Open Forum: Musculoskeletal Rehabilitation - Facilitated by Kieran Doyle
May 25, 2026Open Forum Case Synopsis – Musculoskeletal Rehabilitation
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In this session, Kieran Doyle walks clinicians through a high-level case involving a 28-year-old AFL athlete presenting with gradual onset ankle pain—highlighting how seemingly “routine” presentations can mask high-risk pathology.
The discussion centres on recognising red flags for bone stress injury, particularly in high-risk anatomical sites like the talus, and emphasises the limitations of clinical testing alone. A structured clinical reasoning approach is explored, including red flag stacking, use of imaging thresholds, and the application of the Bull vs Bear framework to support balanced decision-making.
Key learning points include when to escalate for imaging (particularly MRI), how to navigate Australian referral pathways and financial barriers, and why early suspicion is critical in preventing serious complications such as fracture or avascular necrosis. The session also reinforces the importance of screening for underlying contributors (e.g. RED-S) and setting realistic, criterion-based return-to-sport timelines.
Overall, this case challenges clinicians to think beyond first impressions and apply a more deliberate, risk-aware approach to managing bone stress presentations in athletic populations.
