- 01
Agree
Get a written plan before treatment, including work and exercise.
- 02
Pace
Keep activity within that plan and discuss symptoms before increasing it.
- 03
Review
Coordinate the return to activity with the injection team and physiotherapist.
Start with a shared plan
Professor Lee’s concern is doing too much too soon after an injection. A useful recovery plan explains what to pause, what movement is appropriate and how the team will help you progress. It should fit your symptoms and the demands of your usual activities.
If you are working with a physiotherapist, share your injection date and written aftercare instructions. The therapist and treating clinician can coordinate the next steps.
What the published protocol says
The 2025 cohort advised rest for 24 hours and avoidance of strenuous activity for 72 hours, with aftercare instructions and a contact number. Those are the instructions recorded in that study.
The October 2025 manufacturer instructions advise avoiding strenuous activity during the first few weeks, with rehabilitation when possible. Do not read the older 72-hour study protocol as clearance to resume sport on day four; follow the plan agreed with your treating team.
Progress is about the right amount of activity
A rehabilitation session can mean gentle movement, strength work or demanding exercise. The label alone does not tell you whether it is appropriate at a particular stage. Ask which activities fit your current recovery and what would signal that you should scale back.
There is no evidence in the reviewed papers that all physiotherapy is harmful or that exercise should be avoided indefinitely. The practical aim is to choose the right timing and intensity.
Use symptoms to start a conversation
If an activity repeatedly increases symptoms, contact the team before increasing the load further. A symptom diary can help describe what you did, how the knee felt afterwards and whether it settled.
A hot, increasingly swollen joint, severe worsening pain or feeling unwell needs prompt medical assessment. Do not wait for a routine physiotherapy review for those symptoms.
Return with a plan you understand
Before increasing activity, be clear about the next step, when your progress will be reviewed and whom to contact if it does not feel right. The purpose of early pacing is to support a considered return to the activities that matter to you.
Sources and further reading
- Gao et al. (2025): 24-month prospective knee cohort
- Published correction: ethics approval reference
- Arthrosamid instructions for use, October 2025
- Manufacturer rehabilitation resources
General information to support a clinical conversation. AMSK and Professor Lee are part of the MSK Doctors group; group publications are identified above.
Editorial review notes · Preview only
Historical aftercare verified in cohort section 2.2 and distinguished from October 2025 IFU. No published causal evidence found for “physio often causes complications” or a permanent exercise ban.
