title: Rehabilitation after first-time anterior cruciate ligament injury and reconstruction in female football players: a study of resilience factors.
abstract: BACKGROUND
  Most of the research in the area of psychosocial factors in rehabilitation after sports injuries has focused on risk behaviors, while relatively few studies have focused on behaviors that facilitate rehabilitation. The objective of our study was to understand the psychosocial features that characterize elite female football players who express a resilient behaviour during rehabilitation after a first-time anterior cruciate ligament (ACL) injury and reconstruction.
  
  
  METHODS
  A qualitative method was used based on individual in-person interviews and video communication of players who incurred a first-time ACL tear during the 2012 season of the Swedish Women's Elite Football League. In total, 13 players had a first-time ACL and were interviewed post-season. The interviews were followed by a thematic content analysis. Based on this, eight players were identified as showing resilient behaviors during their rehabilitation and were included in the final analysis.
  
  
  RESULTS
  Three core themes representing psychosocial factors that help players cope successfully with rehabilitation were identified: (I) constructive communication and rich interaction with significant others; (II) strong belief in the importance and efficacy of one's own actions; and (III) the ability to set reasonable goals.
  
  
  CONCLUSIONS
  The findings suggest three core themes of psychosocial factors that characterize first-time ACL-injured elite female football players showing resilience during rehabilitation after ACL reconstruction. Suggestions for medical teams about ways to support communication, self-efficacy, and goal-setting during the rehabilitation process, are provided.
authors.affiliation: Center of Research on Welfare, Health and Sport, Halmstad University, Box 823, S-301 18 Halmstad, Sweden.
authors.forename: Urban
authors.initials: U
authors.lastname: Johnson
authors.affiliation: Center of Research on Welfare, Health and Sport, Halmstad University, Box 823, S-301 18 Halmstad, Sweden.
authors.forename: Andreas
authors.initials: A
authors.lastname: Ivarsson
authors.affiliation: Department of Orthopaedics, Sahlgrenska University Hospital, Gothenburg, S-413 45 Sweden ; Sahlgrenska Academy Institute of Clinical Sciences, Gothenburg University, Gothenburg, S-405 30 Sweden ; Football Research Group, Linköping, Sweden.
authors.forename: Jón
authors.initials: J
authors.lastname: Karlsson
authors.affiliation: Football Research Group, Linköping, Sweden ; Department of Medical and Health Sciences, Division of Physiotherapy, Linköping University, Linköping, S-581 83 Sweden.
authors.forename: Martin
authors.initials: M
authors.lastname: Hägglund
authors.affiliation: Football Research Group, Linköping, Sweden ; Department of Medical and Health Sciences, Division of Community Medicine, Linköping University, Linköping, S-581 83 Sweden.
authors.forename: Markus
authors.initials: M
authors.lastname: Waldén
authors.affiliation: The Swedish School of Sport and Health Sciences, Stockholm, Box 5626, S-114 86 Sweden ; Karolinska University Hospital, Stockholm, S-171 77 Sweden.
authors.forename: Mats
authors.initials: M
authors.lastname: Börjesson
keywords: Athletic injury; Behavior; Female football; Psychosocial; Resilience