Why 'six weeks' is the wrong answer
Timeframes are useful for setting expectations, but they describe an average, not an individual. Two athletes with the same diagnosis can be weeks apart depending on how much they lost, how consistently they rehabbed, and where they are in their growth.
Criteria-based return asks a different question: can this athlete now do the things the sport will demand, without symptoms carrying over to the next day?
The criteria that matter
- No pain on the specific provocation test - the heel squeeze, tibial tuberosity palpation, or single-leg squat.
- Strength within roughly 10% of the other side on relevant tests.
- Single-leg hop distance within roughly 10% of the other side.
- Able to complete a full training session's worth of running and jumping volume in rehab.
- Able to sprint, decelerate and change direction at full effort without hesitation.
- Confidence, the athlete believes the limb will hold up.
Staging the return
Each stage is cleared by the 24-hour rule: symptoms return to baseline by the next morning and there is no increase in stiffness. If a stage fails, repeat it rather than dropping back to the beginning.
- Stage 1: full non-contact training with the squad.
- Stage 2: full training including contact and competitive drills.
- Stage 3: 20–30 minutes of match play.
- Stage 4: increasing minutes across two to three fixtures.
- Stage 5: full match load with no restrictions.
The load trap on return
The most common error is returning to the full pre-injury schedule immediately. An athlete who has trained twice a week in rehab cannot absorb five sessions and a match in week one; capacity has fallen, and the demand has jumped.
Plan the first three weeks back at roughly 50%, 75% and 90% of normal load, and keep the rehab strength work going throughout, that is what prevents the second episode.
Signs they came back too soon
- Pain returning during warm-ups rather than only at the end of sessions.
- Limping after games, or morning stiffness returning.
- Visible avoidance - favouring one side, not committing to turns.
- Performance well below normal despite feeling fit.
The psychological side
Confidence lags physical recovery, and a young athlete who does not trust the limb will move differently, which itself raises reinjury risk. Graded exposure, clear criteria they can see themselves passing, and a coach who protects their minutes in the first fortnight all help more than reassurance alone.