sports/Recreation. The text analysis resulted in two parts "This really happened, cold facts" and "Prerequisites and hindrances for return to gymnastics." The gymnasts' narratives were similar and reached saturation.

A cruciate ligament injury is a large trauma, and the physical and psychological demands must be understood. The results of the present study may be included in a framework for return to gymnastics, where the individual prerequisites and goals should be determined. The timeline within this framework would depend on the extent of the injury, expected time for healing and physical as well as psychological demands with respect to gymnastics' level. It may also include suggestions for different psychological strategies and performance enhancement techniques to increase the gymnasts' self-efficacy and encourage and motivate the gymnasts through the long and demanding rehabilitation.