As a Rehabilitation Coach, I’ve seen first-hand how challenging and transformative the recovery process can be for athletes. One of the most memorable cases I’ve worked on was that of a 27-year-old semi-professional footballer who suffered a severe ankle fracture during a match in July 2024. The injury required surgery with internal fixation, followed by six weeks of non-weightbearing immobilisation. Her journey back to competitive football was not only a testament to her resilience but also to the power of a multidisciplinary approach to rehabilitation.
This process was a collaborative effort involving physiotherapy, nutrition, psychology, and strength and conditioning professionals. Each member of the team played a vital role in her recovery, addressing the physical, nutritional, and psychological demands of her rehabilitation. My role was to design and guide her exercise programme, ensuring a safe and progressive return to peak performance.
Phase One: Building Foundations
The initial phase focused on the basics: restoring ankle range of motion, regaining a normal gait pattern, and maintaining overall conditioning. During this time, we worked closely with her physiotherapist to address joint stiffness and prevent complications from immobilisation.
We used innovative strategies such as cross-education—training the uninjured leg to preserve strength on the injured side—and incorporated cardiovascular conditioning through seated ski-erg and arms-only assault bike exercises. Nutrition support ensured her dietary intake optimised healing, while psychological support helped her cope with the frustrations of being sidelined.
Objective measures, such as isometric mid-thigh pulls (IMTP), were essential to track her strength and asymmetry between legs. By the end of this phase, her confidence and physical capacity had improved enough to progress to the next stage.
Phase Two: Reloading and Strengthening
As we transitioned to the reloading phase, the focus shifted to rebuilding strength and reintroducing controlled dynamic movements. Plyometric exercises, such as assisted hops and static squat jumps, were gradually introduced to prepare her for higher-impact activities.
Jump performance metrics, including squat jump (SJ) and countermovement jump (CMJ), revealed early deficits in her stretch-shortening cycle (SSC) ability. This information guided our programming, ensuring a balance of slow and fast SSC exercises to restore her explosive power.
Throughout this stage, the collaboration with the physiotherapy team remained crucial to monitor her progress, while the psychology staff provided strategies to address any fear of reinjury.
Phase Three: Return to Performance
The final phase focused on sport-specific preparation and power development. Working closely with her club’s sport scientist, we gradually reintroduced her to pitch-based activities. This began with linear interval running and progressed to curvilinear running, cutting drills, and technical ball work.
Plyometric training became more intense, with exercises such as loaded squat jumps, depth jumps, and triple hops aimed at improving her rate of force development (RFD) and power. Nutritional support was tailored to ensure she met the energy demands of this stage, while psychological coaching helped her rebuild confidence as she neared her return to competitive play.
By the end of her rehabilitation, she had achieved a 42% improvement in maximal strength, reduced her asymmetries to within 10%, and significantly improved her SSC ability. These measurable gains gave her the physical readiness—and confidence—to return to full-contact football after just 6.5 months.
The Importance of a Team Approach
This case highlighted the power of a multidisciplinary team in supporting an athlete’s recovery. Each professional brought their expertise to the table, ensuring no aspect of her rehabilitation was overlooked. For me, as a Rehabilitation Coach, it reinforced the importance of combining data-driven programming with a holistic understanding of the athlete’s psychological and physical needs.
Watching her play her first competitive minutes after months of hard work was an incredibly rewarding moment for all involved.
If you’re interested in exploring the full details of this rehabilitation programme, including the objective testing, exercise progression, and multidisciplinary strategies we used, I invite you to download our comprehensive review.
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