Less than six weeks before Round 1 of the 2024 AFLW season, North Melbourne defender Libby Birch suffered a serious MCL injury.

As she prepares for a potential return to play, the two-time premiership player shares her rehab diary.

Week 1

It was an intense week. After taking a tackle on Tuesday, we initially feared I had ruptured my ACL. In that moment, as I sat in the locker room, I felt like I had let everyone down - my teammates, my coach, and the new club I had just joined. The thought of being sidelined for a year was devastating. But when the scans revealed only a high-grade 2 MCL injury, I was thrilled. The relief and excitement of knowing I could return this season and play for my team was immense.

I felt incredibly grateful for the 6-8 week recovery timeframe. Though still significant, it was a far better outcome than a year-long absence. When you face the possibility of missing out on something you love for a year, anything shorter feels like a win.

The next day, I emailed the medical staff to set my sights on Round 1, which at that stage was under six weeks away. I knew it would be a challenging goal, but I was determined to push my body as much as possible to rejoin my teammates as soon as I could.

Initially, my knee was immobilised in a brace and set at 30 degrees of flexion. I wasn’t allowed to straighten or bend it, so I was on crutches for the first few days. I had a strict regimen of 30-minute exercises to complete four times a day, and I began sessions in a hyperbaric chamber within the first 72 hours after the injury. This chamber, which delivers 100 per cent oxygen under pressure, helps boost blood flow and accelerate healing. Every time I exercised or went for a short walk, it was crucial to rest, elevate my knee, and apply ice to manage the inflammation.

Week 2

I was thrilled to be at camp with the team at the end of week 1. It was incredible to see all the young girls playing footy down in Hobart and a very special opportunity to give back to the community. Even though there was a mini-break for everyone after camp, I decided to stay at the club to keep advancing my rehab. 

Early in the week I worked with Mary, our sports psychologist, on visualisation techniques to mentally rehearse my skills. On Tuesday, I achieved a significant milestone by loosening my brace to allow for more knee flexion. This progress enabled me to do more exercises in the gym. On my days off, I focused on off-legs conditioning, ropes, and boxing, which allowed me to support my teammates during their training sessions on the days we were in at the club.

As the week progressed, I concentrated on double-leg strengthening exercises and worked towards single-leg squats by the end of the week. I also incorporated some light pogo jumps and was able to loosen my brace to full flexion again.  This improvement let me focus on refining my walking and stair mechanics. Thursday was a highlight as I had my first kick of the footy!

With the goal of removing the brace the following Tuesday, I increased my daily walking and continued to challenge my knee.

Week 3

I hit a major milestone this week. After passing all the strength tests for my quad and hamstring, with less than a 20 per cent deficit, I finally got the BRACE OFF! I was absolutely thrilled and energised to reach this point after two intense weeks of round-the-clock rehab.

But of course, the work didn’t stop there. The next challenge was my first straight-line run. It felt amazing to be running again, but this part of the process is all about how the knee responds after each session. I have to admit, despite seeing significant progress in my running and beginning to try changes of direction, I felt the most uncertain this week. It wasn’t about the knee itself, but more about how my body was handling the increased demands. I felt clunky, out of rhythm, and slower than usual. Every movement seemed laboured and my lungs were burning. I felt like I had a long way to go after being off for two weeks.

The gym sessions have been solid, with 90-minute workouts three times a week. Each session pushed me and my knee to the line.

Persistence paid off this week. After an extra skills session on Friday that helped me regain some of my rhythm, I was in a much better place. On Saturday, I finally felt a shift. 

Watching my teammates play their first competitive match sim against the Saints was incredibly motivating and exciting. It gave me a renewed sense of determination and made me even more eager to continue pushing through my rehab, as I was getting closer and closer to full fitness each day. 

Week 4

Another demanding week of training, both on the track and in the gym. We ramped up the intensity once again, which was challenging both mentally and physically. At times I’ve struggled with feeling out of sync and lacking the explosive push-off I had before the injury. Despite the frustration, this week I just tried to focus on making gradual improvements with each session.

To prepare for Round 1, the medical team and I have worked hard to progressively increase my running loads. This week was crucial for assessing how well my body and knee could handle the demands of a full training session in a controlled environment with the rehab staff. 

A key milestone was successfully completing a change-of-direction test, which involved sprinting and shifting direction at speed, while being pursued. Incorporating contact and tackling into my training was another significant achievement, especially considering that’s where the injury occurred just four weeks ago. It can’t be understated how keen I am to be back training with the team – hopefully in week 5 😊!

We had an awesome rehab crew stay down in Melbourne as the team headed off to Sydney for their praccy match against GWS. Although we greatly missed being with them, we got our session done early Saturday morning, and got to watch our team play on livestream at the club afterwards. 

Week 5

I had been given an incredible opportunity to jump back into full training with the team, thanks to my knee recovering faster than anyone had anticipated. It felt amazing to be back on the field after having everything taken away from me just four weeks earlier. There was truly nothing better than being out there with my teammates once again.

During the period I was sidelined, I had dedicated a lot of time to visualising my skills and movements. This mental preparation really paid off, as I managed to integrate into team training seamlessly, almost as if I had never been away. I was immensely proud of the work I had put in to get myself ready for full training just two weeks before the start of the season.

I couldn’t have been more thankful for the support I received from my teammates, who had been incredibly encouraging throughout my recovery. Equally, I was deeply grateful to the medical team. Their relentless effort and commitment played a crucial role in getting me back out on the field as soon as possible. Without their dedication, none of this would have been possible. 

Now, it was time to focus on fine-tuning my performance for the team, and continuing to build on the progress I had made.

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