Accelerated Return to Competition Following a Full-Thickness Abdominal Wall Tear in an Elite Sprinter: A Data-informed Case Report

Background Muscle strain injuries are a leading cause of time loss in elite sport. While lower-limb muscle strains are well documented, full-thickness lateral abdominal wall tears involving the external oblique, internal oblique, and transversus abdominis are rare in elite sprinting, with limited evidence to guide rehabilitation or return-to-sport decision-making. The purpose of this case report was to describe the rehabilitation and return-to-competition process following a full-thickness lateral abdominal wall tear in an elite international sprinter. Case Description A 22-year-old elite international sprinter sustained a full-thickness tear of the external oblique, internal oblique, and transversus abdominis during block acceleration. Rehabilitation commenced two days post-injury and emphasized early optimal loading, objective monitoring using trunk force profiling and sprint kinematic assessment, and collaborative decision-making across the medical, coaching, and performance teams. Progression was guided by athlete response and objective performance data rather than predetermined time-based criteria. Outcomes Pain-free sprinting was achieved within 16 days, unrestricted training resumed by Day 18, and the athlete returned to competition on Day 28, recording a lifetime personal best of 10.08 seconds in the 100 m. Persistent asymmetries remained in selected trunk force measures despite successful return to competition. Discussion This case report provides a descriptive example of individualized, data-informed rehabilitation following a severe abdominal wall injury and may contribute to ongoing discussion regarding the role of objective monitoring, clinical reasoning, and symmetry restoration in return-to-sport decision-making.