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Return to sport — a structured approach

Quick answer (60 sec read) Returning to sport after injury or surgery requires graduated load progression, not just "rest until it stops hurting." Max uses a staged approach built around symptom monitoring, objective load targets, and clear functional milestones.

The two most common reasons patients re-injure after returning to sport: returning too fast without addressing the contributing factors, and returning too slowly with no clear plan or milestone structure. A staged return-to-sport plan threads the needle between the two — structured, trackable, adapted to your sport and timeline, and built around objective markers rather than feel alone.

What a return-to-sport process typically looks like

The specific stages depend on the injury, your sport, and where you are in recovery. In general:

  1. Pain-free or pain-managed baseline — confirm the injury is settled enough to begin loading without flare. This rarely means zero symptoms; it usually means symptoms are predictable, manageable, and not worsening with controlled load
  2. Graduated loading — progressive exercise prescription from low-load, low-speed work through to sport-specific demand. The Cook and Purdam continuum and Kongsgaard's heavy slow resistance framework guide tendon loading; general strength-and-conditioning principles guide broader reload
  3. Functional milestones — objective criteria (single-leg hop symmetry, strength symmetry, sport-specific movement-pattern quality, agility-test performance) that confirm readiness for the next stage
  4. Return to full training — monitored re-introduction to full training load with a planned watch-list for the first four to six weeks
  5. Return to competition — final gate before returning to match play, with a monitoring protocol through the first competition block (typically three to four matches or events)

Common presentations that benefit from a staged return

  • Tendinopathy in runners and court-sport athletes — Achilles, patellar, and plantar presentations where return-to-running and return-to-jumping need separate progressions
  • Post-surgical rehabilitation — hip, knee, ankle, or shoulder surgery rehab, in collaboration with the surgical team and the physiotherapist managing the early post-op phase
  • Persistent hamstring, groin, or lower-limb muscle strains in field-sport athletes — particularly recurrent strains where the return-to-sprint progression needs more structure than "feels okay"
  • Recurrent overuse injuries in cyclists, weight-trainers, and racquet-sport athletes where the broader load picture has been missed in previous episodes

When to involve Max

A return-to-sport consultation is most useful at one of these decision points:

  • Early after an injury — to set the framework before bad habits or rushed decisions take hold
  • Plateau in rehabilitation — when the early phase has gone well but the bridge back to full sport is stalling
  • After re-injury — to audit what went wrong and design a more conservative progression
  • Pre-event — when you have a specific event (a race, a competition season, a return-to-team date) and want a planned ramp toward it

How this fits with your existing care team

If you're already seeing a physiotherapist, a surgeon, an S&C coach, or a sports physician, Max works alongside them rather than replacing them. With your consent, Max can write to your GP or other treating practitioners to keep everyone aligned. Where a specialist or imaging is the right next step, Max will say so and refer.

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Max Bellaiche · AHPRA OST0004003860 · Master of Osteopathic Medicine
Educational content, not medical advice. In an emergency, call 000.