From 'My world fell apart' to 'The best thing that happened in my life': elite athletes' longitudinal journeys after an injury.

This study explored the perspectives of elite athletes diagnosed with an injury requiring a minimum of 4 months of rehabilitation based on the health professional's prognosis. Through a longitudinal phenomenological design, we captured perceptions and experiences of elite athletes from different sports, countries and injury types following major injury. Athletes were interviewed at different stages of the return to sport process (from early rehabilitation to return to performance), resulting in a total of 31 interviews analysed using longitudinal interpretative phenomenological analysis. Three overarching journey phases were identified. (1) The Rough Start was characterised by uncertainty about the future, loss of athletic identity, emotional distress and feelings of isolation as athletes adjusted to injury. (2) The Roller coaster rehab reflected emotional fluctuations, small achievements and setbacks, the influence of previous injury experiences, the importance of support systems and challenges related to communication with health professionals. (3) The Journey's End involved athletes feeling like athletes again, experiencing a sense of accomplishment and reflecting on personal growth. During this phase, some athletes reassessed priorities or made decisions about career transitions. The final steps towards return to performance were often shaped by factors beyond athletes' control, including team dynamics, competition opportunities and organisational decisions. Despite shared themes, athletes' narratives showed substantial variability. This study provides in-depth insight into how athletes' journeys are non-linear and highly individual. It highlights the importance of flexible, athlete-centred care that values communication, individual responses to injury and the wider sporting and career context, rather than relying solely on standardised protocols or physical criteria.