Abstract
A 26-year-old male international soccer player suffered a West Point Ankle Grade III syndesmosis injury leading up to the 2022 Fédération Internationale de Football Association (FIFA) World Cup. After surgical stabilization, the player completed an 11-phase return-to-performance pathway designed to ensure rapid and safe return to play. The pathway employs distinct phases that incorporate clinical, psychological, and sports-specific criteria to inform decision-making throughout the process. In this case report, we outline the phases and criteria used in conjunction with shared decision-making by the interdisciplinary team to ensure a successful return to play at the highest level. The effectiveness of this pathway was demonstrated by the player competing at the 2022 FIFA World Cup.