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"Ever Since My Injury, I Feel Like Every Day Is Leg Day": A Qualitative Study on Long-Term Neuromuscular Recovery
Beyza Tayfur1,2, Dylan Morrissey1,3, Stuart Charles Miller1
1Sports and Exercise Medicine, Queen Mary University of London, London, United Kingdom.
Context:
Persistent neuromuscular deficits and physical activity limitations are common after traumatic knee injuries. While biomedical literature focuses on measurable strength, there is a lack of depth regarding how individuals navigate the long-term journey of recovery including the psychological and social adaptations required in daily life. This study explored individuals' lived experiences of rehabilitation and long-term recovery following traumatic knee injury, focusing on their perceptions of physical function, symptom management, and the evolution of their physical activity engagement.
Design:
Qualitative study.
Methods:
We used semistructured, one-on-one interviews conducted online with 19 individuals (9 females, median age = 34 [interquartile range: 28-40], median = 7 [3-14] y postinjury) who had sustained a traumatic knee injury. Participants were purposively selected for maximum variation. Data were analyzed using reflexive thematic analysis.
Results:
Three themes were identified that characterize recovery as a nonlinear journey of identity reconstruction. (1) An unreliable limb: initial neuromuscular silence and permanent limitations-participants described an early state of bodily alienation where the muscle was perceived as disconnected from control. Long-term deficits were framed by participants as a fragility of progress. (2) The pendulum of recovery: balancing progress, symptoms, and systemic friction-recovery was reported as an oscillation between progress and setbacks. Participants identified visceral barriers and a clinical void in health care guidance as primary deterrents to sustained engagement. (3) The forever knee: acceptance and stewardship-participants described a transition toward lifelong stewardship involving the psychological labor of mourning the preinjury self and accepting a new normal of good enough function and exercise routines.
Conclusions:
Neuromuscular recovery is a multifaceted psychosocial process rather than a linear biological event. Participants identified that a lack of long-term guidance often results in permanent activity reduction. To optimize outcomes, rehabilitation should focus on fostering self-efficacy and support the long-term stewardship of the "forever knee."
