The Differential Effects of First-Person and Third-Person Motor Imagery on Anxiety and Psychological Readiness in Athletes Recovering from ACL Reconstruction: A Longitudinal Study

Psychological factors such as anxiety and fear of reinjury are critical barriers to successful recovery after anterior cruciate ligament (ACL) reconstruction. Motor imagery (MI) has been proposed as a promising psychological tool, with first-person and third-person perspectives potentially offering distinct benefits. In this study, 100 athletes aged 18 to 25 years who returned to sport after ACL reconstruction were followed for nine months to examine how imagery perspectives influence psychological recovery. Imagery ability was assessed using the Vividness of Movement Imagery Questionnaire-2, psychological readiness with the ACL-Return to Sport after Injury scale, and anxiety with the State-Trait Anxiety Inventory. Repeated assessments demonstrated that first-person imagery consistently enhanced psychological readiness and reduced anxiety across all time points, emerging as the strongest predictor of positive outcomes. Third-person imagery was particularly effective in lowering situational anxiety around the six-month mark, when athletes faced critical challenges in their return-to-sport process. Together, these findings highlight the complementary roles of first-person and third-person imagery in rehabilitation. Incorporating both perspectives into psychological training programs may optimize athletes’ readiness, alleviate anxiety, and foster a smoother and more confident transition back to competitive sport.