Case Study: Rob’s Soft Tissue Injury Cascade

Dec 30

During Covid lockdown in 2020, like many others, I suddenly had more time to exercise from home. My routine shifted quickly from running once a week for 10km to running four to five times a week and completing backyard HIIT sessions most days.

At first, I felt stronger and enjoyed having a new focus during an uncertain time. That confidence was short lived as small niggles began to build into injuries, eventually forcing me to stop and reflect. I had to ask myself a familiar question
“What would I tell my patients?”

Injury Timeline

Mid April 2020
Strained my right hip flexor while sprinting at the end of a HIIT session. I had not sprinted in six months. Not ideal.

Two weeks later
Returned to outdoor five a side soccer. Running and changing direction felt fine although kicking beyond ten metres caused discomfort. At the end of the game, when fatigue set in, I strained my right adductor while chasing the ball.

May 2020
Continued jogging and HIIT and completed some basic groin rehabilitation.

Early May
Played soccer for the next two weeks and strained my left adductor on both occasions. My right hip flexor remained irritated from kicking.

Mid May
Stopped soccer and focused on rehabilitation. Symptoms settled and I felt fully recovered.

Early June
Increased running again, continued HIIT and started indoor soccer. In one week I ran close to 30km, played soccer and completed three HIIT sessions. I felt strong and assumed I was back to normal.

Early to mid June
Both Achilles tendons became sore and stiff, gradually worsening. My running cadence dropped from 187 to 174. I lost my spring, hopping was painful and my power was reduced. I was completely frustrated at this point.

Mid June
Stopped running and soccer for three to four weeks and began Achilles and hip flexor rehabilitation.

August
Returned to soccer at full capacity.

Why Did This Happen?

Looking back, the pattern became clear.

The original hip flexor strain had not fully healed, leaving me with weakness and reduced muscle length
Kicking continued to aggravate the area which placed more demand on both adductors during sprinting and soccer
I increased overall training load too quickly with running, HIIT, jumping and change of direction work
I did not allow full recovery in flexibility, strength and power before returning to higher intensity activity

The key to breaking the cycle was restoring capacity in the original injury. Once I could run every second day at around 80 percent of previous distance and intensity, I gradually reintroduced soccer. The moment I could kick the ball with power and feel no hip flexor symptoms, I knew the underlying issue had resolved.