•  
  •  
 

Abstract

Competitive sports injuries have significant physiological and psychological consequences for athletes. While rehabilitation medicine effectively addresses the physical aspects of injury recovery, the psychological and emotional journey of injured athletes remains neglected. Thus, the current study addresses this gap by examining athletes’ transforming belief systems and emotional experiences during injury rehabilitation. A qualitative research design grounded in grounded theory principles was conducted with professional athletes to understand how their beliefs toward rehabilitation evolved over time. Findings revealed a dynamic process of belief transformation consisting of seven interconnected stages, captured in the Rehabilitation Belief and Engagement Transformation (RBET) Model: (1) Pre-rehabilitation Beliefs and Practices, (2) Initial/Early Emotional and Mental Struggles, (3) Emergence of Motivational Drivers, (4) Engagement in Rehabilitation, (5) Gradual Recovery and Readjustment, (6) Re-evaluation and Turning Point, and (7) Reintegration and Performance Adaptation. This seven-step model traces athletes’ journey from initial skepticism and risk-taking behaviors to emotional struggles marked by distress, fear, and self-doubt. With the emergence of motivational drivers, athletes gradually engage in rehabilitation to navigate both physical and psychological challenges. Rehabilitation progress fosters emotional upheaval and cognitive shifts, leading to re-evaluation of beliefs and full adherence to recovery procedures. Ultimately, athletes reintegrate into sport with adjusted mindsets, strategic performance adaptations, and renewed identity. The RBET model contributes to a more holistic understanding of recovery, emphasizing that effective rehabilitation must address not only physiological healing but also the psychological and emotional transformations that athletes undergo.

Bahasa Abstract

Cedera dalam olahraga kompetitif memiliki konsekuensi yang signifikan secara fisiologis dan psikologis bagi atlet. Meskipun pengobatan rehabilitasi secara efektif dapat menangani cedera yang bersifat fisik, namun aspek psikologis dan emosional pada atlet yang mengalami cedera masih cenderung diabaikan. Dengan demikian, penelitian ini dilakukan untuk mengatasi kesenjangan tersebut dengan mengkaji perubahan belief system dan pengalaman emosional pada atlet selama masa pemulihan cedera. Desain penelitian kualitatif yang menggunakan prinsip dasar grounded theory ini dilaksanakan dengan melibatkan atlet profesional untuk memahami bagaimana keyakinan mereka terhadap rehabilitasi berkembang dari waktu ke waktu. Temuan mengungkapkan proses dinamis transformasi kepercayaan yang terdiri dari tujuh tahapan yang saling terkait dan tercakup Model Rehabilitation Belief and Engagement Transformation (RBET): (1) Kepercayaan dan Praktik Pra-rehabilitasi, (2) Perjuangan Emosional dan Mental Awal, (3) Munculnya Penggerak Motivasi, (4) Keterlibatan dalam Rehabilitasi, (5) Pemulihan dan Penyesuaian Bertahap, (6) Evaluasi Ulang dan Titik Balik, dan (7) Reintegrasi dan Adaptasi Kinerja. Model tujuh langkah ini menelusuri perjalanan atlet dari skeptisisme awal dan perilaku pengambilan risiko hingga pergumulan emosional yang ditandai dengan distres, ketakutan, dan keraguan diri. Dengan munculnya pendorong motivasi, atlet secara bertahap terlibat dalam rehabilitasi hingga mampu mengatasi tantangan fisik dan psikologis. Kemajuan rehabilitasi mendorong perubahan emosional dan pergeseran kognitif, yang mengarah pada evaluasi ulang keyakinan dan kepatuhan penuh terhadap prosedur pemulihan. Pada akhirnya, atlet kembali ke dalam dunia olahraga dengan pola pikir yang telah beradaptasi, adaptasi performa strategis, dan identitas yang pulih kembali. Model RBET berkontribusi pada pemahaman pemulihan yang lebih holistik, menekankan bahwa rehabilitasi yang efektif harus mengatasi pemulihan fisiologis sekaligus transformasi psikologis dan emosional yang dialami oleh atlet.

References

Abrams, M. P., Carleton, R. N., & Asmundson, G. J. G. (2007). An exploration of the psychometric properties of the pass-20 with a nonclinical sample. The Journal of Pain, 8(11), 879–886. https://doi.org/10.1016/j.jpain.2007.06.004

Ahmed, S. K. (2025). Sample size for saturation in qualitative research: Debates, definitions, and strategies. Journal of Medicine, Surgery, and Public Health, 5, 100171. https://doi.org/10.1016/j.glmedi.2024.100171

Ang D., & Delariarte C. (2023) Psychological Factors Facilitative to Sports Injury Rehabilitation Adherence Among Filipino Injured Athletes: A Basis for Intervention Program. The Asian Conference on Psychology & the Behavioral Sciences 2023 Official Conference Proceedings (pp. 341-346) https://doi.org/10.22492/issn.2187-4743.2023.29

Ardern, C. L., Taylor, N. F., Feller, J. A., & Webster, K. E. (2012). A systematic review of the psychological factors associated with returning to sport following injury. British Journal of Sports Medicine, 47(17), 1120–1126. https://doi.org/10.1136/bjsports-2012-091203

Bardel, M.-H., Woodman, T., Perreaut-Pierre, E., & Barizien, N. (2013). The role of athletes' pain-related anxiety in pain-related attentional processes. Anxiety, Stress & Coping, 26(5), 573–583. https://doi.org/10.1080/10615806.2012.757306

Blanchard, S., & Glasgow, P. (2014). A theoretical model to describe progressions and regressions for exercise rehabilitation. Physical therapy in sport : official journal of the Association of Chartered Physiotherapists in Sports Medicine, 15(3), 131–135. https://doi.org/10.1016/j.ptsp.2014.05.001

Brewer, B. W. (2007). Psychology of sport injury rehabilitation. Handbook of Sport Psychology, 404–424. https://doi.org/10.1002/9781118270011.ch18

Chan, G. Q., Claudio, K. S., & Go, E. (2013). Mind over matter: A qualitative study on the perceived effects of sports injuries, coping strategies, and stages of recovery of injured Filipino student athletes. Retrieved from https://animorepository.dlsu.edu.ph/etd_bachelors/11557

Charmaz, K. (2006). Constructing grounded theory a practical guide through qualitative analysis. Sage Publications.

Charmaz, K. (2008). Constructionism and the Grounded Theory. In J. A. Holstein & J. F. Gubrium, Handbook of Constructionist Research (pp.397-412). New York: The Guilford Press.

Clement, D., Arvinen-Barrow, M., & Fetty, T. (2015). Psychosocial responses during different phases of sport-injury rehabilitation: A qualitative study. Journal of Athletic Training, 50(1), 95–104. https://doi.org/10.4085/1062-6050-49.3.52

Cuambot, J.I.V., Reyes, M.E.S. & Trinidad, K.K.V. (2025). Pain anxiety and sports injury rehabilitation belief among Filipino national athletes. North American Journal of Psychology, 27(1), 135-148.

Dhillon, H., Dhilllon, S., & Dhillon, M. S. (2017). Current concepts in sports injury rehabilitation. Indian Journal of Orthopaedics, 51(5), 529–536. https://doi.org/10.4103/ortho.ijortho_226_17

Donald, S., Burelle, S., & Tracey, J. (2024). Perceptions and experiences of psychological readiness during the return to sport after injury. Journal for Advancing Sport Psychology in Research, 4(1), 21–37. https://doi.org/10.55743/000024

Ekenros, L., Fridén, C., & von Rosen, P. (2023). Experiences of rehabilitation in Young Elite Athletes: An interview study. BMJ Open Sport & Exercise Medicine, 9(4). https://doi.org/10.1136/bmjsem-2023-001716

Forsdyke, D., Madigan, D., Gledhill, A., & Smith, A. (2022). Perceived social support, reinjury anxiety, and psychological readiness to return to sport in soccer players. Journal of Sport Rehabilitation, 31(6), 749–755. https://doi.org/10.1123/jsr.2021-0181

Forsdyke, D., Smith, A., Jones, M., & Gledhill, A. (2016). Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: A mixed studies systematic review. British Journal of Sports Medicine, 50(9), 537–544. https://doi.org/10.1136/bjsports-2015-094850

Glaser, B. G. (1965). The constant comparative method of qualitative analysis. Social Problems, 12(4), 436–445. https://doi.org/10.1525/sp.1965.12.4.03a00070

Glaser, B., & Strauss, A. (1967). The Discovery of Grounded Theory: Strategies for Qualitative Research. Mill Valley, CA: Sociology Press.

Guest, G., Bunce, A., & Johnson, L. (2006). How many interviews are enough? Field Methods, 18(1), 59–82. https://doi.org/10.1177/1525822x05279903

Haugen, E. (2022). Athlete Mental Health & Psychological Impact of Sport Injury. Operative Techniques in Sports Medicine, 30(1), 150898. https://doi.org/10.1016/j.otsm.2022.150898

Heil, J. (1993). Psychology of sport injury. Human Kinetics Publishers.

Houle, J. L. W., Brewer, B. W., & Kluck, A. S. (2010). Developmental trends in athletic identity: A two-part retrospective study. Journal of Sport Behavior, 33(2), 146–159.

Indriuniene, V. (2015). Athletic identity of students actively involved in sports and its relationship with induced stress. SOCIETY, INTEGRATION, EDUCATION. Proceedings of the International Scientific Conference, 3, 539. https://doi.org/10.17770/sie2015vol3.474

Islam, M. F., Guerrero, M., Nguyen, R. L., Porcaro, A., Cummings, C., Stevens, E., Kang, A., & Jason, L. A. (2023). The importance of social support in recovery populations: Toward a multilevel understanding. Alcoholism Treatment Quarterly, 41(2), 222–236. https://doi.org/10.1080/07347324.2023.2181119

Jeansonne, J. J., Hoenig, J., & Hollander, D. (2008). Applying sport science theories to increase rehabilitation adherence. Athletic Therapy Today, 13(3), 18–19. https://doi.org/10.1123/att.13.3.18

Jeong, L., & Li, D. (2024). Psychological well-being from sports injuries in adolescence: A narrative review. Cureus 16(7), e64018. https://doi.org/10.7759/cureus.64018

Jessiman-Perreault, G., & Godley, J. (2016). Playing through the pain:  a university-based study of sports injury. Advances in Physical Education, 06(03), 178–194. https://doi.org/10.4236/ape.2016.63020

Kraemer, W., Denegar, C., & Flanagan, S. (2009). Recovery from injury in sport: Considerations in the transition from medical care to performance care. Sports Health: A Multidisciplinary Approach, 1(5), 392–395. https://doi.org/10.1177/1941738109343156

Kristensen, J. Å., Haugen, T., & Ommundsen, Y. (2023). Perceived social pressure and intention to play through injuries in junior ice hockey: The Sporting Environment Matters. Journal of Sports Sciences, 41(14), 1363–1371. https://doi.org/10.1080/02640414.2023.2273084

Lagundino, M. M., Reyes, M. S., & Cayubit, R. F. (2024). Identity after Impairment: Development of an Athletic Identity Model of Filipino Para-athletes. Makara Human Behavior Studies in Asia, 28(2), 110-125. https://doi.org/10.7454/hubs.asia.1240524

Laurel, D., Christopher, C., Ciara, C., Gil, G., & William M, W. (2023). Impact of traumatic sports injury on an athlete’s psychological wellbeing, adherence to sport and athletic identity. Journal of Sports Medicine and Therapy, 8(3), 036–046. https://doi.org/10.29328/journal.jsmt.1001070

Mason, M. (2010). Sample Size and Saturation in PhD Studies Using Qualitative Interviews. Forum Qualitative Sozialforschung Forum: Qualitative Social Research, 11(3). https://doi.org/10.17169/fqs-11.3.1428.

McClay, M. H., & Levitt, E. E. (1991). The psychological effects of sports injuries. Journal of Hand Therapy, 4(2), 83–85. https://doi.org/10.1016/s0894-1130(12)80108-6

McCracken, L. M. (2012). Pain anxiety symptoms scale (pass) and short version pass-20. Encyclopedia of Behavioral Medicine, 1423–1424. https://doi.org/10.1007/978-1-4419-1005-9_907

McCracken, L. M., & Dhingra, L. (2002). A short version of the pain anxiety symptoms scale (pass-20): Preliminary development and validity. Pain Research and Management, 7(1), 45–50. https://doi.org/10.1155/2002/517163

Mitić, P., Nedeljković, J., Bojanić, Ž., Franceško, M., Milovanović, I., Bianco, A., & Drid, P. (2021). Differences in the psychological profiles of elite and non-elite athletes. Frontiers in Psychology, 12. https://doi.org/10.3389/fpsyg.2021.635651

Murray, M., Wekesser, M., DeFreese, J. D., Kuenze, C., Brinkman, C., Gould, D., & Baez, S. (2025). Patient perceptions of psychological and rehabilitation experiences after Anterior Cruciate Ligament Reconstruction: A qualitative study. Journal of Sport Rehabilitation, 34(2), 77–83. https://doi.org/10.1123/jsr.2023-0385

Panjaitan, L.A., (2021). Sports rehabilitation phases: A literature review. International Journal of Medical and Exercise Science, 7(3), 1096-1103. https://doi.org/10.36678/IJMAES.2021.V07I03.008

Park, A. L., Furie, K., & Wong, S. E. (2023). Stronger athlete identity is a risk factor for more severe depressive symptoms after musculoskeletal injury in pediatric athletes: A systematic review. Current Reviews in Musculoskeletal Medicine, 16(5), 220–228. https://doi.org/10.1007/s12178-023-09828-0

Piussi, R., Ivarsson, A., Johnson, U., & Senorski, E. H. (2024). Psychological factors in sports injury rehabilitation: How can a sports rehabilitation practitioner facilitate communication? JOSPT Open, 2(1), 1–3. https://doi.org/10.2519/josptopen.2023.0007

Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change: Applications to addictive behaviors. American Psychologist, 47(9), 1102–1114. https://doi.org/10.1037//0003-066x.47.9.1102

Raihan, N., & Cogburn, M. (2023, March 6). Stages of change theory. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK556005/

Rice, S. M., Gwyther, K., Santesteban-Echarri, O., Baron, D., Gorczynski, P., Gouttebarge, V., Reardon, C. L., Hitchcock, M. E., Hainline, B., & Purcell, R. (2019). Determinants of anxiety in Elite Athletes: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(11), 722–730. https://doi.org/10.1136/bjsports-2019-100620

Ristolainen, L., Kettunen, J. A., Kujala, U. M., & Heinonen, A. (2011). Sport injuries as the main cause of sport career termination among Finnish top‐level athletes. European Journal of Sport Science, 12(3), 274–282. https://doi.org/10.1080/17461391.2011.566365 

Robinson, K., & Kossman, M. K. (2025). Psychosocial factors on athlete return to sport readiness after Anterior Cruciate Ligament Reconstruction: A critically appraised topic. Journal of Sport Rehabilitation, 34(2), 171–176. https://doi.org/10.1123/jsr.2024-0034

Rodríguez, S., Suarez-Cuervo, A. N., & León-Prieto, C. (2024). Exercise progressions and regressions in sports training and rehabilitation. Journal of Bodywork and Movement Therapies, 40, 1879–1889. https://doi.org/10.1016/j.jbmt.2024.10.026

Ryou, J., & Lee, E. (2023). Capital game: Male athletes’ rationalisation of playing hurt and reproduction of the risk, pain, and injury custom in professional combat sports. Qualitative Research in Sport, Exercise and Health, 16(1), 68–85. https://doi.org/10.1080/2159676x.2023.2243953

Schubring, A., Halltén, M., Barker-Ruchti, N., & Post, A. (2023). Balancing risk-taking and self-care: The ecology of athlete health behaviour during the Olympic Qualification Phase. International Review for the Sociology of Sport, 58(8), 1326–1348. https://doi.org/10.1177/10126902231168098

Theobald, A., & Dennis, J. (2022). Sports injuries and their lingering long-term effects: Proposing the addition of injury prevention programs within athletics. Journal of Student Research, 11(4). https://doi.org/10.47611/jsrhs.v11i4.3681

Weinberg, R., Vernau, D., & Horn, T. (2013). Playing through pain and injury: Psychosocial considerations. Journal of Clinical Sport Psychology, 7(1), 41–59. https://doi.org/10.1123/jcsp.7.1.41

Yang, J., Schaefer, J. T., Zhang, N., Covassin, T., Ding, K., & Heiden, E. (2014). Social support from the athletic trainer and symptoms of depression and anxiety at return to play. Journal of Athletic Training, 49(6), 773–779. https://doi.org/10.4085/1062-6050-49.3.65

Yang, S. X., Cheng, S., & Su, D. L. (2022). Sports injury and Stressor-related disorder in competitive athletes: A systematic review and a new framework. Burns & Trauma, 10. https://doi.org/10.1093/burnst/tkac017

Zhou, X.-Y., Xu, X.-M., Wang, F., Wu, S.-Y., Yang, Y.-L., Li, M., Huang, J.-M., & Wei, X.-Z. (2017). Validations and psychological properties of a simplified Chinese version of pain anxiety symptoms scale (SC-pass). Medicine, 96(10), e5626. https://doi.org/10.1097/md.0000000000005626

Download

Share

COinS
 
 

To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.