1 Before you use it
What it is
Fear of movement and of re-injury — the belief that activity will cause damage.
Use the TSK-11. The original 17-item version contains items with known problems, and the short form is the one to teach.
When to reach for it
When a patient's guarding, avoidance or reluctance is out of proportion to the presentation. Post-ACL, post-dislocation, whiplash, and persistent low back pain are the obvious ones.
Re-measure it. Fear that doesn't shift while strength does is the reason a return-to-sport decision fails.
2 Giving it
Scoring
Eleven items, 1–4 each, summed to 11–44. Higher means more fear.
Do not mix versions within an episode of care — the ranges differ and the series becomes uninterpretable.
What it doesn’t measure
Pain, catastrophising, or general anxiety. It is specific to movement and re-injury beliefs.
Pair it with: PCS if catastrophising looks like the driver, ACL-RSI for sport-specific readiness, and a confidence rating for the joint itself.
Repeat it
3 Reading the score
Interpreting it
Higher scores indicate greater kinesiophobia.
Its clinical value is the direction it points you, not the number. A high score says the conversation and the graded exposure matter as much as the loading dose — which is the same instruction the ACL, patellar instability and persistent low back pain pages already give.
Is the change real?
On placement
ACL reconstruction, 5 months, avoiding the pivot drills. TSK-11 was 31 at month 3 and is 25 today. Same version both times.
Read it as 6 points down — a 19% change, over the 16%-of-total MDC (measured in chronic musculoskeletal pain). Real. The library carries no MCID, and the value of the number is the direction it points, not the figure.
Do the score says the conversation and the graded exposure are working. Keep the exposure ladder going, and don't mix in the TSK-17 mid-episode.
Student trap. Reading a high score as a personality finding. It's a modifiable belief about movement, and it's a treatment target — say that to the patient.
Official source: null. We don't host the form.
This is a learning tool. It does not diagnose patients and does not replace your clinical educator.
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