We are now approaching one year since the first national lockdown here in London which began on 23rd March 2020. Firstly I don’t think anyone could foresee the devastating outcome of the pandemic in terms of number of deaths and the overall number of cases too. My thoughts are with all of those who have been affected by Covid-19 in some way. For many of us who have not been unwell or had close family or colleagues tragically killed by the virus, it has been more a case of chronic stress and mental health impact that perhaps has been the issue. I also suspect that we will see many cases of so called “long covid” in times to come as well.
For the first 3 months of the pandemic my clinics were fully closed- and then opened at the end of June. Since then we have been able to stay open- wearing PPE and ensuring safe practice- with a mixture of face-face and video consultations. At nearly a year on, I have been reflecting on what the pandemic has meant in terms of what conditions I have been seeing in clinic.
Firstly I have not been seeing sports trauma or related injuries- normally in winter and spring I would be seeing many ski-related injuries but of course without skiing this is not happening. Football, rugby and other sports injuries from contact or training have also been very rare. However, I have been seeing many cases of back and neck pain- partly due to people working from home- sitting more and in some cases with inadequate equipment for safe home working. The other main areas of injury relate to running. As a runner myself I know how many people either started running in lockdown, or increased their running as a result of being at home more and with gyms being closed. I have seen many running injuries in clinic and there has been a noticeable increase in these types of injury.
Stress fractures perhaps represent the largest group of injuries that I have seen. The bones that may be affected include the tibia(shin bone), metatarsals of the foot, hip, calcaneus(heel bone) and various others too. I have written about stress fractures on one of my other blogs so please do read if of interest.
Another running related issue seen is that of Patellofemoral pain. This is a condition when the knee cap/patella may irritate the underlying structures of the knee. Increasing activity and poor footwear can cause this. Also I often find in patients that they have weak gluteal muscles- this muscles in the buttock are very important for maintaining our leg stability and especially when running. In these cases pain will often be present when running or when loading the knee in a partially flexed position- such as being on stairs. Some patients may also have pain sitting when quadriceps tightness becomes a factor. BUPA have some nice information on this as shown below.
Running is a great activity and contrary to some beliefs it has not been proven to cause knee osteoarthritis. Exercise is vital for health so if for whatever reason you are having issues then get checked or book an appointment for assessment. My own personal clinic link is on my home page.
I expect that as lockdown eases we will see a partial shift in the conditions that we see although of course running injuries are always around.
For health it is so important that we exercise so whatever form you enjoy – running, cycling, gym, HIIT sessions, swimming and more- we have lots to look forward to as lockdown eases. As always keep well- and happy exercise to all.
Dr Michael S. Burdon
Consultant Physician in Sport, Exercise and MSK Medicine.