Four short guides from the team, written for patients. They are general advice, not a diagnosis. If you are unsure, book a first visit or see your doctor.
01Back and neck4 min read
Lower back pain in the first week
Most sudden back pain settles within a few weeks. What helps in the first days, and the signs that mean you should see a doctor quickly.
Lying on your back with your calves on a chair takes load off the lower back. Hips and knees both bend to about 90°.
Sudden lower back pain is frightening, but in most people it settles within two to six weeks. What you do in the first week makes a difference to how quickly.
Keep moving
Bed rest slows recovery. Walk for five to ten minutes every hour or two, on flat ground at an easy pace. Some pain while you move is normal and does not mean you are causing damage.
Find easier positions
Lie on your back with your calves on a chair, as in the drawing, or on your side with a pillow between your knees. A warm shower or a hot water bottle for 15 minutes can ease muscle spasm. Change position often instead of holding one for an hour.
Go back to normal in smaller pieces
Return to daily tasks as soon as you can. Lift lighter loads, hold them close to your body and bend your knees. Most people can go back to work within days, sometimes on lighter duties for a week.
See a doctor the same day if
You have numbness around the groin or inner thighs, trouble passing urine or controlling your bowels, a fever with back pain, weakness in a leg that is getting worse, or pain after a fall or accident.
See a physiotherapist or your doctor if the pain has not started to ease after a week, or if it wakes you every night.
02Sports and running5 min read
Getting back to running with a sore knee
A six week run and walk plan, three strength exercises, and when a sore knee needs to be looked at.
Three runs a week with a rest day between. Move to the next week only if the knee stays quiet during the run and the next morning.
Pain at the front of the knee is the most common problem we see in runners. It usually comes from doing more than the knee is ready for, rather than from one bad run.
Start with run and walk intervals
Follow the plan in the chart, three times a week. If the pain rises above 3 out of 10 during a run, or the knee is worse the next morning, repeat the week before instead of moving on.
Three exercises, three times a week
Sit to stand from a chair, 3 sets of 10, slowly. Step downs from a low step, 3 sets of 8 on each leg, keeping the knee over the middle toe. Calf raises, 3 sets of 12, with a pause at the top. They take ten minutes and build the strength the knee uses on every stride.
Check the basics
Shoes lose their cushioning after 600 to 800 km. Shorter, quicker steps reduce the load on the knee for many runners. Add hills and speed work last, one at a time.
Book a visit if
The knee swells, locks or gives way, the pain wakes you at night, or two weeks of lighter running has not helped.
03Back and neck3 min read
Neck and shoulder pain from desk work
Small changes spread through the day work better than one long stretch. How to set up a desk, and two exercises.
A desk set-up that suits most people. Small changes through the day matter more than a perfect chair.
Neck and shoulder pain from desk work rarely has one cause. It builds up from hours in the same position, so the answer is many small changes spread across the day.
Change position every 30 minutes
Stand up, walk to the window or fill a glass of water. A timer works better than good intentions. Take phone calls standing up.
Raise the screen
The top of the screen should be level with your eyes and about an arm's length away. If you use a laptop, put it on a stand and use a separate keyboard and mouse.
Let the desk carry your arms
Rest your forearms on the desk or the arms of the chair, with your elbows bent to about 90°. Shoulders that hold the arms up all day get tired and tight.
Two small exercises
Chin tucks. Slide your head straight back as if making a double chin, hold for three seconds, and repeat ten times. Shoulder blade squeezes. Draw the shoulder blades gently back and down, hold for three seconds, and repeat ten times. Do both every couple of hours.
Book a visit if
The pain spreads down the arm, you have tingling or numbness in the hand, or it has lasted more than four weeks.
04Rehab after surgery5 min read
After a knee replacement, the first six weeks
What most people can expect, how far the knee usually bends by each stage, and the daily habits that help.
How far the knee bends, in degrees. Many people reach about 90° by week 2 and about 110° by week 6. Your surgeon may set different targets.
Your surgeon's instructions come first. This is a general guide to the first six weeks after a knee replacement, and the habits that help.
Walk every day
Start with short walks using your frame or crutches, several times a day, and add a little each day. By week six most people walk for 20 to 30 minutes at a time, many without an aid.
Work on the bend and the straightening
Both matter. Do your bending exercises two or three times a day, and spend some time each day with the leg straight and the heel supported on a rolled towel. We measure both at each visit in the first six weeks.
Control the swelling
Swelling is normal for weeks and is usually worse in the evening. Raise the leg above hip height, use ice wrapped in a cloth for 15 minutes a few times a day, and pump your ankles often.
Stairs and sleep
Go up stairs with the stronger leg first and down with the operated leg first. Sleep on your back, or on your side with a pillow between the knees if your surgeon allows it.
Call your surgeon or doctor if
You have pain, heat or swelling in the calf, redness or discharge at the wound, or a temperature above 38°. Call emergency services for chest pain or sudden shortness of breath.
