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January is a predictable spike in runner’s knee. Not because knees suddenly fail in winter, but because training load changes faster than tissue can adapt. Runner’s knee, clinically termed patellofemoral pain, describes pain around or behind the kneecap. It reflects irritation of the joint surfaces and surrounding structures when load exceeds capacity. The key issue is not damage. It is tolerance. In January, three factors collide. First, training volume increases. Many runne

The idea that back pain stems from a weak or inactive core persists despite decades of contradictory medical research evidence. Research consistently shows that people with back pain often have more muscle activity, not less. The spine is not fragile. It is a column designed to transfer load. Problems arise not because it lacks strength, but because movement becomes guarded, rigid, and fearful. Stability whilst useful for force transfer when squatting or deadliftling, is not

Pain feels physical, sharp, and real, because it is. But pain is not a direct readout of tissue damage (anyone who has a papercut understands this). It is an output of the nervous system, shaped by context, expectation, fatigue, stress, and prior experience. Studies in pain science show low correlations between imaging findings and pain levels. Disc bulges appear in pain-free individuals. Arthritic changes exist without symptoms. Conversely, people can experience severe pain

Although we can help with advice on flexibility and mobility, physiotherapy is not about “loosening tight muscles” or “putting joints back in place.” At its core, physiotherapy is about how the body tolerates load, how the nervous system processes threat, and how tissues adapt over time. Human tissue responds to stress in predictable ways. Muscle fibres increase cross-sectional area when exposed to progressive load. Tendons stiffen and reorganise collagen alignment when loadi