Introduction <p>This case report presents a 3-year follow-up of a male para-athlete who experienced severe psychological distress and long-term institutionalisation following a traumatic spinal cord injury. The case highlights the therapeutic role of adaptive sport in promoting psychological, functional, and social recovery in a paraplegic individual unresponsive to standard medical care.</p> Main symptoms <p>At baseline, the participant showed major depressive symptoms, persistent suicidal ideation, emotional flatness, and social withdrawal. Despite previous pharmacological and psychiatric interventions, there was little improvement in psychological functioning or quality of life.</p> Diagnoses/interventions/outcomes <p>Diagnosed with paraplegia and chronic depression, the participant was introduced to adapted sport as a therapeutic strategy. Over 36&#xa0;months, he demonstrated steady improvements across multiple domains, including depression, anxiety, stress, self-image, daily functioning, independence, and social relationships. He also progressed to competitive success at national and international levels. Functionally, independence increased by 122%, representing a more than two-fold improvement from baseline, while self-image improved by 80%. Social interaction showed the largest change, with an increase of over 250%, reflecting a marked multi-fold enhancement in interpersonal engagement compared to initial levels.</p> Conclusion <p>This case provides evidence for the use of adaptive sports as an effective long-term intervention to support psychosocial rehabilitation in individuals with spinal cord injury and resistant depression. Structured sport engagement helped reestablish identity, motivation, and daily participation, with sustainable gains across psychological and functional domains.</p>