Background: Sports-related traumatic injuries, such as anterior cruciate ligament (ACL) rupture, rotator cuff tears, and Achilles tendon ruptures, often require surgical intervention followed by structured rehabilitation. Optimizing post-surgical rehabilitation is crucial for restoring strength, mobility, and safe return to pre-injury activity levels. This review combines current evidence on rehabilitation strategies and functional outcomes after surgery for major sports-related injuries.

Methods: A comprehensive PubMed search was conducted using keywords including “sports injury,” “rehabilitation,” “surgery,” “functional outcomes,” and “return to sport.” Systematic reviews, meta-analyses, and clinical guidelines published between 2015 and 2025 were included in this analysis. Studies were appraised for methodological quality and relevance to post-surgical rehabilitation principles and outcome measures.

Results: Evidence supports early, criterion-based rehabilitation emphasising progressive loading, proprioception, and neuromuscular control. The Aspetar Clinical Practice Guidelines for ACL reconstruction recommend individualised, goal-driven protocols and objective criteria for return to sport rather than time-based approaches. Meta-analyses of rotator cuff and Achilles tendon repairs indicate that early mobilization accelerates recovery without compromising repair integrity. Adjunctive therapies, such as blood-flow restriction training, improve quadriceps strength after ACL reconstruction, though results vary. Psychological readiness and functional symmetry consistently predict safe return to sport. Collectively, these findings illustrate that evidence-based rehabilitation strategies directly enhance post-surgical functional outcomes in athletes.

Conclusions: Modern rehabilitation following sports-related surgery should adopt an evidence-based, individualised, and multidisciplinary approach. The rehabilitation plan should integrate early functional activity, progressive strengthening, and psychological assessment. Collaboration among surgeons, physiatrists, and physiotherapists is essential to optimise outcomes and reduce the risk of re-injury.