Clinical Edge - 178. Patellofemoral pain 2 - What to do when runners won't reduce their training with Tom Goom

Many runners patellofemoral pain (PFP) is aggravated by the activity they love. They either stop running to let their pain settle, and then it returns as soon as they start back up again, or keep running despite the pain getting worse. They may know (and you may have told them) they should reduce their training….but what happens when they can’t? Or won’t?

In this episode, Tom Goom (Running Physio) and David Pope explore the second pillar of successful PFP rehab: education and empowerment. Using the real case of Alice, a HYROX athlete preparing for competition, you’ll discover how and when to help runners continue training safely while building long-term confidence and self-management.

You’ll discover:

Why simply telling runners to “stop running” often leads to poor outcomes
Practical communication strategies that improve patient buy-in and adherence
How to uncover the real reasons patients resist reducing their training
Ways to keep runners connected to the physical and social benefits of their sport during rehab
How to explain PFP without creating fear around “maltracking,” arthritis, or joint damage
A simple framework that patients understand and can use to confidently self-manage flare-ups
How to educate patients about the balance between training stress and recovery to improve both performance and rehabilitation
Practical load management strategies for runners with symptoms so irritable they can’t tolerate running yet

Throughout the episode, Tom demonstrates how education isn’t simply about explaining a diagnosis. It’s about helping patients understand their pain, make better decisions independently, and confidently adjust their training as symptoms change.

This is part two of a four-part podcast series with Tom Goom on PFP. In the next episode, Tom and David dive into the third pillar of rehabilitation: how to choose and progress strengthening exercises that build capacity without flaring symptoms, while avoiding the common rehab mistakes that slow recovery.

Timeline

00:00 - Introduction
02:42 - Case study: Recurrent PFP and HYROX load
09:22 - Subjective clues
11:57 - Barriers to recovery
13:48 - Offloading when the knee can't tolerate running
17:12 - Helping patients understand and self-manage
23:48 - Self-management approach
27:11 - Stress, recovery and progress
28:47 - Key takeaways & free resources

Free resources

Running injury assessment sheet — Tom's go-to assessment sheet for every runner, giving you the structure to gather all the key information you need. It includes his screening questions for past medical history, a weekly training structure block, the key physical tests he performs, and a QR code to an energy availability questionnaire.
Free “Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)” — Join Tom's free webinar to see his assessment and treatment in action, with visuals of the assessment tests, gait assessment and the traffic-light and sweet-spot approaches, plus the exercises, evidence and best-practice guidelines behind treating patellofemoral pain.

Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs.

178. Patellofemoral pain 2 - What to do when runners won't reduce their training with Tom Goom

Free resources

Links associated with this episode