LIVERPOOL, ENGLAND - Saturday, September 12, 2020: Liverpool’s Virgil van Dijk during the opening FA Premier League match between Liverpool FC and Leeds United FC at Anfield. The game was played behind closed doors due to the UK government’s social distancing laws during the Coronavirus COVID-19 Pandemic. Liverpool won 4-3. (Pic by David Rawcliffe/Propaganda)

Virgil van Dijk ‘on schedule’ – timeline for defender’s rehab

Virgil Van Dijk is now roughly eight weeks into his rehab process, but recent glimpses of his recovery do not mean he is ahead of schedule.

Following surgery for what the club has called a multi-ligament injury in late October, Van Dijk recently released a video and multiple pictures on Instagram featuring what he’s been doing in rehabilitation.

Typically at eight weeks following an ACL-repair, the athlete is firmly entrenched in “phase II” of the rehabilitation program which consists of numerous items including:

  • Normalizing gait (walking)
  • Optimizing leg control for non-impact movements
  • Eliminating active inflammation or swelling
  • Focusing on improving knee flexion (bending) via exercises such as wall slides and knee to chest
  • Aquatic therapy
  • Strengthening
  • Conditioning
  • Weight acceptance and body control

In the video posted by Van Dijk and photos posted by the club, many of his activities align with phase II.

He’s working on hip flexion and knee bending with loaded step-ups, strengthening via barbell loaded hip thrusts, loaded partial range-squats with the assistance of blood flow restriction (BFR – the cuff you see around his thighs) to improve weight acceptance and strength symmetry, watching a monitor of himself walking while in a pool to work on normalising his gait (walking pattern), working on core strength and body control, and lastly doing some ball work in a straight forward-back line (the sagittal plane).

It’s natural to be excited and optimistic watching the video but this is roughly what you would expect to see from an elite athlete eight weeks into his or her post-ACL-repair rehabilitation program, essentially, Van Dijk looks to be coming along as expected.

It’s possible – depending on the other damage he suffered in the knee, specifically if another ligament required surgical repair – that he’s slightly ahead of schedule because you would expect multiple ligament reconstruction to delay return timelines.

However, that’s the information we don’t know and may not ever know so I cannot make that assumption.

LIVERPOOL, ENGLAND - Saturday, October 17, 2020: Liverpool’s Virgil van Dijk walks off injured during the FA Premier League match between Everton FC and Liverpool FC, the 237th Merseyside Derby, at Goodison Park. The game was played behind closed doors due to the UK government’s social distancing laws during the Coronavirus COVID-19 Pandemic. (Pic by David Rawcliffe/Propaganda)

My initial estimation following news of his injury and multi-ligament damage was that he would likely be out for the rest of this season, and that missing Euro 2020(21) could prove prudent considering another short-turnaround to the next Premier League season.

Nothing in this video has significantly altered that opinion and we’re also missing out on key information such as how he’s responding to activity from a pain and soreness perspective which is critical to gauging progress.

However, that opinion is certainly subject to change as Van Dijk advances through the phases of ACL rehabilitation, with phase III of typically when athletes return to running, higher load strengthening with increased emphasis on single leg eccentrics, movement in multiple planes, higher intensity low-impact conditioning, and low amplitude plyometrics with a focus on landing mechanics.

I’d expect Virgil to enter that phase near mid-January and I’ll continue to update as we learn more.