Biopsychosocial Sports Physiotherapy Interventions After Injury in Athletes: A Narrative Review

Abstract

Background: Sports injury rehabilitation has traditionally focused on biological impairments such as pain, swelling, restricted range of motion, weakness, impaired biomechanics, and delayed tissue healing. Although these factors remain central to sports physiotherapy, athlete recovery and return to sport are also influenced by psychological and social factors, including fear of reinjury, anxiety, confidence, motivation, athletic identity, coach pressure, team expectations, social support, and communication quality. Objective: This narrative review aimed to synthesize recent literature on biopsychosocial sports physiotherapy interventions after injury in athletes and to explain why rehabilitation should move beyond impairment-only models toward whole-athlete recovery. Methods: A targeted narrative literature search was conducted using key concepts related to biopsychosocial sports injury rehabilitation, sports physiotherapy, return to sport, psychological readiness, fear of reinjury, social support, graded exposure, shared decision-making, and multidisciplinary care. Recent reviews, clinical commentaries, return-to-sport studies, and relevant athlete rehabilitation literature were prioritized. Evidence was synthesized conceptually across biological, psychological, and social domains. No meta-analysis, formal risk-of-bias assessment, or certainty grading was performed because the review was designed as a narrative synthesis. Results: The reviewed literature indicates that biological rehabilitation remains foundational, but physical recovery alone may be insufficient for safe and sustainable return to sport. Psychological readiness, fear-of-reinjury management, athlete confidence, education, goal setting, graded exposure, social support, and shared decision-making are clinically relevant components of rehabilitation. Biopsychosocial physiotherapy may improve rehabilitation adherence, confidence, communication, individualized decision-making, and return-to-sport planning. Conclusion: Biopsychosocial sports physiotherapy provides a broader and more clinically responsive framework than impairment-only rehabilitation. Future research should evaluate structured biopsychosocial protocols across specific sports, injury types, and competitive levels.