178. Patellofemoral pain 2 - What to do when runners won't reduce their training with Tom Goom

Patellofemoral pain management in athletes requires a collaborative, team-based approach that prioritizes patient autonomy over rigid training cessation. Rather than mandating rest, clinicians should work with patients to identify manageable activity levels, using "traffic light" systems to empower self-regulation. Addressing the psychological and social significance of exercise is critical, particularly for athletes who rely on sport for mental well-being. Reframing clinical terminology—describing the knee as "irritated" or "sensitive" rather than "degenerated" or "maltracking"—prevents negative patient beliefs and fosters a positive outlook on recovery. For instance, modifying training sessions through "movement snacks" or alternative exercises, such as arm-only rowing, allows athletes to maintain cardiovascular fitness and social engagement while providing the knee necessary recovery time. This strategy ensures that load management remains consistent with the patient’s long-term goals and prevents the deconditioning associated with total inactivity.