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The progression to functional activities can begin once the patient can jog without pain and is comfortable doing plyometric drills. The idea of this stage is to progress from gentle exercise to the high intensity at which games are played, by breaking down complex movements and strengthening all of the components. All exercises are preceded by a warm up. As each exercise is a progression they should be completed at least one day apart, under the supervision of a chartered physiotherapist.

Exercise 1

Variable pace running with the gradual introduction of turns.

This involves running round a 20m diameter figure-of-eight course. The figure-of-eight course puts very gentle stress on the ankle and prepares the player for later turning drills. The pace is limited to walk, jog or half pace running and is determined by the physiotherapist who shouts out the desired pace. The physiotherapist also shouts the commands stop and start. This re-introduces the player to the variable demands of a game of football and the Physiotherapist can observe for any compensatory movements that may have resulted from the injury and if not addressed could cause future injuries when returning to activity.

The session should last about 25 minutes.

Exercise 2

Variable pace running with gradual turns and various starting positions.

The player starts at one end of the course and makes a 30m run up to a 20m diameter semicircle, around which they gently turn before completing another straight 30m run back to the finish. The pace of the run is dictated by the physiotherapist and is either a jog or half pace. The starting position should be different for each run (standing, lying on back, lying on front, sprint start position, squatting, right side lying, left side lying, jumping, hopping, facing backwards).

The patient should aim to complete 20 runs.

Exercise 3

A progression of exercise 1 - variable pace running with slightly tighter turns.

Run round a 10m diameter figure-of-eight course. The figure-of-eight course puts stress on the ankle and prepares the player for later turning drills. The paces used are walking, jogging, half pace running, and three-quarter pace running, as determined by the physiotherapist who shouts out the desired pace. The physiotherapist also shouts the commands stop and start.

The session should last about 25 minutes.

Exercise 4

A progression of exercise 2 - variable pace running with gradual turns and various starting positions.

The player starts at one end of the course and makes a 30m run up to a 20m diameter semicircle, around which they gently turn before completing another straight 30m run back to the finish. The pace of the run is either three-quarter or full pace, as dictated by the physiotherapist. The starting position should be different for each run (standing, lying on back, lying on front, sprint start position, squatting, right side lying, left side lying, jumping, hopping, facing backwards).

The player should aim to complete 20 runs.

Exercise 5

Two 5m diameter circles are placed 30m apart. Travelling at full pace the player makes a run, with a football at the feet, goes around the far circle and then back to the finish.

This should be repeated 20 times.

Exercise 6

As exercise 5, but single cones are used instead of 5m diameter circles.

Exercise 7

Six cones are placed 5m apart in a straight line. The player completes a shuttle run, at full pace, turning alternately to the left and right.

This should be repeated 10 times.


Before a gradual return to full training is considered, the patient should be happy with all normal ball work drills, all types of passing. For instance in Football; instep, side foot, front foot, outside of foot, side foot volley, laces volley, half volley, over all distances, heading, jumping and heading, and tackling.




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