A clinical case report on biceps femoris T-junction surgical repair & rehabilitation of an international footballer

This clinical case study details the management of an international footballer who sustained a high-grade biceps femoris T junction tendon injury. Following surgical repair of the tendon, the player completed a phased return to training rehabilitation programme that was designed to progressively expose load and function from a strengthening, physical conditioning and technical performance aspect. This case report outlines the phases and subsequent aims in conjunction with shared decision-making processes that assisted to ensure a successful rehabilitation. This case report considers the alignment of “normal” training load and volume as a comparative marker as well as additional comparative physical profiling metrics to further inform suitability to return to training. This case report further outlines the importance of individualised rehabilitation as well as longitudinal monitoring upon returning to training to reduce further risk of (re)injury and return to performance. • Surgical intervention required same rehabilitative period as non-surgical approach with a significantly reduced risk of future injury and less risk of loss of physical attributes (speed) • An allied and holistic team approach can help facilitate the ‘safest’ rehabilitation pathway with best interests of player, parent club and loan-club being considered demonstrating applied insight loan-club dynamics • Rehabilitation can be mapped to “normal” training volumes as an alternative to “match-play” demands and achieve successful return to training, play and performance offering a practically relevant benchmark and rehabilitation framing tool to shape and direct rehabilitation needs and progressions with consideration of intensive/extensive rehabilitation planning • Injury management and monitoring does not “stop” at the point of returning to training; continued monitoring allows for appropriate volume prescription and training load adjustment advocating longitudinal monitoring and clear aims of each specific phase of rehabilitation, and return to training • Comprehensive screening assists in reducing the risk of future injuries with bilateral comparison as well as reflective on baseline values with the applied consideration of MRI, DEXA as well as ‘gold standard’ strength assessment and physical profiling tests and functional performance markers providing a holistic evaluation framework