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Mental Health in Sport Injury and Rehabilitation: Intersecting Public Health Concerns

Special Issue Editors


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Guest Editor
Department of Psychology, School of Social Work and Behavioral Sciences, Springfield College, 263 Alden Street, Springfield, MA 01109, USA
Interests: psychology of sport injury; rehabilitation adherence; self-identity in sport and exercise

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Guest Editor
Department of Exercise and Sport Science, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
Interests: psychology of sport injury; clinical outcomes assessments; technology-informed care; sport injury rehabilitation

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Guest Editor
Department of Personality, Evaluation and Psychological Treatment, Universidad de Murcia, 35000 Murcia, Spain
Interests: sport psychology; sport injuries; high performance; personality; mental health; soccer
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Special Issue Information

Dear Colleagues,

Mental health and sport injury are areas of substantial—and intersecting—areas of public health concern in the 21st century. Awareness of the importance of and attention to mental health in sport have increased dramatically over the past two decades. Mental health overlaps with other key areas of athlete functioning, including sleep, nutrition, physiology, and performance. Indeed, mental health is also directly relevant to the common and debilitating problem of sport injury, as psychological factors are associated with the occurrence of, responses to, recovery from, and return-to-play after injury among athletes. Identification of mental health antecedents of sport injury has important implications for prevention. Similarly, understanding interrelationships among mental health and recovery processes and outcomes can inform the development of holistic rehabilitation strategies that contribute to the physical and psychological well-being of athletes after injury.

The goal of this Special Issue of the International Journal of Environmental Research and Public Health (IJERPH) is to assemble a collection of articles elucidating the role of mental health factors as prospective causes, concomitants, and consequences of sport injury phenomena. Original research manuscripts, reviews, and case reports are invited to be considered for potential inclusion in the Special Issue.

Prof. Dr. Britton W. Brewer
Dr. Shelby Baez
Dr. Aurelio Olmedilla Zafra
Guest Editors

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Keywords

  • athlete
  • concussion
  • injury
  • intervention
  • mental health
  • musculoskeletal
  • prevention
  • psychology
  • rehabilitation
  • sport

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Published Papers (4 papers)

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Research

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24 pages, 1050 KB  
Article
Self-Presentation Concerns Among Injured Adolescent Athletes: A Qualitative Investigation
by Noémie Demers, Leslie Podlog, Lucie Forté, Alexis Ruffault, Marie-Lyne Nault and Jeffrey G. Caron
Int. J. Environ. Res. Public Health 2025, 22(11), 1687; https://doi.org/10.3390/ijerph22111687 - 7 Nov 2025
Viewed by 1149
Abstract
Sport psychology research has shown that athletes might experience self-presentation concerns. However, fairly limited work has examined these specific concerns among athletes experiencing an injury, particularly among adolescent populations. Therefore, the purpose of this qualitative study was to explore the nature, precursors, and [...] Read more.
Sport psychology research has shown that athletes might experience self-presentation concerns. However, fairly limited work has examined these specific concerns among athletes experiencing an injury, particularly among adolescent populations. Therefore, the purpose of this qualitative study was to explore the nature, precursors, and implications of injured adolescent athletes’ self-presentation concerns. Semi-structured interviews were conducted with female (n = 12) and male (n = 2) competitive adolescent athletes (Mage = 15.1 years) who experienced a variety of serious injuries (e.g., ACL rupture, labrum tear) as a result of competing in various sports. Braun and Clark’s thematic analysis (2006) was used to develop themes pertaining to the nature, precursors, and implications of injury. Findings highlight a range of specific types of self-presentation concerns (e.g., concerns over “faking” an injury, lacking capability, disappointing others), the impact of the closeness of relationships with significant others, key implications (e.g., future sport apprehensions, negative emotions, motivational enhancements), and coping strategies. Results identify factors for targeted interventions aimed at managing self-presentation concerns among injured adolescents. Full article
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13 pages, 864 KB  
Article
Long-Term Cognitive Decline in MMA Fighters: A Two-Year Cohort Study on Executive Function Impairments Due to Repetitive Head Strikes
by Michele Andrade de Brito, José Raimundo Fernandes, Keveenrick Ferreira Costa, Clóvis Albuquerque Maurício, Aleksandro Ferreira Gonçalves, Otávio de Toledo Nóbrega, Esteban Aedo-Muñhoz, Ciro José Brito, Diego Ignácio Vanezuela Pérez and Bianca Miarka
Int. J. Environ. Res. Public Health 2025, 22(7), 1004; https://doi.org/10.3390/ijerph22071004 - 26 Jun 2025
Viewed by 5335
Abstract
Background: This study examines the long-term cognitive consequences of repetitive head impact on executive functions in mixed martial arts (MMA) fighters over two years. Methods: Neuropsychological tests assessed executive functions in two groups: competitive (CG; n = 26) and recreational groups (RG; n [...] Read more.
Background: This study examines the long-term cognitive consequences of repetitive head impact on executive functions in mixed martial arts (MMA) fighters over two years. Methods: Neuropsychological tests assessed executive functions in two groups: competitive (CG; n = 26) and recreational groups (RG; n = 26). Results: A significant interaction between time and group was observed. The CG experienced greater declines in Mental Processing Speed (MPS) after 1 year [4.6 s (3.1; 6.1); p ≤ 0.001] and 2 years [14.6 s (5.1; 24.0); p = 0.003]. Inhibitory control (IC) also declined after 1 year [4.7 a.u. (3.0; 6.2); p ≤ 0.001] and 2 years [10.0 a.u. (11.6; 11.4); p ≤ 0.001]. Cognitive flexibility (CF) showed a pronounced reduction after 1 year [4.8 a.u. (3.0; 6.7); p ≤ 0.001] and 2 years [7.5 a.u. (5.9; 9.1); p ≤ 0.001]. Automatic (AP) and controlled processes (CP), as well as direct (DM) and indirect memory (IM), also showed significant impairments in CG. Conclusions: These findings highlight the detrimental effects of MMA competitions on cognitive function, emphasizing the need for monitoring and interventions to preserve fighters’ health and performance. Full article
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12 pages, 1146 KB  
Article
Changes in Pain-Related Psychological Distress After Surgery in Patients with Musculoskeletal Injury
by Grant H. Cabell, Billy I. Kim, Kevin A. Wu, Emily J. Luo, Clark Bulleit, Nicholas J. Morriss, Trevor A. Lentz and Brian C. Lau
Int. J. Environ. Res. Public Health 2025, 22(6), 857; https://doi.org/10.3390/ijerph22060857 - 30 May 2025
Viewed by 1568
Abstract
(1) Background: Pain experiences are shaped by both physical injury and psychological distress, posing challenges for orthopedic care. While surgery may alleviate injury-related distress, the extent of psychological improvement post surgery remains unclear. Thus, the purpose of this study was to evaluate changes [...] Read more.
(1) Background: Pain experiences are shaped by both physical injury and psychological distress, posing challenges for orthopedic care. While surgery may alleviate injury-related distress, the extent of psychological improvement post surgery remains unclear. Thus, the purpose of this study was to evaluate changes in general and pain-specific psychological distress after surgical intervention for musculoskeletal injury. (2) Methods: A retrospective review was conducted on 133 patients who underwent musculoskeletal surgery between February 2020 and August 2022 by a single sports medicine fellowship-trained surgeon. Psychological distress was assessed using the Optimal Screening for Prediction of Referral and Outcome Yellow-Flag (OSPRO-YF) tool, both before and at least six months after surgery. Pre- and postoperative scores were compared using paired t-tests, and clinically meaningful changes were evaluated using a distribution-based minimal clinically important difference (MCID) threshold. (3) Results: Significant reductions were found in total OSPRO-YF scores and several subdomains including fear avoidance (physical activity and work), kinesiophobia, and pain anxiety. However, 88% of patients showed no meaningful change in overall psychological distress. In patients with high baseline distress, over 20% showed meaningful improvement in six subdomains. (4) Conclusions: Psychological distress often persists after musculoskeletal surgery. Targeted psychological interventions may benefit patients with high preoperative distress. Full article
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20 pages, 1263 KB  
Case Report
Beyond the Injury: A Case Report on Psychological Intervention During ACL Rehabilitation in a Professional Futsal Player
by Luis Miguel Ramos-Pastrana, Laura Gil-Caselles, Roberto Ruiz-Barquín, José María Giménez-Egido and Aurelio Olmedilla-Zafra
Int. J. Environ. Res. Public Health 2026, 23(1), 26; https://doi.org/10.3390/ijerph23010026 - 23 Dec 2025
Viewed by 515
Abstract
Background: An anterior cruciate ligament (ACL) rupture is one of the most psychologically demanding injuries in professional sport. This study aimed to describe a structured psychological intervention conducted during the rehabilitation process following an ACL rupture in a professional female futsal player. Methods: [...] Read more.
Background: An anterior cruciate ligament (ACL) rupture is one of the most psychologically demanding injuries in professional sport. This study aimed to describe a structured psychological intervention conducted during the rehabilitation process following an ACL rupture in a professional female futsal player. Methods: A single-case longitudinal design was implemented with three phases (pre-test, intervention, post-test) across a 12-month rehabilitation period. Psychological assessment was conducted at four key points: initial evaluation, rehabilitation follow-up, medical discharge, and three- and six-month follow-ups. The battery included perfectionism (FMPS), anxiety (STAI), depression (BDI-II), mental health indicators (DASS-21, GHQ-12), sleep quality (PSQI), pain perception and catastrophizing (VAS, PCS), mood states (POMS), psychological readiness for return to play (PRIA-RS), and perceived intervention effectiveness. The program consisted of 15 individual sessions plus a follow-up, combining cognitive–behavioral therapy principles, mindfulness-based techniques (relaxation, body scan, visualization), cognitive restructuring, sleep hygiene, goal setting, problem-solving, and emotional expression strategies. Results: Progressive and sustained improvements were observed in mood states and pain catastrophizing, along with enhanced sleep quality, psychological readiness, and reintegration into competition. Improved overall mental health indicators were also observed, supporting adherence to rehabilitation and return-to-play confidence. Conclusions: This case highlights the relevance of structured psychological intervention as an integral component of injury rehabilitation in professional athletes with ACL rupture, supporting its inclusion in multidisciplinary care and future research to optimize recovery and prevent maladaptive outcomes. Full article
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