Lengthy lay-offs are not exclusively confined to sports stars at the very top.

There comes a time for everyone that, despite the best efforts of rest, rehab, physios, that the only option is surgery.

In the early phase of my career, telling people that I couldn't help them and that they would require surgery for the injury which they came to see me with was difficult.

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That was until I began to realise that giving my patients that firm and solid advice as to what to do next was actually what most wanted - even if that was to explore the options of surgery.

When it comes to injuries like ACL or cartilage tears of the knee, snapped ankle ligaments or even back pain which is so severe that runners have to put the trainers away and cyclists can't sit in the saddle, surgery is often inevitable.

Most injuries I diagnose in my physio room have an external cause - when you would be stopped from playing the sport that you love by an injury that has had nothing to do with sport.

A back problem, such as a disc bulge or a slipped disc, is often caused through genetics or poor sitting posture.

If you spend all day sat at your desk with bad posture you are effectively squashing the discs at the bottom of your back.

Then you hit the saddle, head for a two-hour bike ride, and the added pressure and exertion of climbing hills or adding speed can place so much force through these discs they bulge and cause pain.

If you're a footballer sitting in a bad position at work then bouncing on the hard surface of a five-a-side pitch, it's possible that this type of back problem could occur.

But it isn't the twisting or turning that's caused the problem, or the sitting in the saddle for two hours on your bike, it's the eight hours spent sitting which is the real problem.

A disc problem that requires surgery doesn't have to be the end of your sporting days.

One of the most famous cases of spinal surgery in the Premier League happened to former Birmingham midfielder David Dunn.

His back problem was so severe that spinal surgery was the only option to cure the problem and resulted in a 12-month lay-off from the game, but five years later Dunn is still able to play 30+ games per season for Blackburn.

More locally, one of the physios at my Guisborough clinic, Samantha Dakers, had surgery aged 18 for a slipped disc in her back that was carried out by the North-East based, world renowned surgeon Dr Manoj Krishna.

He is the go-to surgeon in the North-East for advice on back and neck pain, which is so bad that it is severely restricting the things that you want to do in life.

Since surgery Samantha has returned to pursue a very physical career in physiotherapy, runs her own pilates and fitness classes and regularly runs the Great North Run and events like the Race for Life in Hartlepool.

Mr Krishna has a brilliant website, spinalsurgeon.com, which gives very practical and personal advice as well as information on his open meetings and coffee mornings where you can go along and speak to him and other patients.

Surgery is a lot more common than you might think. The most important thing is to get the correct diagnosis and ask the right questions. Once you get that, surgery is the easy bit.