My lockdown knee pain recovery

In the first lockdown, despite the fear and uncertainty of the pandemic, and the adjustment to working from home, I tried my best to see the positives. The sun was shining, and I was no longer commuting into London every day, which meant I had more free time for new activities like planting sunflowers and HIIT workouts in the garden with friends over Zoom.

I subscribed to the Les Mills fitness app and did one of their deep 15-minute stretches every morning before work, and a flow session on Saturday mornings. I went for a walk nearly every evening, and even got back into running twice a week, which is something I hadn’t done for years! I had so much more free time, and it was a novelty to be able to fill it with stuff that made me feel good.

Then… winter lockdown hit, and it was a totally different story. It was dark and cold, and things weren’t looking good for the UK. I didn’t feel motivated, and I certainly wasn’t moving as much. I was shuffling from laptop to fridge, from fridge to sofa, from sofa to bed and far from feeling my best. That’s when the knee pain set in…

Painful symptoms

I had started to get a niggling pain in my knee. It’s something I’ve had on and off for years (I assumed it was to do with a past athletics injury, but I’d never been to see anyone about it). I’ve largely ignored it as it usually goes away on its own and only kicks up a fuss when I’m sat or laying down in the same position for too long. However, as the weeks went by my knee pain really started to play up.

My knee pain meant I couldn’t find a comfortable stationary position and I was constantly shifting in my chair – a total distraction at work. My knee pain even started waking me up in the night and disrupting my sleep. I had to do something about it. As physiotherapy was still considered essential travel according to government guidelines, I booked in for a physiotherapy assessment with James Lee at the Bodyset clinic in Streatley.

Physiotherapy assessment

During my assessment I described the knee pain I was experiencing, and James completely understood what I was describing. He used an objective strength testing tool called a ‘HandHeld Dynamometer (HHD)’ (Gait and Motion’s EasyForce) to measure how strong each of my legs were and give us a baseline to work with. It turned out that my left knee (the problem) was a lot weaker than my right, and you can’t argue with the numbers…

Peak Isometric Force Scores with HHD | week 1
Bodyweight 63.3kg

Quadriceps (Ideally 50% of my body weight) (L) 11.6kg (Average of 9.1), (R) 14.8 (Average of 11.9)
Hamstrings (Ideally 70% of quadriceps score) (L) 16.5 (Average of 12), (R) 15.4 (Average of 13.6)
Glutes (Ideally 20-25% bodyweight) (L) 6.9kg (Average of 5.4), 10.6 (Average of 8.7)

James explained that the cause of my knee pain was related to the Patellofemoral joint and the Infrapatellar fat pad at the front of my knee. In certain positions, this structure can be overloaded (knees bent or fully straight) and it is often secondary to sub-optimal strength in the quadriceps and glutes.

After the strength tests, James advised me to avoid resting positions such as standing with my knees locked straight and to optimise my desk setup using a footstool.

He also showed me a set of exercises for me to do at home to start building my strength. He prescribed them on the Bodyset app which was really easy to download and use at home. You can watch demonstrations of all the exercises to make sure you’re doing it right and record any pain or difficulty levels for James to review as you go. If I did get stuck, James reassured me he’d be there to help with any questions I had.

Rehabilitation

In the interest of putting a stop to my knee pain once and for all, I signed up for a course of 6 physiotherapy treatment sessions. Each time we met, James would ask me how I was getting on, refer to the app and make sure that what we were doing was pushing me in the right direction.

At the start of each physiotherapy appointment, I would get on the leg press to fatigue my muscles a little before trying out new exercises he was going to prescribe me. He took me through every exercise a few times to make sure I was comfortable with them. He also gave me tips on how to make sure I was doing it right and explained how it was meant to feel. By the time I’d got home James had updated my programme on the Telehab app and I was good to get started at home.

Setbacks

James had explained that my knee would feel better after a couple of sessions, but to stick with the programme to ensure the changes we were making were lasting. If you don’t stick with it for the duration of the course, the benefits will wear off. It reminded me of a course of antibiotics, in that you get your 7-day course, you may feel better after a couple of days, but if you stop taking them, your original symptoms will inevitably come back.

As a couple of sessions went by, I was feeling no pain in my knee. I got more confident with my exercises and was resting less and pushing more…

James had added forward and side lunges to my programme. However, after a couple of sessions at home, my knee started to hurt again. And this time, it wasn’t just my left, it was my right as well. I was a little disheartened.

I dropped James an email about the issue I was having and he told me to drop the new exercise and carry on with the rest. The next time we met, James prescribed some alternate exercises and explained we had probably done too much too soon. Every body is different and sometimes there is a bit of trial and error involved.
After a few home sessions with the new exercises, the knee pain had gone again.

Results

I’ve had eight sessions with James now. There’s no knee pain whatsoever and I’m so happy with the results!

Every week I went from strength to strength, and I felt so much better. I was shocked at how much a short 20-30-minute exercise session every couple of days could impact my recovery so effectively.
It’s one thing to feel the results, but it’s another to actually see them… I was amazed at the transformation when James got the dynamometer out for a retest.

Peak Isometric Force Scores with HHD | week 8
Bodyweight 63.3kg

Quads (L) 26.1kg (Av of 21kg), (R) 25.4kg (av 22.2kg)
Hamstrings (L) 21.9kg (R) 22.2kg
Glutes (L) 11.8kg, (R) 15kg

Both my legs are so much stronger and there’s now very little difference in strength between my left and right!

I’m going to continue to see James for another course, because I’d like to get back into my running again, safely, without risk of injury. He is tailoring the next few sessions of my programme to make sure that I’m still building strength and preparing my body (specifically my knee) for a return to running.

Lessons learned

I’ve really learnt how important it is to keep our bodies moving! A little bit of exercise each day doesn’t require a lot of effort or time. It keeps complications at bay and helps our minds and bodies stay happy, healthy, and pain-free.

My commute and travelling to meetings prior to lockdown meant I was on my feet, moving my body every day and in the first lockdown, I made an effort to build healthy habits. By the time lockdown two and three rolled around I did nothing, and the pain set in.

If you’re in pain like I was, I really encourage you to get moving and see a physiotherapist. They really can help, and work wonders for your body. It’s crazy how much better I feel, and I only wish I’d thought of booking in to see a physio sooner. The time I’ve spent with James has motivated me to get back into moving more, listening to, and taking better care of, my body.