COVID-19 has had a significant impact on individuals, families and sporting populations. And as Melbourne begins to emerge from their second pandemic lockdown, physiotherapists are preparing for the inevitable post-lockdown fallout, which has physical and mental health implications.

Andrew Wynd, a Melbourne-based sports physiotherapist, says the impact of COVID-19 is ever-growing due to gym closures, loss of strength and increased sitting and screen times.

“Limited ability to participate in sport and recreation due to restrictions has had an obvious physical impact, but also mental health implications.

“Working from home has placed unusual postural strains on workers, especially their spines- leading to a rapid rise in postural pain and spinal complaints.”

These types of complaints have made up the majority of new presentations in the last few months due to restrictions on work and sporting endeavours, explains Mr Wynd.

“The more sedentary nature of work and sporting restrictions has resulted in many individual losing critical strength and conditioning, which increases the risk of injury significantly as we return to more ‘normal’ activities.

“When the last lockdown was removed, we saw a rapid rise on overuse injuries from weak and deconditioned clients desperate to return to their favourite sporting or recreational pursuits.”

The injuries following stage four lockdown in Victoria are expected to be worse and more prevalent than that experienced after the first lockdown, which was stage two nation-wide, explains Mr Wynd.

“During the past few months we have seen an extraordinary rise in bone stress injuries, and in just our clinic alone, have strangely seen a record number of fibula, or lower limb, stress fractures.

“We can only attribute this to reliance on walking and running as the primary form of exercise.

“Rapid changes in load, such as going from a few km jogging a few times a week, to 5 kilometres every day, can result in overuse injuries, particularly of bone.”

The management of these injuries requires immobilisation and a period of rest, which can further negatively impact general health and wellbeing.

Education is vital to minimise the risk of injury in the first instance and to ensure a smooth transition back into sport when restrictions lift.

“We have reached out to community sporting clubs and offered webinars educating on minimising injury risk and safe return to play.”

It’s not just physical health that’s under pressure due to injury, but also mental health.

“We know from recent research that there is an association with mental health and plantar heel pain.

“And with a special interest in foot and ankle conditions, we were concerned about the increasing cases presenting.”

In an effort to reduce this type of injury, Mr Wynd is encouraging people to use the time spent at home as an opportunity to strengthen their feet and ankles through an online platform.

“Fewer people are attending offices wearing corporate attire like high-heels, so we have found this has become the perfect opportunity to focus on strengthening the feet, ankles and working on foot posture and toe alignment.

“It has been hugely successful, and clients have been extremely appreciative with reports of reduced foot and heel pain at this early stage.

“We further hope this will help prevent some of the lower limb issues that may arise as we come out of lockdown,” says Mr Wynd.

Physiotherapist Michael Dermansky says the second lockdown will result in reduced muscle tone, fitness and strength, but patience is key to returning to ‘normal.’

“When lockdown is over, we want to get back to our normal life, but strengthening needs to be done gradually and with structure. 

“Unfortunately, we lose strength and muscle mass faster than regaining muscle tone, so a graded and progressive strengthening program is extremely important to do this safely and effectively.”

The psychological and social impact of the pandemic and isolation is also concerning, says Mr Dermansky. 

“Although there is no long-term data on COVID-19 as yet, over 30 per cent of the people recovering from SARS and MERS had signs of post-traumatic stress syndrome that needed professional help.”

For most though, it will be a gradual return to a more social and active life, and physiotherapy is a safe way to facilitate it.

“Participation in exercise classes and training run by physiotherapists will be an important place for people to come together safely, regain strength and connect to other people again.

“Even during the lockdown, Zoom exercise sessions involve not only interacting with the instructor but with other participants.

“This is an important part of re-building social networks and connecting to others during the pandemic. 

“As a profession, physiotherapists have a major role to play in restoring normality to the lives of both the people directly affected by COVID-19 and the rest of society during this pandemic and beyond. So, don’t wait – get started!”