A Novel Approach to On-Court Movement Progression Following Bilateral Inguinal and Umbilical Hernia Repair in an Elite Tennis Player: A Case Report

BACKGROUND: There is an absence of evidence-based rehabilitation protocols tailored for elite tennis players following hernia repair in the existing literature. This case report presents a novel, on-court progressive mobility program to return to sport (RTS) in a professional tennis athlete. CASE PRESENTATION: A multidisciplinary approach guided a tennis-specific on-court progression informed by cognitive load and movement-variability concepts. A postoperatively structured 10-week RTS protocol advanced from rest to full competition, with progression informed by perceived exertion, pain, functional capacity, and psychosocial status. OUTCOMES AND FOLLOW-UP: Despite residual pain and incomplete functional restoration, early RTS was pursued due to competitive priorities. Match return induced a substantial load increase without symptom escalation, enabling progressive improvement and full competitive readiness by week 10. DISCUSSION: This case highlights the value of individualized on-court rehabilitation and shared decision-making, while illustrating the tension between accelerated RTS demands and comprehensive recovery in elite sport contexts.