Quick take: United’s start to the season has mixed results and a growing injury list. Below, our therapists unpack what’s known publicly, explain likely sports rehab mechanisms, and outline how evidence‑based rehab gets players (and weekend athletes) safely back on the pitch.
What we know so far (public reports)
- Diogo Dalot withdrew from the Portugal squad with muscle discomfort last week, a precaution that puts load management in the spotlight before the derby.
- Lisandro Martínez has been in light work since his serious knee injury earlier this year, with timelines still conservative; expect return decisions to hinge on objective strength and stability metrics.
- Matheus Cunha left the Burnley match early with a suspected hamstring issue; his own update suggests he’s back on the bike and progressing through early‑stage conditioning.
(We reference only information already reported by clubs and major outlets; details can change as medical teams reassess.)
How these injuries typically happen
Hamstrings (e.g., Cunha): Usually a high‑speed sprint or forceful deceleration moment. Micro‑tears occur at the musculotendinous junction; risk rises with fatigue, previous injury, and inadequate exposure to top‑speed running in the build‑up.
Anterior knee/ligament (e.g., Martínez history): Often non‑contact, but contact mechanisms and rotational forces can compromise stability. Even when cleared to “train,” return‑to‑play depends on meeting criteria, not just how the knee feels.
General muscle overload (e.g., Dalot): Congested fixtures and rapid spikes in workload can outpace the tissue’s capacity. Small warning signs (tightness, cramp, reduced acceleration) matter.
The Hekas return‑to‑play framework for their sports rehab
We favour criteria‑based over calendar‑based rehab. That means you progress when you meet objective markers, not because a certain number of days have passed.
- Calm the tissue
Acute pain control, swelling management, and protected loading. For muscle strains, that might mean relative rest + isometrics; for knees, early range without provoking swelling. - Restore quality movement
Regain range of motion and re‑establish joint mechanics. We blend manual therapy (including IASTM/T Tool where indicated) with neuromuscular drills so movement patterns are clean before adding speed or power. - Build capacity
Progressive strength from isolated to compound patterns. Expect stage gates (e.g., hamstring strength symmetry ≥90%, hop‑test symmetry ≥90%, or pain ≤2/10 on loaded tasks) before change‑of‑direction work begins. - Add speed & chaos
Plyometrics, high‑speed running, and reactive football tasks. GPS or timing gates help us match pre‑injury sprint loads and decelerations before contact training resumes. - Return to team
Non‑contact → controlled contact → full training. We monitor next‑day soreness and swelling to ensure the step “sticks.”
Why criteria matter: Skipping steps risks re‑injury. Hitting objective numbers builds trust between player, coach and therapist, crucial in derby weeks.
Sports rehab sample plan
Hamstring strain (Grade I–II):
- Early: isometric hamstring holds, cycling or AlterG for blood flow, trunk stability.
- Mid: eccentric strength (RDLs, Nordic variants), curved‑treadmill or resisted runs, change‑of‑direction progressions.
- Late: max‑velocity exposures (flying 20s), sharp decels, position‑specific patterns; return once top speed and repeated sprint ability match pre‑injury baselines.
Post‑knee ligament recovery (later‑stage):
- Early‑late: quad strength restoration (30–70° range work), balance and perturbation training.
- Mid‑late: hop testing battery (single, triple, crossover), hamstring:quad ratio checks, contact preparation via grappling drills.
- Clearance: symmetrical strength ≥90–95%, no effusion after high‑intensity training, coach‑led integration plan.
Important: These are generic examples, not medical advice for any specific player.
What weekend players can copy (safely)
- Track your loads. Sudden spikes (e.g., chasing a couch‑to‑10k PB) drive strains. Step up weekly volume by ~10–15% where possible.
- Sprint smart. Include small doses of near‑max speed work before matches to keep hamstrings conditioned for game demands.
- Strength is insurance. Make eccentrics (Nordics, RDLs) and single‑leg work a non‑negotiable.
- Sleep & fuel. Inadequate recovery raises soft‑tissue risk as much as training errors do.
How Hekas can help
- Injury assessment (40–60 min): differential testing, strength metrics, and a clear plan.
- Manual therapy & IASTM (T Tool) to address protective tone and scar‑tissue adhesions.
- Rehab coaching with app‑based progressions, load management, and GPS/tempo guidance for runners and field sport athletes.
- Return‑to‑sport testing so you know when it’s truly safe to push.
Ready to start your own comeback?
Book a Sports Injury Assessment in Manchester
Or call 07443441225
Disclaimer: This article summarises publicly reported information and general rehab principles. It’s not personalised medical advice. If you’re injured, book an assessment with a qualified clinician.
