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. Chapters: 00:00 Introduction and recap 02:34 When to start rehab 04:55 Assessment findings 06:51 Squats to rebuild tolerance 09:17 Psychosocial screening and gait 10:13 Matching rehab to HYROX 12:11 Stage 1: low knee-stress work 14:25 Stage 2: loaded knee flexion 16:08 Review frequency and goals 19:00 Stage 3: knee-focused loading 21:23 Stage 4: power work 24:40 Keys to avoid flare-ups 26:12 Webinar and resources