Clinical Edge - 179. Patellofemoral pain 3 - Effective rehab that won't flare their symptoms with Tom Goom

Strengthening exercises are a key part of successful patellofemoral pain (PFP) rehabilitation. Squats, lunges and single leg squats are often painful early on and can aggravate your patients pain, but on the flip side, we want to build up their tolerance and confidence with these movements.

If you introduce an exercise your patient isn’t ready for, progress too quickly, or overload the knee too early, you’ll often flare your patients pain and set their rehabilitation back.

In this episode, Tom Goom (Running Physio) and David Pope explore the third pillar of successful PFP treatment: progressive rehab.

Continuing the case of Alice from the previous two podcasts, a HYROX athlete preparing for competition, Tom and I walk through exactly how to choose, modify and progress exercises that build strength, restore confidence and prepare patients for the demands of running and sport, without flaring their symptoms.

You’ll discover:

How to decide when to prioritise load management before introducing strengthening exercises
Why rehabilitation should be tailored to the individual rather than using a “cookie-cutter” exercise program
The key strength deficits Tom commonly looks for in runners with PFP, and how to assess them
How to select exercises that improve strength while minimising stress on the patellofemoral joint
Practical ways to modify squats, lunges and other knee-loading exercises to reduce pain while rebuilding movement tolerance
A simple four-stage progression from low-irritability exercises through to sport-specific strength and power training
How to integrate rehabilitation into a patient’s existing training so they are more likely to stick with the program

Throughout the episode, Tom shares the clinical reasoning behind each exercise choice, showing how to progress patients from simple strengthening exercises to the powerful, sport-specific movements required for running and HYROX competition, without provoking unnecessary flare-ups.

This is part three of a four-part podcast series with Tom Goom on PFP. In the final episode, available later this week, Tom and David explore the fourth pillar of rehabilitation: how to safely progress running volume, speed and training so patients can confidently return to racing and competition while minimising the risk of recurrence.

Timeline:

2:45 - Introduction & Recap
5:20 - When to Start Rehab
7:40 - Assessment Findings
9:37 - Squats to Rebuild Tolerance
12:03 - Psychosocial Screening & Gait
13:11 - Matching Rehab to HYROX
14:57 - Stage 1: Low Knee-Stress Work
17:11 - Stage 2: Loaded Knee Flexion
18:53 - Review Frequency & Goals
21:49 - Stage 3: Knee-Focused Loading
24:09 - Stage 4: Power Work
27:43 - Keys to Avoid Flare-Ups
28:58 - Webinar & 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.

179. Patellofemoral pain 3 - Effective rehab that won't flare their symptoms with Tom Goom

Free resources

Links associated with this episode