179. Patellofemoral pain 3 - Effective rehab that won't flare their symptoms with Tom Goom
Release Date: 07/08/2026
Physio Edge podcast
Patellofemoral pain (PFP) rehabilitation doesn’t end when your patient gets stronger. The real challenge is getting them back to running, training and racing without triggering another flare-up. In this final episode of the four-part series, Tom Goom (Running Physio) and David Pope explore the fourth pillar of successful PFP rehabilitation: a planned return to running. Continuing Alice’s journey from the previous episodes, a HYROX athlete preparing for competition, Tom and David break down exactly how to rebuild running volume, progress training safely, and help runners hit their goals,...
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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:...
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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...
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Patellofemoral pain (PFP) is one of the most common running injuries, and the high recurrence rate can make it a frustrating injury for patients to experience and clinicians to treat. In this episode, Tom Goom (Running Physio) and David Pope break down why PFP has such a high recurrence rate, and what most rehab plans miss. You’ll also discover: The "Four pillars" framework Tom uses to treat PFP and other running injuries How and when to keep patients running or exercising when it is essential for their mental health and social life How to find a manageable starting point when a...
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Anterior hip pain is often blamed on the hip flexors, but in runners, that’s rarely the diagnosis. So how can you identify the real cause and guide patients to a safe, effective recovery? In this episode, Tom Goom (Running Physio) explores the function of the hip flexors in running, key differentials for anterior hip or groin pain, and practical rehab strategies you can use right away. You’ll discover: Why true hip flexor tendinopathy is uncommon in endurance runners Red flags and key tests to identify bone stress fractures and intra‑articular pathology Early‑stage loading strategies...
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Your patient presents with shoulder pain, and straight away you need to identify: Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is it rotator cuff related shoulder pain, frozen shoulder, instability, or something else entirely? Is the pain actually coming from the shoulder? Could it be the cervical spine? Is there a tear that needs urgent referral? Should you order imaging? Refer to a surgeon? Or confidently continue with rehab? In this podcast, Jo Gibson (Upper Limb Rehabilitation Specialist Physio) guides you through a simple,...
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Your patient is running, playing sport, or jumping or lunging forward - an activity with fast eccentric or concentric activity in dorsiflexion,and suddenly they feel like they’ve been kicked in the back of the leg. They might hear a snap and have difficulty weightbearing, walking and pushing off. What’s your likely diagnosis? You picked it - an Achilles tendon (AT) rupture. AT ruptures are a devastating injury that can drastically impact a patient’s ability to walk, run, or return to sport. Despite their frequency, there’s a lot of uncertainty among clinicians, patients, and even...
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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
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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.
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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.
Click here for your access, or login here if you're a Clinical Edge member.
Links associated with this episode
- 178. Patellofemoral pain 2 - What to do when runners won't reduce their training. Physio Edge Track record: Running repairs podcast with Tom Goom
- 177. Patellofemoral pain 1 - Why it has such a high recurrence rate, and what most rehab plans miss. Physio Edge Track record: Running repairs podcast with Tom Goom
- Download your free running injury assessment sheet
- Register for the free “Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)”
- Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom
- Click here to download your podcast handout
- Improve your confidence and clinical reasoning with a Clinical Edge membership here
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