Case Report: Knee pain and running

how we did his rehab

A recent patient I had success with in getting back to running was a 31 year old Air Force engineer with knee pain.

The pain got worse when he started training for a half marathon (his training program sucked)

His issue was chronic, been going on for awhile, and he’d have pain at ~ 800m when he’d start running. Also the pain would linger after his runs.

He had no pain at rest unless it was after running.

I’m going to lay out how we treated him and how we got him back to running his Air Force 1.5 mile fitness test without pain.

Assessment

First and foremost this guy was TIGHT. Super tight hamstrings, and really stiff in the upper back.

He was also not very coordinated. He had trouble skipping, and not a lot of control over his body in space. Could be related to stiffness, could just be an general level of dis-coordination

Are you a good dancer?

I ask this all the time. Of course his answer was “no”

The other thing that stood out with his running was something called a “pronatory whip” on toe off.

Basically the heel of the involved knee would rotate, which can cause excessive movement at the knee. Do that repetitively over the course of a long run, and we can see how that can add stresses to the knee joint.

This could be related to ankle or hip mobility.

I didn’t try to specifically address this, but did monitor it moving forward.

His signs and symptoms were very consistent with patella tendinopathy, so treatment would be directed at it.

Here’s a recap of the treatment.

Treatment