This single case study follows the assessment and rehabilitation of the lumbar spine stabilising muscles, transversus abdominis (TrA) and lumbar multifidus, of an elite soccer player following an exacerbation of a chronic low back injury. The subject had already completed a stabilising muscle retraining exercise program involving supervised Clinical Pilates sessions as well as specific retraining exercises for the lumbar spine stabilising muscles. However, following completion of this program, the subject was unable to return to sport due to continuing signs and symptoms. The subject was then referred to the Physiotherapy Ultrasound Imaging Clinic and commenced a lumbar spine stabilising muscle retraining program with the assistance of real-time ultrasound imaging (RTUI). The subject progressed quickly with the visual biofeedback unique to RTUI and returned to playing at an elite level after 6 weeks of supervised retraining. At a 2 year follow-up assessment, the subject had been pain free since discharge while continuing to play in senior ranks on contract in Europe. This paper discusses the perceived benefits for both the subject and attending physiotherapist of utilising RTUI compared to conventional methods in the clinical setting to assist in the rehabilitation of TrA and multifidus following injury to the lumbar spine.