Article Text

Download PDFPDF

Physical preparation and return to sport of the football player with a tibia-fibula fracture: applying the ‘control-chaos continuum’
  1. Matt Taberner1,2,
  2. Nicol van Dyk3,
  3. Tom Allen4,
  4. Chris Richter5,6,
  5. Carl Howarth7,
  6. Simon Scott8,
  7. Daniel D Cohen9,10
  1. 1Performance Department, Everton Football Club, Liverpool, UK
  2. 2School of Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, UK
  3. 3Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
  4. 4Arsenal Performance and Research Team, Arsenal Football Club, London, UK
  5. 5Sports Surgery Clinic, Dublin, Ireland
  6. 6University of Roehampton, London, UK
  7. 7Medical Department, Everton Football Club, Liverpool, UK
  8. 8Trauma and Orthopaedic Department, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
  9. 9University of Santander (UDES), Bucaramanga, Colombia
  10. 10Simon Bolivar University, Barranquilla, Colombia
  1. Correspondence to Mr Matt Taberner; matthewtaberner{at}


Contact in elite football can result in severe injury such as traumatic fracture. Limited information exists regarding the rehabilitation and return to sport (RTS) of these injuries especially in elite football. We outline the RTS of an elite English Premier League footballer following a tibia-fibula fracture including gym-based physical preparation and the use of ‘control-chaos continuum’ as a framework for on-pitch sport-specific conditioning, development of technical skills while returning the player to pre-injury chronic running loads considering the qualitative nature of movement in competition. Strength and power diagnostics were used to back up clinical reasoning and decision-making throughout rehabilitation and the RTS process. The player returned to full team training after 7.5 months, completed 90 min match-play after 9 months and remains injury-free 11 months post-RTS.

  • rehabilitation
  • football
  • bone
  • sporting injuries

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

View Full Text

Statistics from


  • Twitter @@MattTaberner, @@NicolvanDyk, @@tallen_5, @@ChrisRichterPhD, @@danielcohen1971

  • Contributors SS surgically operated on the player, CH led early physiotherapy management, MT led physical preparation, planned and wrote the manuscript, NVD, DDC and TA provided guidance and assisted in the writing of the manuscript. CR provided analysis of S&C diagnostics.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests DC consults to a company that sells strength and power diagnostic equipment.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.