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The purpose of this article was to provide a brief historical perspective of the psychological factors that affect the potential for athletic injury, the psychological variables that affect recovery from injury, and the increasing pressure athletes face to return to play as soon as possible following an injury.A literature search was conducted using SportDiscus with keywords athlete, injury, sport psychology, and return to play. Further support for the literature cited and conclusions comes from more than 16 years of collegial consultations and direct clinical experience with multiple collegiate, Olympic, and professional sport organizations.Although the primary body of research regarding the psychological factors affecting sport injury and return to play is found in studies conducted in the 1980s, more recent research continues to support many of the original findings. Additionally, the applied experience of a full-time licensed and practicing sport psychologist is consistent with the early and subsequent research.Research, supported by applied experience, has resulted in the development of a set of causative psychological factors that increase the likelihood of sport injury, increase the potential recovery time from injury, and have thus far stood the test of time. One factor, however, that has changed over the years is the increasing pressure that elite athletes experience in returning to play much more quickly following an injury. Awareness of this increasing pressure is an important consideration for health care providers and sport organizations to ensure that athletes return medically and psychologically ready to play.