Table 3.

Themes and Formulated Meanings Generated From Participants' Interviews

Theme	Formulated Meanings	Important Statements, No. (%)
Hesitation and lack of confidence led to self-limiting tendencies.	• Patients experienced hesitation when performing certain activities after ACLR.	67 (29)
	• Some patients perceived their knee as unstable when returning to sport or activity.
	• Physical and psychological confidence were not always synonymous after ACLR.
	• Patients relied on a knee brace during activity.
	• To avoid reinjury, patients were self-limiting in the activities in which they participated.
	• Regaining confidence in one's knee after ACLR was an important step toward recovery and return to sport.
Awareness was heightened after ACLR.	• Patients were scared on first returning to sport after ACLR because they were afraid of reinjuring their knee.	28 (12)
	• Many patients disliked the restrictive and cumbersome nature of a knee brace, as well as the attention it brought them.
	• Sustaining an ACL injury caused participants to be more aware and conscious of their knee when returning to sport or activity.
	• Returning to sport after ACLR coincided with anxious feelings in regard to a patient's ability to perform at the same level as before ACL injury.
Expectations and assumptions about the recovery process influenced the decision to return to sport after ACLR.	• Patients were excited to return to sport after ACLR.	30 (13)
	• Limitations in everyday life were frustrating to patients after ACLR.
	• Lengthy rehabilitation programs were frustrating for patients undergoing and recovering from ACLR.
	• Patients often assumed that they would certainly return to sport at either the same or a higher level after ACLR.
	• Expectations regarding outcomes after ACLR dictated a person's decision to return to sport.
Coming to terms with ACL injury led to a reprioritization.	• The timing of when a patient sustained an ACL injury influenced how he or she coped with and responded to the injury.	52 (22)
	• The decision to return to sport was influenced by the quality of life patients desired after ACLR.
	• Often, the decision to return to sport was replaced by other life priorities.
	• Some patients had difficulty discerning whether their decision not to return to sport was based on fear of reinjury or just a loss of interest.
	• Patients who had never experienced a major injury were in shock after ACL injury.
Athletic participation helped reinforce intrinsic personal characteristics.	• Intrinsic characteristics reinforced through athletic participation influenced the decision to return to sport after ACLR.	45 (19)
	• Motivation to return to sport was influenced by a competitive rehabilitation environment and patient self-motivation.
	• Patients who participated in sports their entire lives had a strong sense of athletic identity and connection with their sport.
	• It was beneficial for patients to maintain a healthy lifestyle after ACLR, regardless of their return-to-sport status.
Having a strong support system both in and out of rehabilitation was a key factor in building a patient's confidence.	• Confidence after ACLR was important in feeling successful and stemmed from external support.	12 (5)

Abbreviations: ACL, anterior cruciate ligament; ACLR, anterior cruciate ligament reconstruction.