Helena Walker — Working in Academy Rugby Union: The Highs, Lows & Everything in Between — Injury Rehab Network

The latest Injury Rehab Network event featured a highly practical and honest presentation from Helena Walker, Junior Academy Sport Rehabilitator at Sale Sharks.

The session gave attendees a detailed insight into the realities of working in Academy Rugby Union, including the differences between academy and first-team environments, the challenges of supporting developing athletes, and the importance of education, communication and individualised rehabilitation.

The online event took place on the afternoon of Wednesday 10th June, with over 80 practitioners joining from across the sports healthcare community. The recording is online here.

Helena Walker

Helena Walker, Sport Rehabilitator, Sale Sharks

Helena graduated with a degree in BSc Sport Rehabilitation in 2021, and since she has gradually worked her way into the Academy Rugby world. Since being qualified as a Graduate Sport Rehabilitator, Helena has worked in both rugby league and union, semi-professional football, dance, basketball and private clinic work. Helena now works full-time with Sale Sharks Academy, leading the program for the u16s and 17s and assisting with the u18s. Helena completed her second season with the club in May 2026, using the time to develop her own processes, what works best for players at this level and what needs adapting from working with adults.

Working in Academy Rugby Union: The Highs, Lows & Everything in Between

Helena Walker is the Junior Academy Sport Rehabilitator at Sale Sharks, where she leads the medical provision for the club’s under-16 and under-17 academy players.

Her role covers a wide range of responsibilities, including game-day medical cover, pitch-side assessment, injury assessment, rehabilitation planning, treatment, return-to-play support, medical equipment preparation, and communication with players, parents, coaches and the wider multidisciplinary team.

Alongside her academy role, Helena also supports other areas of the Sale Sharks pathway, including the under-18s programme, under-15s activity, and occasional first-team training sessions and games. She also heads up the medical team at Sale FC, giving her experience across academy, senior, semi-professional and performance rugby environments.

Helena’s background has been shaped strongly by rugby, but she has also worked across other settings, including university sport, rugby league, football, basketball, dance and clinic-based practice. This breadth of experience has helped inform her approach to managing young athletes in a demanding academy environment.

Working in Academy Rugby Union

Adapting First-Team Processes for Academy Players

Helena began by explaining how academy medical teams can integrate and adapt first-team processes, while recognising that academy players are not full-time professional athletes.

At Sale Sharks, this includes using consistent macro plans, rehabilitation structures and key performance indicators to guide players from injury through to return to play. These may include clinical assessment, range of movement, mobility testing, strength testing, capacity measures and gym-based markers.

However, Helena highlighted that academy rehabilitation has to be delivered within different constraints. At any one time, she may be working with up to 30 injured or rehabilitating players across two age groups. This means rehabilitation plans must be clear, realistic and adaptable.

For shorter-term injuries, this may involve simple visual presentations with pictures and instructions. For longer-term injuries, players may receive more detailed spreadsheet-based plans with video links and key coaching points. The aim is to give each player the right level of support, while recognising the practical limits of time, staffing and contact hours.

The Challenge of Different Medical Timelines

One of the clearest differences between academy and first-team environments is access to imaging, consultations and private medical support.

In a first-team setting, a player may be injured on a Saturday and scanned by Sunday or Monday. In academy rugby, this is often dependent on the family’s circumstances, including whether they have private health insurance, whether they can fund private appointments, or whether the player goes through the NHS.

Helena shared a powerful example of a player who dislocated his shoulder in November 2024. After a further subluxation in February 2025, he eventually underwent surgery in July 2025. When ongoing pain and weakness persisted during rehabilitation, further imaging in February 2026 showed non-union following his procedure, requiring revision surgery. This has meant a likely return to rugby in early 2027, over two years after the original injury.

By contrast, Helena described two players with similar first-time dislocations who were able to access private care and returned to play within a much shorter timeframe.

The example highlighted one of the major challenges in academy sport: practitioners often have to manage the same injury with very different timelines, resources and levels of medical access.

Supporting Players Through First-Time Serious Injuries

For many academy players, a significant injury may be the first major setback they have experienced in sport.

Helena explained that this makes education and support a crucial part of the rehabilitation process. As the intensity of academy rugby increases, players need to understand loading, recovery, tissue healing, injury risk and the importance of progressing gradually.

She also discussed the emotional impact of being injured. For many young academy players, rugby is central to their identity and future ambitions. Being removed from the team environment can be extremely difficult.

To help with this, Helena encourages injured players to find a new focus away from rugby, such as learning a language, playing an instrument, juggling or another skill-based hobby. This gives players something positive to work on during what may be a long and frustrating rehabilitation process.

Growth, Maturation and Exercise Selection

Academy players are still developing physically, which means injuries and rehabilitation plans must be considered in the context of growth, maturation and movement competency.

Helena discussed the importance of recognising age-related injuries, including growth plate injuries, and making sure these are identified and managed properly. She gave the example of a player with a thumb fracture that was later found to involve the growth plate and required surgery.

Exercise selection also needs careful consideration. In a first-team environment, practitioners may select the most appropriate exercise for the injury and performance goal. In academy rugby, the player may not yet have the training history or movement competency to complete that exercise safely.

Helena explained how Sale Sharks use a movement continuum in collaboration with strength and conditioning coaches. For example, a player may progress from a push-up, to a weighted push-up, to a floor press, and then to a bench press. This helps ensure players are not pushed too far too soon and that good movement patterns are developed over time.

Teenage Rugby Players Stretching

Return to Play Beyond the Academy Environment

Another key challenge is that academy players often return to play outside the academy environment.

Many players are also playing school or club rugby, and the academy may not always have a fixture available at the right point in the player’s rehabilitation. Helena explained that practitioners therefore need to work closely with players, parents and external coaches to manage return-to-play plans safely.

This may include agreeing gradual minutes, managing contact exposure, supporting coaches to understand the reasons for a staged return, and making sure players are not rushed back simply because they are important to a school or club team.

In some cases, it may also involve teaching a player or parent how to apply taping or strapping safely, providing videos, and making sure the player has the equipment and support they need away from the academy.

Using Testing, KPIs and Injury Audit Data

Helena also discussed how testing and key performance indicators guide the rehabilitation process.

At Sale Sharks, the academy has access to first-team testing equipment, including force plates, ForceFrame, Dynamometer and NordBord. These tools can be valuable in rehabilitation, but Helena stressed that academy practitioners must be realistic about what can be achieved.

Unlike a first-team pre-season, where players may have extensive baseline testing across several days, academy players may only have one three-hour testing evening with 40 to 50 players. This means the team must prioritise the tests that will give them the most useful information.

Examples include knee-to-wall testing, toe touch testing, grip strength, the ASH test, counter-movement jump, broad jump and chin-up capacity.

Where baseline data is limited, practitioners may need to compare the injured side to the uninjured side, look at capacity and gym-based markers, or compare the player with appropriate peers. Helena gave the example of a smaller under-16 scrum-half returning from a second collarbone fracture. Comparing him with first-team male players would have created unrealistic targets, so more appropriate benchmarks were used to support a safe and achievable return.

Helena also highlighted the value of injury audits. Sale Sharks track how injuries occur, when they occur, where they occur and which areas are becoming more prominent. This data has directly informed changes to testing and prehabilitation priorities.

For example, ankle injuries reduced from 25.5% to 16.5% across one season, while shoulder injuries increased from 16% to 20%, with a notable rise in shoulder operations. Lower limb soft tissue injuries also increased from 5% to 12%, prompting the introduction of additional testing such as the Thomas test and ASH test.

Managing Load Across School, Club and Academy Rugby

A major theme of the session was the limited contact time academy practitioners have with players.

Helena explained that academy players may only be with the club for around two and a half hours per week during some parts of the season, yet they may be playing a significant amount of rugby elsewhere.

During the main school rugby block from September to December, some players may play up to three matches per week, in addition to training and general day-to-day activity. Last season, 51.7% of under-17 injuries occurred in school or club environments, compared with 36.3% sustained within the academy setting.

This means academy sessions must be planned carefully to avoid adding unnecessary load. During the school block, sessions may include education, gym-based work and lower-load pitch activities, rather than further high-volume running or contact exposure.

Helena also explained how the medical education focus changes across the year. Pre-season focuses on prehabilitation and preparing players for increased load. The school block focuses on recovery. The academy league period focuses on game-day preparation and recovery strategies. The later playing block brings these areas together, while the off-season focuses on recovery and preparation for the next age group.

The Realities of Academy Sport

Helena gave a clear picture of the practical realities of academy sport.

Academy practitioners may work across different sites, different gyms, different pitch surfaces and different session structures. Rehabilitation plans need to work in a range of environments, including those available at school, club or boarding accommodation.

Players may also rely on parents, taxis, school buses and long journeys to attend sessions. Some players in the catchment area may travel more than two hours to attend academy training. This requires flexibility, understanding and communication.

Game days can also vary considerably. Age-grade rugby may involve standard matches, triangular fixtures, festivals, tournaments or multiple squads playing across a longer day. Medical staff must adapt to different formats while ensuring every player feels properly supported and that maximum playing minutes are managed safely.

Education First

A central message from Helena’s presentation was that academy rugby is about education as much as performance.

Players need to learn how to help themselves, whether that is managing a tight hamstring, completing activations, using recovery strategies, seeking feedback, reviewing clips, understanding nutrition or engaging with psychological support.

The aim is not to create dependency on the practitioner, but to help young athletes develop the knowledge, behaviours and confidence they will need as they progress through the pathway and beyond.

Helena also emphasised that every player is different. Some players are focused entirely on becoming professional rugby players. Others may prioritise university, education or different career routes. For the academy, the aim is to support each player’s development while keeping education and long-term wellbeing at the centre.

Remembering They Are Still Young People

One of the strongest points in Helena’s presentation was the reminder that academy players are still young people.

Some may be physically mature, strong and imposing, but they are still teenagers navigating school, family life, rugby pressure, injury, uncertainty and ambition.

Helena shared the example of a 16-year-old player undergoing ACL rehabilitation. Although he is physically large and does not necessarily look his age, he is still a young person processing a major injury, a long rehabilitation timeline and a significant amount of information.

This reinforces the importance of communication with parents, schools, coaches and support staff. Players need time to understand their injury, ask questions and feel supported throughout the process.

Q&A Highlights

Helena answered several questions from the audience about the wider support available to academy players.

Q1: Is psychological support available for injured academy players?

Helena explained that Sale Sharks do have access to psychological support, although not to the same extent as a first-team environment.

The academy works with psychology support where possible, often involving students who are developing their own practice. Helena explained that she may flag players who would benefit from additional support and help create opportunities for more informal, relaxed conversations.

She also highlighted the value of injured players speaking to each other. Rehabilitation clinics can give players going through similar injuries the chance to support one another during what can be a difficult period.

Q2: How can practitioners support players during long waiting lists?

Helena explained that her role is partly to keep players progressing where possible, while also helping to facilitate the wider process.

This may include adapting rehabilitation or prehabilitation to keep the player challenged, contacting consultants or hospitals, writing referral letters, and exploring whether there are appropriate ways to reduce waiting times or keep the player moving forward safely.

Q3: Are parents included in education around prehabilitation and injury management?

Yes. Helena explained that Sale Sharks deliver player presentations that also include parents. Depending on the age group, there may be around four to six of these sessions each year.

These sessions can cover areas such as rehabilitation buy-in, nutrition, psychological support, school commitments and wider player development. Helena emphasised that educating parents is an important part of supporting the player.

Q4: What are Helena’s thoughts on bio-banding?

Helena explained that Sale Sharks do not currently use bio-banding, but the academy does take a rounded view of player development, growth and maturation.

She discussed the importance of avoiding simplistic judgements based on size, height or weight. For example, if a player gains 6kg across a season, their rugby involvements may temporarily reduce because they are now carrying more mass in a faster game. However, that same player may also be stronger, jumping higher and developing qualities that will benefit them longer term.

The key message was to understand the developing athlete in context, rather than judging performance in isolation.

Presentation Recording

The recording of Helena’s presentation is online here

You can follow Helena on Linkedin here

2026 Injury Rehab Network events

You can join us for our next Injury Rehab Network event on 24th June June at 7pm, where Professor Jim Khan will be discussing appendicitis and the modern athlete. Find out more here.

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