Psychological resilience and sports injury among athletes: a systematic review of injury incidence, recovery processes, and psychological correlates.

backgroundIt is commonly mentioned that psychological resilience is a significant protective factor in the context of sports injuries, nevertheless, the existing evidence is inconsistent, especially in terms of its changing effectiveness when moving along the injury spectrum (between risk exposure and post-injury rehabilitation).

objectiveThis systematic review aimed to investigate the protective effect of resilience on sports injury outcomes in athletes and explore variations in this effect across different phases of the injury timeline.

methodsIn accordance with the PRISMA 2020 guideline, we searched four core electronic databases (PubMed, Web of Science, SPORTDiscus, and PsycINFO) from inception to December 31, 2025, to identify quantitative studies that used validated resilience measures in relation to injury outcomes (incidence, severity, recovery, injury-related stress, and coping responses). Google Scholar was additionally searched as a supplementary source to identify any peer‑reviewed records potentially missed by the core databases; however, due to its limited reproducibility, Google Scholar results were screened but not used for systematic counting. A total of 12 articles (N = 3,780) met the inclusion criteria. Methodological quality was appraised using the Mixed Methods Appraisal Tool (MMAT), and findings were synthesized via narrative synthesis.

resultsTotally, twelve studies, which included 3,780 athletes, met the inclusion criteria. The evidence constructed shows to indicate a phase and complex relationship. Resilience had the strongest and most consistent effects on the recovery phase as noted after an injury has been sustained. In this case, a more resilient person exhibited quicker recovery curves, less load of symptoms, including post-concussion syndrome, lesser concentrations of injury stress, and enhanced adaptive attitudes towards rehabilitation. In contrast, the support for a protective effect of resilience during the pre-injury phase of injury incidence was inconsistent and limited by methodological flaws. Notably, one study in high-intensity contact sports yielded a paradoxical finding: higher resilience was associated with more severe injuries, suggesting that contextual variables may act as a critical moderator in this relationship. Limited evidence was available regarding resilience during the acute injury phase.

conclusionCurrent evidence suggests that psychological resilience may be associated with favorable injury-related outcomes in athletes, particularly during the post-injury recovery phase, where it appears to support adaptation and reduce stress. However, its role in the pre-injury phase remains inconclusive. Moreover, in high-intensity contact sports, resilience may exacerbate injury severity. Overall, resilience should be cautiously interpreted as a phase-sensitive psychological resource, whose influence varies across the pre-injury, acute injury, and post-injury recovery phases of the sports injury continuum.