Sports Injury Clinic

Assessment, rehabilitation and support for returning to activity

Sports injuries can happen suddenly during training or competition, or develop gradually through repeated movement and increased physical load. They can affect strength, movement, confidence and the ability to continue with sport or exercise.

A sports injury clinic focuses on identifying what has been injured, understanding why the problem may have developed and building a rehabilitation plan around the physical demands of your activity. Physiotherapy commonly forms an important part of managing sports-related muscle and joint injuries.

When a sports injury assessment may help

You may benefit from an assessment if you are experiencing:

• Muscle strains
• Ligament sprains
• Tendon pain
• Knee pain or instability
• Ankle and foot injuries
• Shoulder pain
• Hip or groin problems
• Back pain related to sport or exercise
• Pain during running
• Repeated or recurring injuries
• Reduced movement after an injury
• Weakness following a period away from sport
• Pain that appears when training intensity increases
• Difficulty returning to sport after surgery
• An injury that is limiting training or performance

Sports injury rehabilitation is not limited to competitive athletes. It may be suitable for people involved in recreational sport, running, gym training or regular physical activity. NHS sports injury services similarly manage sports-related injuries across different levels of participation.

Sudden and gradual-onset injuries

Not all sports injuries happen during one obvious movement.

A sudden injury may occur during a fall, tackle, landing, sprint, change of direction or heavy lift. Pain, swelling or difficulty moving may appear immediately.

A gradual-onset injury develops over time. Symptoms may initially appear only after exercise before becoming noticeable during training or everyday activities. Changes in training volume, intensity, recovery or repeated loading can all be relevant when assessing these problems.

Understanding how the symptoms started helps guide both treatment and the plan for returning to activity.

What happens during your first appointment?

Your appointment begins with a discussion about the injury, your symptoms and the sport or activity you take part in.

The physiotherapist may ask about:

• How and when the problem started
• Your current training routine
• Recent changes in training or activity
• Previous injuries
• Pain, swelling or instability
• Movements that aggravate the symptoms
• Competitions or events you are working towards
• Previous treatment or surgery
• What level of activity you want to return to

A physical assessment may then look at:

• Joint movement
• Muscle strength
• Flexibility
• Balance and coordination
• Areas of pain or tenderness
• Movement control
• Walking or running where relevant
• Sport-specific movements

The assessment helps determine what may be limiting you and what needs to be addressed during rehabilitation.

What treatment may include

Sports injury treatment is based on the type of injury, its severity and your current stage of recovery.

Movement and mobility exercises

Early rehabilitation may focus on restoring comfortable movement and reducing stiffness around the affected area.

Strengthening

Strength is gradually rebuilt around the injured area and throughout the movements needed for your sport. Rehabilitation normally progresses from simpler exercises towards more demanding activity as recovery allows.

Balance and control

Some injuries affect balance, coordination or confidence in a joint. Exercises may be used to improve control during standing, landing, stepping or changing direction.

Manual therapy

Hands-on techniques may be used where appropriate to address stiffness, restricted movement or muscle tension alongside active rehabilitation.

Sport-specific rehabilitation

As recovery progresses, exercises can begin to reflect the movements required for your sport. This may include running, jumping, landing, accelerating, decelerating, changing direction or throwing depending on the activity.

Home or gym programme

You may be given exercises to complete between appointments. The programme can be adjusted as your strength, movement and tolerance improve.

Building strength after an injury

Pain settling does not always mean that an injured area is ready for full training.

An injury can leave temporary changes in strength, movement, balance or confidence. Returning immediately to previous training levels may place demands on the body that it is not yet prepared for.

Rehabilitation therefore usually involves gradually rebuilding the amount of load the injured area can tolerate. Exercise can progress from controlled strengthening towards more demanding and sport-specific movements. A gradual return to activity is commonly recommended rather than moving directly from rehabilitation into full sport.

Returning to running and sport

Returning to sport is usually a process rather than a single point in recovery.

Depending on the injury and activity, rehabilitation may progress through stages such as:

• Comfortable everyday movement
• Basic strength exercises
• Higher-level strengthening
• Jogging or light activity
• Running and faster movement
• Jumping and landing
• Changes of direction
• Sport-specific drills
• Modified training
• Full training
• Return to competition

The exact stages will vary considerably between injuries and sports.

The decision to progress should consider symptoms, movement, strength and the physical demands of the activity rather than relying only on the amount of time that has passed since the injury. NHS rehabilitation guidance also recommends building back into sport gradually.

Rehabilitation after sports surgery

Physiotherapy may also form part of recovery following surgery for a sports-related injury.

Depending on the procedure and medical guidance, rehabilitation may focus on:

• Restoring movement
• Managing stiffness
• Rebuilding muscle strength
• Improving balance and control
• Walking normally
• Progressing towards running
• Reintroducing sport-specific movements
• Preparing for a return to training

Recovery times vary significantly between procedures. For example, rehabilitation following ACL reconstruction can take many months before a return to sport is appropriate, so progression should follow the individual rehabilitation plan rather than a fixed expectation.

Recurring sports injuries

If the same problem repeatedly returns, the assessment may look beyond the painful area.

Factors such as strength, movement control, previous injury, training demands and recovery between sessions may be considered. The aim is to understand what happens when the body is placed under the demands of the activity.

Treatment may then include a combination of rehabilitation and changes to how training is progressed.

Training load and recovery

Sports injuries can sometimes appear after a sudden increase in activity, such as increasing running distance, returning to training after a break or adding more intense sessions.

This does not necessarily mean the activity needs to be stopped completely. Depending on the injury, it may be possible to temporarily modify the amount or type of training while rehabilitation continues. For some tendon problems, for example, clinical guidance recommends modifying activity rather than relying on complete rest.

Your physiotherapist can help decide which activities may be continued and which should temporarily be reduced.

Sport-specific movement

Different sports place different demands on the body.

A runner may need to tolerate repeated impact over distance, while a footballer may need to sprint, stop and change direction. A tennis player may need repeated overhead movement, while someone returning to gym training may need to lift safely under increasing resistance.

For this reason, later-stage rehabilitation should reflect the activity you are returning to rather than relying only on general exercises.

Returning after time away from sport

You do not necessarily need to have a new injury to attend a sports injury clinic.

After surgery, illness, an extended break or a previous injury, strength and conditioning may have changed. Returning immediately to your previous level of training can be difficult.

A gradual programme can help rebuild strength, movement and physical tolerance before training intensity increases.

Reducing the chance of another injury

No programme can guarantee that an injury will not happen again, but rehabilitation can address factors that may be relevant to recurrence.

This may include:

• Restoring strength after injury
• Improving balance and movement control
• Rebuilding tolerance to training
• Completing rehabilitation before returning fully
• Progressing training gradually
• Continuing appropriate strengthening alongside sport

Previous injuries can sometimes leave weakness or reduced function if rehabilitation is incomplete, which is one reason return to activity is normally progressed rather than rushed.

When an injury may need further medical assessment

Physiotherapy is appropriate for many sports-related muscle and joint problems, but some injuries require further medical assessment.

Seek appropriate urgent medical advice following an injury if there is severe or worsening pain, significant swelling or bruising, an inability to put weight through the injured area, or major difficulty moving it.

Head injuries and suspected concussion also require appropriate medical assessment and should not be treated simply as a routine muscle or joint injury.

If the physiotherapy assessment raises concerns about the nature of an injury, you may be advised to seek further investigation or review by another healthcare professional.

Rehabilitation based on your goals

The goal of treatment will depend on what you want to return to.

For one person, this may mean being able to run comfortably again. For another, it may mean returning to weekend football, competitive sport, gym training or a physically demanding hobby.

Your rehabilitation can be built around the movements and level of activity that are relevant to you rather than following the same programme for every injury.

How long will rehabilitation take?

Recovery time depends on the type and severity of the injury, how long symptoms have been present and the demands of the sport you want to return to.

A mild injury may require a relatively short rehabilitation period, while ligament injuries, significant muscle injuries or post-operative rehabilitation may take considerably longer.

Progress will be reviewed throughout treatment, and exercises can be changed as your movement, strength and tolerance improve.