Has Covid-19 led to pain when moving? Whilst still awaiting research on changes during lockdown and beyond it is safe to assume many have changed their activity levels. Whether due the closure of sports clubs and gyms, working from home or increased activity in the garden ours bodies need time to adjust. Big changes in our activity equate to changes in load our muscles must manage, for some this leads to injury and that is where we come in.
One of our patients attended for just that reason, during lockdown Patient A has been working from home. Whilst still getting out on his bike regularly he found he began to get pain from the outside of his left knee following periods of sitting and when out walking. During lockdown rather than working on site Patient A had been working at a desk most of the day, something he was not use to. Whilst maintaining cardiovascular fitness through his bike, the lack of walking in his daily routine led to deconditioning of some of the muscles in his legs. Patient A attended for a biomechanical assessment to try and identify any areas that may be leading to his pain. During the assessment we noted two common issues that can lead to pain on the outside of the knee: a weak Gluteus Medius and a dysfunctional big toe joint. In addition, we also noted that Patient A was struggling to balance on one leg for any prolonged length of time, a common issue we find when assessing patients.
When your Gluteus Medius muscle becomes weak, it allows your thigh to rotate and pull inwards abnormally. This abnormal position of your thigh can put excessive stress and strain around your knee joint. The dysfunctional big toe joint was, as a result of a condition called Functional Hallux Limitus where the big toe is unable to bend upwards due to the foot position when taking a step, this can lead to the foot rotating to accommodate putting additional twisting strain on the knee.
As with the majority of soft tissue pain, the answer is not a single intervention but instead a set of tools the patient is able to use in combination. Our main goal with Patient A is to help the tissue strengthen and heal by reducing the stress on the injured area. To do this we used on an exercise program focused strengthening his glutes and improving his balance whilst supplying a pair of orthoses to improve function in his big toe joint.
As with all patients we check in regularly, after three weeks Patient A reported “Pain markedly reduced, he was able to balance on one leg without falling over” and again after eight weeks, “Continuing to strengthen muscles, exercises getting easier and pain has gone. The insoles are very comfortable, can I get a second pair of insoles, so I don’t need to keep swapping them in my shoes”