The Development of a Return to Performance Pathway Involving A Professional Soccer Player Returning From A Multi-Structural Knee Injury: A Case Report

This case report describes a male professional soccer player returning to match play (English Championship League) following a medial meniscectomy that occurred during the course of rehabilitation after Anterior Cruciate Ligament (ACL) reconstruction. The player underwent a medial meniscectomy eight months into an ACL rehabilitation program and following 10 weeks of rehabilitation successfully returned to competitive first team match play. This report outlines description of the pathology, the rehabilitation progressions, and the sports specific performance requirements of the player as they progressed through the return to performance pathway (RTP). The RTP pathway included nine distinct phases with evidenced based criteria required to exit each phase. The first five phases were indoor as the player progressed from the medial meniscectomy, through the rehabilitation pathways to the “gym exit Phase”. The gym exit Phase was assessed with multiple criteria: a) capacity; b) strength; c) isokinetic dynamometry (IKD); d) hop test battery; e) force plate jumps; and f) supine isometric hamstring rate of force (RFD) development qualities to evaluate the players readiness to start sport specific rehabilitation. The last four phases of the RTP pathway are designed to regain the maximal physical capabilities (plyometric and explosive qualities) in the gym and included the retraining of on-field sport specific qualities utilizing the ‘control-chaos continuum.’ The player successfully returned to team play in the ninth and final phase of the RTP pathway. The purpose of this case report was to outline a RTP for a professional soccer player who successfully restored specific injury criteria (strength, capacity and movement quality), physical capabilities (plyometric and explosive qualities). and on-field sport specific criteria utilizing the ‘control-chaos continuum.’ LEVEL OF EVIDENCE: Level 4