# Beyond the Injury: A Case Report on Psychological Intervention During ACL Rehabilitation in a Professional Futsal Player

## TL;DR

This case study shows that psychological support during ACL rehabilitation in a professional futsal player improves mental health, sleep, and readiness to return to sport.

## Contribution

The study provides longitudinal evidence of the benefits of structured psychological intervention in ACL rehabilitation for athletes.

## Key findings

- Psychological intervention led to sustained improvements in mood, sleep quality, and pain management.
- The intervention enhanced psychological readiness for return to play and overall mental health.
- It supports better treatment compliance and rehabilitation outcomes in professional athletes.

## Abstract

Public health relevance—How does this work relate to a public health issue?

ACL injuries represent a public health problem due to their high incidence in athletes, their psychological and functional impact, and the costs associated with rehabilita-tion and return to activity.

The psychological consequences (anxiety, depression, fear of re-injury, etc.) are aspects of the problem that are rarely addressed and can compromise recovery and reintegra-tion into sport.

Public health significance—Why is this work of significance to public health?

This study provides longitudinal evidence that psychological intervention sustainably improves key indicators of mental health, sleep, pain, and readiness to return to sport, thereby improving treatment compliance and rehabilitation outcomes.

This reinforces the need to integrate psychological care into standard rehabilitation programs, with the potential to reduce recurrence, quitting sport and decrease psy-chological problems and the healthcare burden associated with ACL injuries.

Public health implications—What are the key implications or messages for practitioners, policy makers and/or researchers in public health?

Continuous psychological monitoring throughout rehabilitation is important, sub-sequently integrating psychological indicators as a complementary criterion to phys-ical parameters in order to authorize a return to competition.

Practitioners and the research community should promote multidisciplinary work and encourage broader studies that evaluate the impact of these interventions, with the aim of optimizing care and improving outcomes in relation to sports injuries.

Background: An anterior cruciate ligament (ACL) rupture is one of the most psychologically demanding injuries in professional sport. This study aimed to describe a structured psychological intervention conducted during the rehabilitation process following an ACL rupture in a professional female futsal player. Methods: A single-case longitudinal design was implemented with three phases (pre-test, intervention, post-test) across a 12-month rehabilitation period. Psychological assessment was conducted at four key points: initial evaluation, rehabilitation follow-up, medical discharge, and three- and six-month follow-ups. The battery included perfectionism (FMPS), anxiety (STAI), depression (BDI-II), mental health indicators (DASS-21, GHQ-12), sleep quality (PSQI), pain perception and catastrophizing (VAS, PCS), mood states (POMS), psychological readiness for return to play (PRIA-RS), and perceived intervention effectiveness. The program consisted of 15 individual sessions plus a follow-up, combining cognitive–behavioral therapy principles, mindfulness-based techniques (relaxation, body scan, visualization), cognitive restructuring, sleep hygiene, goal setting, problem-solving, and emotional expression strategies. Results: Progressive and sustained improvements were observed in mood states and pain catastrophizing, along with enhanced sleep quality, psychological readiness, and reintegration into competition. Improved overall mental health indicators were also observed, supporting adherence to rehabilitation and return-to-play confidence. Conclusions: This case highlights the relevance of structured psychological intervention as an integral component of injury rehabilitation in professional athletes with ACL rupture, supporting its inclusion in multidisciplinary care and future research to optimize recovery and prevent maladaptive outcomes.