Approximately 1 out of 3 patients fail to return to previous levels of sport participation after anterior cruciate ligament reconstruction (ACLR), with injury-related fear identified as a potential barrier for return to sport. However, we do not know how injury-related fear is associated with other meaningful psychological responses to injury, or how patient perceptions of these psychological responses relate to their rehabilitation experiences. The purpose of this cross-sectional, explanatory sequential mixed-methods study was to explore how perceptions of self-determined motivation, athlete burnout, and injury-related fear affected psychological experiences during ACLR rehabilitation in patients between 4- and 6-months post-ACLR. 13 participants were recruited and completed questionnaires measuring self-determined motivation, athlete burnout, perceived stress, and injury-related fear. A sub-sample of 5 participants participated in a semi-structured interview to further underline patient experiences during ACLR rehabilitation. A strong, positive relationship was observed between perceived stress and injury-related fear (rho = 0.70, p = 0.008). Thematic analysis revealed five themes related to the rehabilitation experience: 1) struggling with the recovery process, 2) acknowledging negative emotional states, 3) drive to return to sport and normal life, 4) understanding and finding purpose in rehabilitation, and 5) successfully navigating the recovery process. These preliminary data suggest that negative emotional states, such as injury-related fear and athlete burnout, may be related to self-determined motivation and perceived stress after ACLR.
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