From Setbacks to Silver Linings

An open and honest interview with Professional Footballer Lily Agg

Well, I’ve gone and done it again.

I somehow managed to convince another elite athlete to sit down and have a chat with this me about their ACL injury.

This time, I had the absolute honour of speaking with professional footballer Lily Agg, who plays for Birmingham City and the Republic of Ireland.

Lily is a force on the field, but she's currently navigating the long and winding road of ACL rehabilitation.

She was incredibly generous with her time and astonishingly open about the highs and, more importantly, the lows of her journey so far.

I’ve structured our conversation into a Q&A below to give you a direct window into her experience.

For my paid subscribers, you can access the full, unedited, and raw conversation where Lily shares even more incredible insights at the bottom of this blog. It truly is a side of the professional athlete's journey you rarely get to see.

---

Q&A with Lily Agg

The Injury

Q: Lily, thanks for joining me. Can you take us back to the moment you got injured? What was the build-up like?

Lily: It was a bit of a perfect storm, to be honest. It was the 5th of January, and we had just come back from the Christmas break. Usually, I’d take a few days to put my feet up, but this time, with the demands of the game increasing, I followed the off-season program religiously. I felt fit, but I was also tired. I’d just bought a house with my partner and moved, so the stress and tiredness from that were very real.

We came back and went straight into four consecutive days of intense fitness testing; running, IKD testing, isokinetic holds, real exertion.

A lot of us were moaning because four days back-to-back is quite extreme. On that fourth day, we had a friendly match. It was freezing, about minus 2 degrees, and it had snowed the night before. The pitch was rock hard and probably shouldn't have gone ahead. I was in the team for the second half, so I had to watch in the cold for an hour before a quick, 5-minute warm-up in a dome. I remember saying at the time that it was a bit of a joke; I wasn't warm and couldn't feel my toes.

Q: What was the mechanism itself, and what was your immediate reaction? Did you feel the "pop" or know straight away what it was?

Lily: I just went to go for a header from a goal kick. It was an indirect contact. A player came from my side and as she made contact with me, she kicked my standing foot. Instead of planting firmly, my foot just jolted out.

The minute it happened, I knew.

I've played for 25 years and always thought, "I'm going to get through my career without doing the dreaded one."

The way I’d describe it, I felt like my knee completely dislocated and shifted over. I screamed, and then just lay on the floor holding my knee. When the physio came on, I just remember repeating, "I've done my knee. I've done my knee." I started crying, but it wasn't even from the pain - it was the emotional realisation. I just knew it was done.

After that, I just got up, bobbled off to the changing room, showered, cried, and then drove myself back to Bristol, crying the whole way. It was tough.

The Early Rehab

Q: Your surgery was very quick, just a week after the injury. What were those first few weeks of recovery like?

Lily: That first month was incredibly difficult. The moment I woke up from surgery, you have some nice medicines helping you, but once you're home, the pain really sinks in. It’s so hard going from being so active to not being able to do anything for yourself.

My biggest thing that helped me was keeping on top of the medicines. I'm normally someone who doesn't even like taking paracetamol for a headache, but I learned quickly that you need all the help you can get. Every time I didn't take my tablets on the time frame, the pain was excruciating.

So my advice is, don't try and be stronger than the medicines, they are there to help. I also had the Game Ready ice machine, which was a lifesaver. I honestly just spent all day, every day, with my leg up in the ice, taking my meds, and watching Netflix.

Q: You mentioned struggling with the early rehab program and developing an "angry knee." Can you elaborate on that conflict between pushing through and listening to your body?

Lily: This was one of the biggest learning curves for me. I was back in at the club two weeks post-op, and there was a huge focus on my quads - we don't want to lose quad strength, we need to get the quad firing. I was trying to do the exercises on the Compex machine, lifting the leg, and the pain was immense. But you’re told to do it, so you think it must be right.

One of the biggest things I struggled with was sleep.

My knee was just throbbing at night, a pain I can’t even describe. The more I pushed in rehab, the worse my sleep got. Eventually, I had to find the balance. I started listening to my body and realised that some days, the exercises were making me feel worse. I felt guilty, like I was being lazy for not doing them, but as soon as I settled down on the exercises, I started to sleep better and could feel my knee settling.

The real turning point was at my 3-month review.

My surgeon was brilliant. He just looked at my knee and said, "What have you been doing? Your knee's angry. You've got an angry, sore, red knee. You're doing too much."

He ordered me to strip everything back - no cycling, no weights.

For two weeks, I did basically nothing.

And honestly, my knee felt the best it had since the surgery. The swelling went down, the pain subsided, and my extension finally came back. It taught me that discomfort is okay, but pain is your body telling you something is wrong.

The Mental Journey

Q: How did you manage the psychological side of the injury? It’s a huge mental battle, especially with the pressure to return.

Lily: It's a complete mind game. I think naturally, you start comparing. I became a bit obsessed, to be honest. I made a list of every player I could find who had done their ACL, and I’d follow their journey on social media, looking at their posts from 3 months and thinking, "Oh, what exercises were they doing? Should I be doing that?" You just constantly compare and question where you're at.

A quote from my surgeon that stuck with me was, "There are 200 exercises that can work a muscle, but a physio might only know six. Those six might not work for every person." It's about adapting to the individual.

In terms of my own mindset, I don't really talk about my struggles openly. My approach is to acknowledge that life gives you choices. You can feel sorry for yourself and go one way, or you can look at it and say, "It's bloody tough, but it's a new day." You have to make the choice to push through, even if it's just a tiny step forward. Don't get me wrong, there have been days that are a complete write-off, and that's okay too. My mum is my best friend, and I confide in her. She feels my pain probably more than me and sends me motivational quotes or clips of me playing to remind me of what I'm working towards.

Q: You shared an incredible story about an unexpected discovery that put everything into perspective. Can you tell us about that?

Lily: Yes. It’s still quite raw and new, but it's a really important part of my story. When I finished my surgery, my surgeon saw a mole at the top of my leg. He said, "I don't like the look of that. I want you to go and get that checked." So I did. I went to my doctor, who agreed and referred me to the hospital. They took a look and said they'd remove it for testing.

About two weeks later, I got a call telling me to come in for a wound check and to speak to them. My mum, who used to be a cancer nurse, knew this wasn't a positive sign. I went back in, and they told me it was a melanoma in situ. It was incredibly scary, but the positive is that because we found it, we removed it right at the start. It could have become life-threatening at any point.

My mum messaged me and said, "I know you don't want to hear this, but this is why you did your knee. If you were playing, there is no way you would have gone to get that mole checked. You're too busy; you would have said it's nothing." She called it the butterfly effect. In hindsight, I have to trust the process. It feels like it was all meant to happen. It showed me there is more to life than football and puts the entire rehab journey into a very different light.

Advice for Others

Q: What is your key message for a young athlete who has just injured their ACL and is looking up to someone like you?

Lily: First, trust your body.

As athletes, we are programmed to push through tough moments in a game, but you cannot push through this kind of pain in rehab. Learn the difference between discomfort and pain. Second, remember it’s a marathon, not a sprint. Take it step-by-step, and know that every day is progress, no matter how small. Don’t get caught up in comparing your journey to anyone else’s.

Most importantly, hold yourself accountable and never lose sight of your "why." I know that if I wake up and decide not to go to the gym, that's on me. I have to make that choice every single day. When I’m in the gym for five hours and telling myself "Why am I here?", I remember my goal: I want to go to the World Cup in Brazil with Ireland. That's my motivation. So when you're at your lowest, remember the feeling of scoring that goal or playing for your country. That's what will get you through.

Q: Finally, what can we as health professionals do better to support athletes through this long and difficult journey?

Lily: Get to know the person you are dealing with on a deeper level. We all handle things differently. I wear my emotions on my face, so if I come in and I'm not chatty or I seem annoyed, it’s not personal - it’s just me dealing with my own stuff.

Also, be mindful of your questions. When you're injured, everyone asks, "Are you okay?" about 100 times a day. You're hobbling on crutches in pain; of course you're not okay. Try asking something different, like "How was your weekend?" or "How's your family?"

From a professional standpoint, give us clarity.

I have so many questions: Why am I doing this? Why am I not doing that? Explain the reasoning behind the program. It builds confidence and trust.

And finally, be an active driver in our sessions. Don't just watch from the side while you're on your phone. We need you to bring the energy and motivation, almost like a personal trainer. We might be low, so we need you to drive us. Ask your athlete what they need from you on any given day, because it will change.

---

A huge thank you once again to Lily for being so incredibly open and sharing her story with The ACL Hub.

Her journey is a powerful reminder that rehab is never a straight line and that the mental challenges are just as significant as the physical ones.

From battling an 'angry knee' to gaining an unexpected and profound perspective on life, her insights are invaluable for any athlete, coach, or clinician navigating the world of sports injury.

---

For Paid Subscribers: Watch the Full Interview

As a thank you for your incredible support which makes these conversations possible, you can now access the full, unedited, and raw 1-hour video interview with Lily.

Hear the full story, the moments we couldn't fit in the blog, and the complete, unfiltered conversation.