Everyone has been affected in different ways by the fallout of coronavirus. In the clinic, we have seen some interesting trends emerge through the injuries and pain problems that have come in the clinic. Know this: one of the most common causes for any injury or pain problem is simply a change to your routine. This comes in many forms – not being able to attend your regular gym class, loss of motivation, getting unwell and trying to get back on the horse, trying some new funky online exercise program. Any of these could ultimately result in injury, and this remains the case for what we are seeing at the clinic right now, months down the track! Read on as we unpack the three waves of covid-related injuries that we have seen at the clinic in the last few months (plus, importantly, physio tips on how to manage them!)


That’s right, in the early days of coronavirus here in WA the lockdown meant a lot of working from home, which for many meant a lot of online meetings! Yes, we are looking at you, Zoom/Teams/Webex and co. And when we re-opened in April, back and neck pain made up the vast majority of what we were seeing. The causes of back pain are many and varied, and we hypothesise that there was a cocktail of

  • cr@ppy positions and less-than-ideal working environments adopted at dining tables, bedrooms and couches around the country

  • prolonged periods spent in sedentary positions (still looking at you, Zoom…)

  • loss of access to gyms, regular exercise activities and other good “offsets” to back pain

  • other known risk factors for back pain like altered stress, sleep patterns, family dynamics, tension, work/financial uncertainty

  • lack of toilet paper (no science on this yet)

This is a brilliant breeding ground for back pain. So we have spent months trying to address the factors we can control, leading us to our ZOOM BACK tips:

  • your back and neck need to move. If you’re in a sedentary job, you need to create movement habits in your day – lunchtime walks; regular dynamic stretches (neck rolls, lumbar curl downs, quick bit of lunchtime office yoga)

  • tension check – stop your work, and before you change anything, do a quick self-scan – are you holding you jaw tense? Shoulders? Perhaps clenching the butt a little disproportionately for the time of day? If you’re holding tension unnecessarily, this will contribute to back pain.

  • breathing – try a slow inhalation over a count of three, allowing your belly to expand; pause; ease it out slowly over a count of five. Repeat 3 times. Breathing is powerful. Learn more here.


So the next wave of problems we saw at the clinic, come May/June or so, was following the point that WA got a bit lucky and we were able to start getting on with a semblance of normal life again. Most folks realised they had lost all normal routine over March and April, and started making an effort to get back into the groove. The oldest error in the book loomed its smug, condescending head – doing too much too soon! We can get all physio-technical here, but most of the injuries in this wave related to this error in one way or another. Think rotator cuff tendons flaring up from getting back into lifting weights, acute low back tweaks, Achilles tendons reminding you of their presence. Familiar? If so, you need to consider our second wave remedies:

  • leave the ego at the door – regress to basics. Slow drills down, incorporate short holds, focus on the quality of a movement rather than the weight you lift. Remind yourself that the goal initially is just to get used to exercising again and building a base. The rest comes later.

  • load management – this is the technical term related to how you structure your week around different exercises/activities. e.g. if you’re coming back in to running, 2-3x/week with at least 48 hours between is wise. Avoid cramming similar loads together – for example, running, cycling, and a lower body strength session on the same day might not go so great if your conditioning is just getting back up. Remember, your tissues get strong when you recover, not while you train.

  • a little TLC – maybe treat yourself to a stretch after that run? Muscle soreness? A minute or two self massage on a roller or trigger ball goes well. Are you getting enough water on board? Enough sleep?


It appears that where sports go, injuries follow. And so it was by June and July we started seeing the classic sports injuries popping up again (coincidence much, winter sports season??). So the rates of ankle injuries, AC joint sprains, knee ligament injuries and the occasional fracture are increasing. Many would argue that these injuries were inevitable due to the prolonged, covid-induced off season, as we know that one of the things that reduces these injury rates is consistent training and exposure to challenging game-like stimuli. So a long layoff was never going to be great. However, there is great evidence for prevention of things like ACL injuries and there has never been more need to implement these strategies. Our strategy for these injuries:

  • 10-15 minutes of landing, alignment and change of direction work done 2-3x/week helps to prevent lower body injuries. Guess what – that’s about the same time as your sports practice warm ups! Here are links to knee injury prevention in netball, soccer and AFL.

  • Speak with your coaches about including injury prevention in the warm up in training

  • Ensure you have built your training, including contact exposure for relevant sports, over a 4-6 week window (minimum!) to be confident and prepped to make quick decisions on the field.

With any luck, there will be no fourth wave of injuries, and hopefully everyone is slowly finding their routine with exercise and movement. A possible silver lining of the darkness this year has been a renewed focus on how important is our basic human need to move, from reducing pain, to managing stress, to social interaction and finding purpose and enjoyment in our day. May you move often, move well, and be ever grateful for your ability to do so!

Ben Mather

Sports & Exercise Physiotherapist | Musculoskeletal Physiotherapist

September 2020

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