Sports Injuries and Mental Health in Child and Adolescent Athletes: A Systematic Review.

BACKGROUND: Sports injuries in children and adolescents may affect physical health, emotional well-being, sleep, quality of life, confidence, sport participation, and readiness to return to sport. OBJECTIVE: This systematic review synthesized evidence on the relationship between sports-related injuries and mental health in athletes aged 19 years or younger, considering both psychological factors associated with injury vulnerability and psychosocial outcomes following injury. METHODS: The review was conducted in accordance with the PRISMA 2020 guidelines. PubMed, Web of Science, Scopus, and Google Scholar were searched from inception to 8 July 2026, with eligibility restricted to studies published between 2021 and 2026. Risk of bias was assessed using Joanna Briggs Institute critical appraisal tools, and findings were synthesized narratively. RESULTS: Twenty-one studies were included. Lower well-being, anxiety, stress, fatigue, sleep disturbance, kinesiophobia, and reduced psychological readiness were associated with injury occurrence, symptom burden, recovery, or reinjury. Conversely, injuries were associated with anxiety, depressive symptoms, sleep problems, reduced health-related quality of life, lower confidence, disrupted athletic identity, and return-to-sport difficulties. CONCLUSIONS: The findings suggest a potentially bidirectional association between sports injury and mental health within a broader biopsychosocial context. However, heterogeneity and predominantly observational designs limit causal inference.