Background Sports injuries can have broad reaching health, performance, and financially-related problems for individual athletes and teams. There are widely recognized psychological injury risk factors therefore it follows that psychological skills training may be able to reduce the levels of injury risk.

Objective To examine the relationship between psychological injury prevention interventions and injury risk reduction.

Design Systematic review adopting PRISMA guidelines (PROSPERO reg. CRD42016035879).

Setting Databases searched were CINAHL, MEDLINE, PsycARTICLES, PsycINFO, SPORTDiscus, PubMed and Science Direct. RCTs, non-RCTs that incorporated a comparison group, pre- and post- designs, and qualitative studies were eligible.

Patients (or Participants) Twelve studies met the inclusion criteria. Studies included 1306 athletes (female n=520; male n=786) with an age range of 10–33 years and drawn from regional to international level sports.

Interventions (or Assessment of Risk Factors) Varying psychological intervention strategies of varying modalities, intensities and volumes were adopted in the final studies.

Main Outcome Measurements Mixed-methods Appraisal Tool (MMAT) was used to appraise study quality.

Results Studies were appraised as having a moderate risk of bias in reporting. Eleven of the 12 included studies demonstrated a reduced injury risk as a result of the intervention. Five of the 12 included studies demonstrated a statistically significant difference. There is a bias towards the Stress Injury Model as the theoretical underpinning, contributing to a bias towards stress management studies. There is a dearth of literature which considers the role of psychological skills training in reducing non-stress related risk factors (e.g. imagery training to manage neuromuscular deficiency).

Conclusions Evidence suggests psychological skills training can reduce the risk of sports injury occurrence, however this claim is drawn on research with a moderate risk of reporting bias.