Giovanni Leoni return timeline after ACL surgery and Virgil Van Dijk example for Liverpool defender

It is almost five years to the week when Virgil van Dijk suffered the sort of injury for Liverpool that used to be a career ender.

Approaching 30, the Reds skipper was cut short at his peak knowing that his ruptured anterior cruciate ligament meant that he was about to spend the next year on the sidelines and that the 2020/21 campaign was a write-off.

After leading his team to the Premier League title the season before during a bizarre Covid-19 interrupted fixture list, having to watch his team concede so easily would have been a painful one to take. He was clattered by Jordan Pickford in a Merseyside derby clash, with the Everton man somehow escaping a red card at the time.

What’s next for Giovanni Leoni on his road back for Liverpool

Giovanni Leoni might not be the captain or as integral to Liverpool’s success as Van Dijk was in 2020, however, the recovery process will be every bit as long, lonely and painful. For the 18-year old who was so impressive against Southampton in the Carabao Cup, thoughts of holding down a regular starting place and becoming a consistent pick under Italy manager Gennaro Gattuso will have to be shelved until next season.

Typically, when it is reported that a player has torn or ruptured their anterior cruciate ligament (ACL), the timeline for return is given as between six and nine months. The reality, is that this figure normally starts at nine months with some players taking even longer due to the complex nature of the rehabilitation process and the set-backs that are all too prevalent.

The nature of Leoni’s injury means that his treatment and return to fitness can’t start until his body has done its part first.

What happens next for Leoni is that, once the swelling and inflammation subsides, the 18-year old will go under the knife and have a segment of one of his hamstring tendons grafted into his knee in the site of his ACL.

One variation of this operation is to graft from the patella (knee cap) and patella tendon at the front of the knee, however, this can lead to long-term knee pain as a side affect. The graft from the hamstring is seen as the lesser of two evils, especially in elite sports where there is 24/7 access to the best facilities, equipment and practitioners.

In the early stages, mobility and range of movement is everything, before gradual attempts are taken to restore strength to muscles that will have already suffered significant loss. Running and weight bearing exercise is a distant thought at this stage with the graft going through a period of vascularisation around the three-month period.

This is when the graft begins to take on its own blood flow, but is also at its weakest. From here, everything is part of a protocol in terms of the type of strength training and movement patterns that are gradually introduced.

Due to when Leoni got injured, there is no point trying to rush him back this season, instead, the target should for him to be pain free and running normally by the end of the 2025/26 season so that he can play a full part in pre-season training next summer, having his playing time gradually increased into next season. His age gives him an advantage in that getting the rehabilitation right could mean that he doesn’t have any problems in the future and fulfil his obvious potential.

Why Van Dijk is the perfect example for Leoni to follow

What often gets missed out is the psychological effects of such an injury with some studies suggesting that elite athletes can take as long as the rehabilitation process to return to their very best form. A point that rings true with Van Dijk but who still managed to play 51 games in his first season back and earn 16th place in the 2022 Ballon d’Or rankings.

Shortly after returning to action having returned to fitness in pre-season the following year and being ready for the first game of the 2021/22 season, Van Dijk gave an insight in an interview with The Guardian into his recovery, confirming that getting back playing doesn’t mean the end of the journey.

“I’m happy where I am today,” he said. “I’m playing at the highest level again, playing with a lot of joy. There is still a lot to improve. The only thing I can do is take it day by day. I am not a robot, I have come back from a very serious injury. I don’t think there are a lot of examples of a player who had an ACL and complex knee injury that gets back to his best after a year. I have work to do.

“I know there are a lot of eyes pointing in my direction, wondering: ‘Is he going to be back in the same way?’ But the only thing I can do is try my best each and every game. I’m my own biggest critic and I know exactly when I can do better, and when things are going well too. How I see it is to just improve as much as I can and I’m fairly confident in the way I see things. It is going in the right way and I am feeling fine.”

If Leoni has any luck, it is that he couldn’t ask for a better mentor, both on and off the pitch, as he begins his first big battle as a senior professional with getting back playing only the beginning of his recovery.