The Relationship Between Kinesiophobia and Psychological Readiness to Return to Sport After Lateral Ankle Ligament Surgery

Background/Objectives: Fear of reinjury and impaired psychological readiness frequently impede return to sport following lateral ankle ligament surgery. This study aimed to analyze the correlation between kinesiophobia and psychological readiness to return to sport before and after intensive rehabilitation in competitive athletes following lateral ankle ligament repair or reconstruction (LALRR). Methods: A prospective longitudinal pre-post observational study was conducted at a specialized sports rehabilitation center between January 2021 and January 2024. Forty-eight competitive athletes (Tegner score ≥ 7) who underwent LALRR completed a 3-week inpatient rehabilitation program (7 h daily). Kinesiophobia was evaluated using the Tampa Scale of Kinesiophobia (TSK-17, TSK-13, TSK-11, and subscales), and psychological readiness was measured using the Ankle Ligament Reconstruction–Return to Sport after Injury (ALR-RSI) score at admission and discharge. Results: Cross-sectional analysis demonstrated weak to moderate negative correlations between ALR-RSI and TSK versions at baseline (rho = −0.28 to −0.43) and at discharge (rho = −0.20 to −0.60; TSK−13: rho = −0.60, 95% CI [−0.77, −0.34], p < 0.0001). Following rehabilitation, ALR-RSI scores significantly improved from 69.8 ± 17.3 to 76.1 ± 17.6 (p = 0.009), while TSK-17 scores decreased from 36.9 ± 7.8 to 33.2 ± 7.3 (p = 0.0001). However, the longitudinal correlation between individual change scores was weak and non-significant (rho = −0.15, 95% CI [−0.41, 0.11], p = 0.32). Conclusions: Kinesiophobia and psychological readiness exhibit weak to moderate inverse correlations cross-sectionally. However, no statistically significant association was detected between changes in kinesiophobia and psychological readiness in this sample (rho = −0.15, p = 0.32). These metrics capture distinct psychological aspects, and both should be monitored independently when assessing athletes prior to sports resumption.