Lower limb · Ankle — post-op · Elite level

Fibula Plate Removal — Phase II (Weeks 3–4)

Detailed exercise prescription for the unilateral strength and load-tolerance phase of the post-fibula plate removal program. Sets, reps, tempo, RPE and clinical cues — built for high-performance football environments.

Download full PDF ← Parent protocol

Author and clinical review: Iván López Martínez, sports physiotherapist and rehabilitation specialist.

Content reviewed 15 August 2026. Educational resource for qualified professionals; progression requires individual assessment and clinical judgement. Full references and limitations are included below.

PhaseII — Unilateral Strength & Load Tolerance (weeks 3–4)
Preceding phasePhase I (weeks 1–2) — FWB pain-free, ankle ROM initiated, peroneal activation achieved
Phase goalBuild single-leg capacity, introduce multiplanar controlled loading, prepare for elastic loading
Frequency5 sessions/week (3 gym + 2 field/pool)
Session duration60–75 min (gym), 30–45 min (field)

Entry criteria (from Phase I)

  • FWB without pain or antalgic gait.
  • Ankle dorsiflexion >5° (or within 3 cm of contralateral in Knee-To-Wall test).
  • Peroneal activation confirmed (manual testing ≥4/5, isometric eversion pain-free).
  • Pain ≤2/10 during Phase I exercises.
  • No reactive swelling post-session (24-hour rule).
  • Single-leg stance ≥20 seconds with stable pelvis.

Mandatory load progression rules — weeks 3–4

  • Pain threshold: pain <4/10 during exercise. No increase at next morning assessment.
  • Swelling rule: no reactive swelling or effusion within 24 h post-session.
  • Volume before intensity: increase reps/sets before adding load. Never both simultaneously.
  • Weekly increment: +10–15% load per week (Week 3 baseline → Week 4 = +10–15%).
  • Red flags to regress: pain >4/10 · increased morning stiffness · local heat/swelling · night pain (infection monitoring).

Weekly structure

Training frequency: 5 sessions/week — 3 gym (Mon / Wed / Fri) + 2 field or pool (Tue / Thu).

  • Week 3 focus: introduce unilateral loading patterns at controlled tempo. Build volume.
  • Week 4 focus: progress load (+10–15%), increase complexity, introduce early plyometric preparation.

Field sessions complement gym work with proprioceptive and gait-specific training. Pool sessions (when available) prepare deloaded running.

Session A — strength & loading (Mon / Wed / Fri)

Each gym session opens with a 10-minute warm-up & activation block (stationary bike, ankle controlled articular rotations, banded eversion isometric holds, arch-doming activation), followed by the unilateral loading block: split-squat variations, step-ups, calf-raise variants in both knee-extended and knee-flexed positions, controlled lateral and rotational loading patterns, and accessory work for the kinetic chain.

The full session plan with sets, reps, load/RPE, tempo, rest periods and clinical cues for every exercise is provided in the downloadable PDF.

Session B — proprioception & field (Tue / Thu)

Field sessions reintroduce gait-specific demand at sub-running intensity: marching variations, controlled lunges in multiple planes, single-leg stance progressions on stable and unstable surfaces, low-amplitude landings from a step. Pool sessions (when available) reintroduce running mechanics in a deloaded environment as preparation for Phase III running progression.

Who this phase is for

  • Athletes who have completed Phase I criteria and are transitioning into unilateral loading.
  • Sports physiotherapists looking for a worked example of weekly load progression in post-op rehab.
  • Strength coaches integrating with the medical team during the late-clinic / early-pitch transition.

Download the full Phase II prescription (PDF)

Includes the complete Mon/Wed/Fri and Tue/Thu session plans with sets, reps, tempo, RPE, rest, and clinical cues for every exercise. Free for qualified health and performance professionals.

Download PDF

Frequently asked questions

What are the entry criteria for Phase II?

Full weight-bearing without pain or antalgic gait, ankle dorsiflexion >5° (or within 3 cm of contralateral on Knee-To-Wall), confirmed peroneal activation (manual ≥4/5, isometric eversion pain-free), pain ≤2/10 during Phase I exercises, no reactive swelling within 24 h, and single-leg stance ≥20 s with stable pelvis.

Why never increase load and volume in the same week?

Doubling the stimulus is the fastest route to flare-ups. Volume before intensity is a load-management principle that protects post-operative tissue: progress sets and reps first, then add load. The +10–15% weekly cap further insures against overshoot.

What is the 24-hour swelling rule?

After every loading session, swelling and morning stiffness are checked the next morning. If either has increased above baseline, the previous session was too much — load is reduced and the next session adjusted. The 24-hour signal is more reliable than in-session feedback for post-operative tissue.

How is the week structured?

Five sessions per week: three gym sessions (Mon/Wed/Fri, 60–75 min) focused on strength and loading, plus two field or pool sessions (Tue/Thu, 30–45 min) for proprioceptive and gait-specific training, or deloaded running preparation.

Related protocols