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 in