• Strength training is perfect for building tissue tolerance and movement patterns as it’s highly configurable for specific goals
• Strength training should be carefully controlled and progressed in keeping with tissue healing and injury recovery
• Exercises target potential underlying causes, maintenance of general leg strength and progressive loading of the injured tissue

Phase 1

• Gentle loading on the injured structure
  • No more than mild discomfort at the injury site
  • No residual soreness after exercises
  • In stable positions (on two feet, holding on to support, etc)
  • Eg. Isometric (static) holds while leaning against a wall
• Moderate loading on uninjured areas
  • Focus on maintaining strength in areas that can support injured area
  • Include a mix of strength, stability and movement pattern exercises
  • Complex movement patterns are not required
  • Eg. Double and single leg deadlift for an ankle sprain (no ankle movement required, double leg targets strength, single leg targets stability)
• Cardio training without stressing the injured area
  • If possible, add some simple cardio in but not at the risk of irritating the healing tissue
  • Cardio selection does not need to be related to your sporting goals
  • Use an interval or variable intensity approach for best effect
  • Eg. Bike for 10min including 5min of 20sec hard:10sec easy repeats

Phase 2

• Increase loading on injured structure
  • If you’ve torn muscle, tendon or ligament fibres, focus on increasing force rather than increasing length
  • Add some movement patterns but only if you can complete the movement with good technique
  • Mild discomfort is OK if it’s not sharp, increasing or lingering
  • Eg. Single leg box squats for FAI
• Add complex movement patterns for uninjured areas
  • Progress towards movement patterns required for your chosen sport
  • Upgrade weight, speed or complexity of an exercise but only one parameter at a time
  • Maintain a few basic strength exercises as adding instability and speed will diminish strength gains
  • Eg. Reverse lunges for PFPS
• Upgrade cardio
  • Increase session intensity and overall weekly volume rather than just increasing each session’s duration
  • Add variety to cardio if possible, such as bike and rower, but not at the expense of overloading the injured tissue
  • If the target sport includes running, consider adding a small amount of running to begin to refresh movement patterns (see our guide on return to running)

Phase 3

• Load the injured tissue during complex movements
  • Select movement patterns that mimic sporting demands
  • Control the loading via speed, range and complexity of the movement
  • There should be no discomfort or soreness at the injury site, however mild tightness may be experienced
  • Eg. Walking lunge for calf tears
• Add a combination of heavy loading, complex and high speed movements
  • Select sport-specific movement patterns
  • Deliberately involve the injured area but only with correct technique (no compensations)
  • Add load or speed based on the requirements of the sport
  • Eg. Box jumps for return to basketball
• Sport-specific cardio
  • Focus on correct technique separately, ie. not during high intensity sessions
  • Be wary of fatigue as it will adversely affect technique
  • Short sessions of high intensity with variable workload are best for regaining fitness
  • Eg. Running intervals of 100m with longer rest breaks

Sport-specific phase

• This phase focuses on your successful return to full participation
• It’s highly specific to your sport, your injury and duration of your recovery so there are no generic recommendations
• Take more time than you feel necessary to return to full loading as we’re typically optimistic with self assessment
• Get feedback from a trusted source (eg. experienced coach) on your technique and performance to spot any missing links prior to full training loads