Exploring Physiotherapists' Perceptions and Practices in the Use of Psychological Interventions in Sports Rehabilitation in Saudi Arabia: A Survey Study

Abstract

Background: Sports injuries impact athletes both physically and psychologically, causing issues like anxiety, depression, and fear of re-injury. Incorporating psychological interventions and emotional support in rehabilitation enhances recovery outcomes. Physiotherapists, due to their close interaction with athletes, play a key role in addressing these psychological aspects and providing comprehensive care. Aim of the study: Explore the psychological interventions in sports injury rehabilitation among physiotherapists in Saudi Arabia, focusing on their practices, perceptions, and referral behaviours. Design: A quantitative descriptive survey study. Methods: This study included 160 physiotherapists in Saudi Arabia, with 53.8% (n = 86) males and 46.3% (n = 74) females. The Physiotherapist and Sport Psychology Questionnaire (PSPQ) was distributed through social media platforms, including X (formerly Twitter) and LinkedIn, between 29 October 2024 and 29 November 2024. The collected data were analysed using the Statistical Package for the Social Sciences (SPSS) software. Results: A total of 18.1% of physiotherapists reported "always" observing psychological impacts on athletes following injuries, with 36.3% observing this "often." Over half (53.8%) of physiotherapists rated addressing the psychological aspects of injuries as "extremely important." Athletes who coped successfully with injuries were commonly characterized by "realistic expectations" (M = 5.04, SD = 2.260) and "patience with themselves" (M = 5.00, SD = 2.226). In contrast, poor coping was associated with traits such as "anger/aggression" (M = 5.54, SD = 2.166) and "poor concentration" (M = 5.07, SD = 2.108). Among the most frequently employed techniques were “encouraging effective communication” (M = 4.40, SD = 0.841), “enhancing self-confidence” (M = 4.29, SD = 0.908), and “setting short-term goals” (M = 4.26, SD = 0.894), all of which were described as "always used." Additionally, the techniques physiotherapists most valued for further development included “setting realistic goals” (M = 4.40, SD = 0.841) and “enhancing self-confidence” (M = 4.29, SD = 0.908). Despite this, 85.6% lacked access to sports psychologists, 80% had never referred athletes, and 89.4% reported an absence of referral guidelines. Conclusion: This study highlights the significant psychological impact of injuries on athletes, as observed by physiotherapists. Physiotherapists demonstrated a high awareness of the importance of addressing the psychological aspects of rehabilitation. Skills such as “setting realistic goals” and “enhancing self-confidence” were identified as the most valued techniques for both current use and further learning. However, the lack of access to sports psychologists and the absence of formal referral guidelines remain major barriers, with most physiotherapists reporting no referrals or collaboration with psychologists. These findings emphasize the urgent need to integrate psychological support into sports injury rehabilitation to improve outcomes for athletes.