Abstract
Psychological interventions remain underutilized in physiotherapy despite the recognized biopsychosocial nature of sports injury rehabilitation. This study examined the effects of integrating sport psychology into standard physiotherapy on anxiety, motivation, functional recovery, and athletic performance. Eighty athletes (18–35 years) with lower-limb injuries in Islamabad, Pakistan, were randomized to standard physiotherapy plus 12-week Psychological Skills Training (PST; n = 40) or standard physiotherapy alone (n = 40). Outcomes were measured at baseline, 6, and 12 weeks via the SAS-2, BREQ-2, LEFS, and Single-Leg Hop Test LSI, with RTS and re-injury rates assessed at 6 months. Data were analyzed using mixed-design ANOVA.Significant Time × Group interactions emerged for all outcomes (p < .001). At 12 weeks, the PST group showed superior reductions in anxiety (η²ₚ = .54), greater motivation (η²ₚ = .49), enhanced function (η²ₚ = .62), and better performance (η²ₚ = .58). At 6 months, the PST group achieved higher successful RTS (85% vs. 60%, p = .006) and lower re-injury rates (7.5% vs. 22.5%, p = .048). Integrating PST into physiotherapy significantly reduces anxiety, improves motivation, accelerates functional recovery, and enhances RTS outcomes. Biopsychosocial rehabilitation models should be standard practice in sports medicine.