As an osteopath, I pick up the pieces when someone has suffered an injury and needs rehabilitation.
I hear all sorts of explanations as to how patients have hurt themselves.
'I broke my wrist falling off a ladder doing DIY', 'I put my back out playing golf', or, 'I turned my ankle in the shower'.
These are all valid reasons. But are they true...?
Because what I'm now hearing more and more often is, 'I did it having sex'.
In fact, at my clinic we've seen a steep rise - a four-fold increase in the last five years - in middle-aged clients who've suffered a nasty mishap while in an amorous act.
It used to be that injuries associated with sexual activity accounted for a small percentage of the non-sporting cases we treated - around 20 per cent.
But in the last five years that's now increased to around 80 per cent. It's a significant jump, and quite surprising.
Most patients are men, roughly in their mid 50s, but we do see women who've experienced such injuries, too.
While the reasons for the spike aren't immediately clear, it's certainly something to be aware of if you do enjoy a healthy sex life.
When it comes to sex, we see everything from neck injuries to wrist fractures, ankle sprains and, of course, back problems.
Hernias are common, too, close to where the adductor muscles of the pelvic region become strained.
With the back, we see everything from facet joint locks - where the back spasms and locks in a particular position - to full-blown disc prolapses and sciatic pain.
As a practitioner, it's my job to explain to the client why their preferred sexual position, combined with any current or past injuries, might be causing acute injury exacerbated by repetition.
It's impossible to say whether there are actually more of these injuries taking place.
The increase in self reported sex-related injuries is a positive trend in my business, because it shows the patient-clinician relationship is based on real trust.
I suspect that there's a new willingness to admit the cause of the injury, rather than a patient simply lying and saying, 'I did it while fishing...'
And that's a good thing indeed.
Honesty can make the difference between someone being treated for two or three weeks, or being treated just once or twice to completely resolve a condition.
Being armed with all the facts gives us an appreciation of the mechanical stresses the patient is putting on their bodies during those activities.
While people might find it hard being open about their private lives, for us there's no real difference between someone rolling over their ankle while playing squash or rolling over it in the bedroom.
If a practitioner understands how it happened, we have a much better understanding of how to treat it and then rehab it properly.
It's only when there's a full appreciation of the situation that a remedy can be found. That's the secret, particularly in complex cases.
And it's rewarding for me personally - if people are comfortable opening up to me, and they'll listen to my advice about things which are clearly personal, I'm doing my job properly.
Here are my tips on treating and preventing sex-related injuries:
Identify the cause
The first thing we do is advise patients to avoid whatever sexual activity caused the injury in the first place, or at least to avoid that particular position. If they're honest about what happened, we can educate them on the best positions for the future to minimise the strain on that particular body part.
One of the most common causes of sex-related injuries we see is where couples have slipped in the shower, so it's important to make sure that your environment is safe. You may want to invest in a bath mat.
It's not just shower slips you need to be wary of. Any sexual position that involves 'lifting' to any degree poses a danger in terms of both falls and muscle injury. For example, one patient we saw had suffered a neck injury after their partner had accidentally fallen on his head during sex. Advice on lifting and bending is also invaluable when dealing with injuries like this, too. Positions involving any form or kneeling, standing, or hovering also put strain on the lower back and lead to injury.
For a broken wrist, a patient will be scanned, casted or put in a splint to immobilise the area, and they'd be referred for surgical consideration if the injury is serious. We also sometimes use laser therapy or oxygen hyperbaric chambers, which exposes the body to 100% oxygen at a pressure that is greater than what you normally experience and which can speed the healing process.
Don't be shy
Be honest about what's happened if you do seek treatment for a sex-related injury. Women tend to be more evasive, whereas I've found men are much more open and honest. Being honest will improve your chances of recovery as a clinician will be better able to pin-point the precise problem.