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.

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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.

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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.

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