Psychological resilience and burnout in professional male athletes: a meta-analysis of injury-related outcomes

Background: This meta-analysis examined associations of psychological resilience, burnout, and perceived stress with injury outcomes (incidence/recurrence and return-to-play (RT-P) duration/time-loss) in professional and semi-professional male athletes. Methods: PubMed/MEDLINE, Scopus, Web of Science, and SPORTDiscus were searched (2010–September 2025; last updated September 2025). Eligible studies included validated psychological measures and extractable quantitative data. Random-effects models were applied; heterogeneity (Q, τ2, I2), publication bias (Egger’s test; trim-and-fill), and robustness (leave-one-out) were assessed. Results: Seventeen studies (27 effects; n = 8947) were included. Resilience was negatively associated with injury occurrence (r = −0.29; 95% CI: −0.36 to −0.21; I2 ≈ 65–68%) and with shorter RT-P duration (Hedges’ g = −0.48), corresponding to ~5.3 fewer time-loss days. Burnout correlated positively with injury (r = 0.34; 95% CI: 0.24–0.43); high-burnout profiles showed higher odds of injury (OR = 1.75; 95% CI: 1.38–2.22). Perceived stress was positively related to injury (r = 0.31; 95% CI: 0.23–0.38). Meta-regression indicated stress predicted burnout (β = 0.42; SE = 0.08; p < 0.001) and the stress × resilience interaction was negative (β = −0.19; SE = 0.08; p = 0.015). Conclusions: Resilience appears protective for injury risk and recovery, whereas burnout and perceived stress are psychosocial risk factors. Integrating validated screening tools (CD-RISC, ABQ, PSS) alongside load–recovery and sleep optimization is recommended. The PROSPERO Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251165025, CRD420251165025.