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Femoral Chondral Defect 8: The Come Back Club

As one of the UK’s leading London physiotherapists, I regularly write about injuries, treatment and assessment techniques.

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After leaving behind years of early starts in the Army, I’d happily managed to forget that there’s more than one 5 o’clock in the day, so it’s a measure of how much I love Tom Bradley that I agreed to drag myself out of bed at 5.30am in order to meet him for a Come Back Club assessment at 7am on a Friday!

Tom is a physio whose path has run parallel to mine for the past 10 years or so; we’ve always been respectfully aware of each other and share a great many mutual industry friends. So I was super excited when he offered me a month’s trial membership of his Come Back Club.

What’s the Come Back Club?

The Come Back Club is a small rehab gym in Shoreditch. You can fit a maximum of 4 patients in there at any one time – three of them following their own programmes, and one having an assessment or supervised session. They have an app so you can book your own individual training times, meaning the space and equipment doesn’t get overloaded.

As a veteran of small group-based rehab programmes in the military (I spent a lot of time at the residential Defence Medical Rehab Centre at Headley Court, both as staff and as a patient after my shoulder surgery in 2005, and set up a local version when I was head of physio for British Forces Cyprus) I’m a huge fan of the social side of rehab – patients being able to meet, share stories, and provide mutual encouragement and support. And Tom’s clearly got this spot on: the camaraderie between the three other patients in the room was palpable.

I’m strong (ish!)

We started with an assessment. My issue is the left knee I injured in 2022, for which I subsequently underwent surgery in 2023, so Tom focused on leg strength. He used a dynamometer to measure and compare the strength and power of my quads, hamstrings and glutes in a variety of positions, and then force plates to measure symmetry and power on squats and jumps. We are in agreement that the testing process is more “good enough” than functionally spectacular; but it is safe, provides some reproducible outcome measures, and stroked my ego by reporting that my quads strength was in the 88th percentile and my hamstring strength in the 92nd! (I’m glossing over the rest!)

Training with Tom

Then the actual training started. Tom is a fan of combining blood flow restriction (BFR) techniques with electrical muscle stimulation. The idea is that your muscles very quickly feel as though they’ve had a super intense workout, with fast strength gains, but without overloading your joints. It didn’t hurt my knee at all, but my muscles were screaming at me as Tom, the smiling sadist who knew exactly how much I temporarily hated him, teased me into going through a series of squats, bridges and calf raises. Walking around the gym, while wearing BFR cuffs around your thighs, looks and feels ridiculous – I felt like John Wayne and Tom calls it the Come Back Club swagger – but everyone’s in the same boat.

And then it was over, and I felt surprisingly light and remarkably unsweaty, considering the lack of air con (then again, it was only 8am!)

So what’s next?

I’ve signed up for a month’s trial package, aiming to go 3x per week; but based on today’s experience I am hugely impressed. Not only am I already working out which of my patients I think will be a good fit for it once they’re past the early stages of physio – but I’m feeling optimistic that building up my strength is the next piece of the puzzle for my own rehab to get back to playing and enjoying tennis!

The Come Back Club is based at 26 Phipp Street, Shoreditch.

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Many people assume that stiff or sore knees is an inevitable part of aging. 

I’m here to show you that doesn’t have to be the case!

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