Return-to-Sport Centre
How an athlete progresses from pain reduction to strength, functional movement, sport-specific drills and competition. Each stage has exit criteria based on symptoms, function and the injured tissue’s healing time.
Pain reduction & protection
rehab phase 1 · inflammatory phaseSource: Rehab Science · PDF pp. 182, 183, 241Calm the tissue, control swelling and pain, keep the rest of the body moving.
- Modify aggravating factors
- Soft tissue work / gentle mobility / isometrics as the protocol allows
- Train the uninjured side and the rest of the body (cross-transfer)
- Aerobic exercise that does not stress the injury
- No pain at rest
- Phase 1 exercises with no more than mild pain (≤ 3/10)
Range of motion & sensorimotor control
rehab phase 2 · maturation phaseSource: Rehab Science · PDF pp. 184, 185, 186Restore full range early and re-train control so muscles protect the healing tissue.
- Mobility and flexibility work
- Sensorimotor drills (slow
- high-quality)
- Isometric and eccentric loading
- Full range with control
- Mild to no pain during phase 2 exercises
- Joint feels stable
Rebuild strength and integrity with full-range resistance training and progressive overload.
- Phase 3 resistance exercises 3–4×/week
- Progress load
- range
- volume and speed
- Train both sides
- Pain resolved with daily tasks
- Impairments resolved
- Strength comparable side to side (clinical testing — see note)
Functional movement & sport-specific drills
rehab phase 3 · remodelling phaseSource: Rehab Science · PDF pp. 168–222Reintroduce the sport's demands gradually.
- Reduce the aggravating sport substantially for 2–4 weeks while rehabbing (e.g. swim instead of run)
- Then reintroduce a little at a time and increase weekly
- Treat the sport like an aggravating factor — if it flares
- reduce and rebuild
- Dynamic warm-ups that mimic the sport
- Sport-specific sets/reps (endurance
- power
- strength)
- Sport drills at increasing volume without next-day flare (24-hour rule)
- Confidence in the joint / low fear of reinjury
Return to competition & prevention
rehab phase 3 · remodelling phaseSource: Rehab Science · PDF pp. 151, 154, 190Full participation while keeping the tissue strong.
- Keep phase 3 exercises 2–3×/week (especially for tendinopathy)
- Manage load volume and magnitude
- Monitor fatigue
- sleep and stress
- Tissue-specific minimum time frames respected (e.g. ≥ 9 months after ACL tear)
Tissue-specific minimum time frames
| Tissue / injury | Guidance | Source |
|---|---|---|
| ACL reconstruction / grade III ligament | Most athletes advised 9–12 months before return to sport | Source: Rehab Science · PDF pp. 151–845 |
| Grade III ligament or tendon injury | Phase 3 for 6–9 months | Source: Rehab Science · PDF p. 152 |
| Traumatic cartilage (meniscus | Phase 2–3 for 4–6 months before full-force sport | Source: Rehab Science · PDF pp. 157, 158 |
| Tendinopathy | ~1–2 wk phase 1, ~2 wk phase 2, 4–6 wk phase 3; continue phase 3 2–3×/week on return | Source: Rehab Science · PDF p. 154 |
| Grade II muscle strain | Phase 3 for a further 6–8 weeks | Source: Rehab Science · PDF p. 153 |
| Grade I–II ligament sprain | Phase 3 for at least 4–6 weeks, until no pain or instability | Source: Rehab Science · PDF pp. 155, 156 |
Additional Evidence-Based Knowledge — Beyond Rehab Science
🔬 Beyond Rehab ScienceMany sports-medicine teams add objective return-to-sport testing (e.g. strength symmetry, hop tests, sport-specific agility and psychological readiness questionnaires). These are not described in Rehab Science; specific test batteries and cut-off values will be added to the Clinical Test Encyclopedia with citations once verified.