Real Health London

Bad knee, good learning

strengthening, loading, osteoarthritis, knee injury


The story of my knee is likely to have started many years ago but, as is often the case with injuries, it didn’t really surface until about 2021.

I was playing my regular weekly tennis game and I noticed my knee would be sore the following day. Not sore enough to cause alarm bells and never for long enough to get me to action it, but it would be painful for a day or two.

This went on for around two months where each time the pain would be a little more intense and it would take a few more days to settle. As you can guess, these symptoms steadily progressed over about four months to the point where the pain was constant and made it impossible to play with normal movement.

With Christmas on the horizon I decided that would be the perfect time to take a break, get my colleagues’ opinion and do the necessary work to get me back on track.

Christmas came but what happened next was unexpected. As I rested, which included a break from the twice daily walk to drop and pick up kids from school, my knee got rapidly worse, to the point where I was unable to walk without pain and had to crawl up stairs and even hop down stairs on my good leg. One random afternoon in the kitchen I made a very simple twisting motion and in a flash I was on the floor, in agony.

Clearly this was not the soft tissue/mechanical loading problem I had told myself this must surely be and looking back I think I always knew I was sort of kidding myself, but that’s another part of this story.


At this point the only sensible thing to do was get my knee scanned and to consult with the relevant expert on how to move forward.

The chat with the orthopaedic surgeon wasn’t the best, but it was honest.

  1. ACL damage
  2. Full lateral meniscus tear
  3. High grade articulation cartilage thinning with full-thickness loss


In summary :

  1. An ACL not unlike a cooked soup noodle
  2. Damage to the shock absorber
  3. Loss of the protective lining

Two things that stood out from the surgeon’s advice (apart from his desire to avoid surgical intervention) were:

  1. Rehab, Rehab, and Rehab !
  2. You could play tennis BUT you really shouldn’t

The first point was a good challenge because I knew I had to put this into the hands of someone else and not do a half job with my own knowledge.

The second point was tough to hear. However, it was interesting that all the specialists I spoke to subsequently replied to the “you really shouldn’t play tennis” advice with as sharp intake of breath and a “yeah well, surgeons always say that though, I wouldn’t be so I sure”.

Obviously this was encouraging and if nothing else, a great motivator.


The rehab turned out to be much more than just working on my knee, and I mean this in a physical sense, but also psychologically.

I put myself in the hands of our Physiotherapist, Stephen, and made a firm commitment to give it 100% because that way, if it didn’t work, at least I knew I hadn’t left it to chance. I had a program that included foot & ankle, legs, knees, thighs, hips and lower back and on both sides!

I would have done this everyday but recovery is important so I decided to take this opportunity and use the in between days to work on my upper body.

Where I had initially thought that handing over my knee project would be tricky because my own professional opinions might differ and there would be a clash, I in fact found it liberating. I removed all preconceived ideas of what I felt should happen or the things I should do. I simply attacked it in very disciplined manner.


The results were amazing! My pain threshold and mobility improved within several weeks to the point where I was not worried about any of the exercises, I could approach a set of stairs without worry and, most importantly, could mess about with my young kids again. The initial inflammation had also settled, the bone bruising had subsided, and I was able to sleep without pain.

Over the course of a few months I continued to progress and I really started to enjoy seeing what else I could do and, as I write this, the journey is still ongoing. Sure, there are setbacks and days where I have a flare up (entirely to be expected with my knee as it is) but I rest, I don’t panic, I trust the  process and carry on.

I am still on track to play some form of tennis. I may have to settle for games of old man’s doubles or a coaching session with my kids but I can’t give it up altogether.

My surgeon says that I am looking at some form of knee replacement in the future but that he wants to me to get deep into my 60s before that happens. Well, one thing I’ve learned form all this is that I like a challenge!!


The absence of tennis made me realise how much I love it (cliché much?) and two things occurred to me:

  1. For the vast majority of recreational tennis players there is a disconnect between their rehabilitation and their tennis coach. Most people who have lessons and get injured will disappear for rehab or just take time out to help them get better. They then return to their coach but without much dialogue or understanding as to how that coach may be able to help with improvement or prevention. I believe it would be of great benefit if this gap can be bridged through sharing of information and direct dialogue.
  1. As an osteopath I am very interested in biomechanics but, whilst its simple enough to familiarise oneself with the various tennis injuries we come across, if you really want to understand what causes and maintains repetitive, non- traumatic injuries, you really need to look at how someone is moving whilst they are playing. This is a luxury primarily found at elite level sports but with a bit of technology, e.g. a smartphone, there is a lot of information suddenly available to clinicians


So, whether it’s a session where I visit you on court to see how and why you move or if you send in some footage that someone has taken of you playing for us to analyse in clinic, we suddenly have a whole new layer to help shape your technique and to help shape your treatment and injury prevention.


I am based at both the Crouch End and Ally Pally Clinics for Real Health London.