Rehabilitation of sports persons who undergo lumbar spinal surgery has received very little attention in the literature and there is a paucity of research documenting recovery. A 38-year-old elite level athlete underwent L4-S1 surgical stabilisation for predominantly L5-S1 instability causing unilateral L5 neuropathy. Pre-operative management included patient education and training in specific stabilising exercises. Post-operative rehabilitation included specifically guided and progressive rehabilitation utilising recent research evidence for segmental and global stabilisation. Other aspects of rehabilitation included re-education of posture, proprioception, balance, trunk muscle endurance, leg strengthening and preparation for a return to road running. The patient made an exceptional recovery, returned to competitive running at a level that compared favourably with pre-injury performances and was 100% satisfied with the outcome. The application of exercise therapy, considered a complex part of clinical physiotherapy, may be important to assist the recovery of patients undergoing lumbar spinal surgery, to accelerate rehabilitation and to facilitate a return to full sporting participation.