Pattellofemoral pain syndrome

Patella mal-tracking means the knee cap is not properly aligned on the knee joint.  The pain is most likely to behind the patella and/or surrounding the patella

This sympton should not be confused with pain that occurs directly on the patellar tendon (patellar tendonitis).


Muscular imbalance, the patella is checked in place only by muscles, if one is too strong or too weak the patella does not sit on its proper location.

Sometimes the problem may arise from Bio-mechanical origin like foot pronation

Treatment prevention:

Quadriceps balanced strengthening plays a significant role in patellar movement.

Hip, hamstring, calf and iliotibial band stretching & strengthening.

Joints  alignment

Compare to walking, in running the ground reaction force is equal to 2.5~3 times your body weight.

The force is equal to the impulse divided by the impact time

If you run with straight legs, the impact time is short, so the force on the knee is large.

Athletes who with bent-knee after impact have longer contact with the ground so the impact time is longer, hence the forces on the knee are smaller.

Keep your hips strong and balanced as they are your body corner stone of in running

Strengthen according to your run style and event, with your physiological needs in mind. Speed runners have different requirement than long distance runners.

Stretch to improve movement.

Enhance control by using specific drills to challenge your body and keep your running form.

Achilles tendinitis

Most commonly occurs in runners who have suddenly increased the intensity or duration of their runs.

RICE (Rest, Ice, Compress, Elevate)

Deep massage

Stretch, strength, assesses running technique and equipment.

The hamstring has three primary actions in the running stride

Extend the hip (but weakly, unless you’re sprinting) in push-off.

 Lift the leg upward in the drive phase.

Slow the foot at and before initial contact. It counters balances the action of the quadriceps.

The primary reasons for hamstring tightness and dysfunction in athletes

Compensatory overuse as it fights to keep the quadriceps action under control.

On the same token over-lengthening of the hamstring will result with the same problem.


Stretch, strength, balance muscle action preferably with eccentric exercises as they mimic best the action of the hamstring in running.

Deep tissue massage may also be necessary to dislodge any muscular tension.

Plantar fasciitis (inflammation of the sole of your feet)

The plantar fascia looks like a series of fat rubber bands, made of collagen, a rigid protein that’s not very stretchy.

Drastic or sudden increases in mileage.

Poor foot structure.

Inappropriate running shoes


Foam roller, golf ball, ice bottle rolled with pressure under the sole of the feet

An assessment of your running technique may be crucial to limit the problem.

Iliotibial band syndrome ( ITB )

 the ITB is a thick layer of fascia running from external side of your hip to your knee. The pain is often located on the side of the knee.

Wearing worn-out shoes.

Running downhill or on banked surfaces.

Running on track in the same direction.

Running too many miles.


Cross train to avoid losing your fitness level and limiting inflammation due to repetitive movement.

Strengthen and stretch appropriate muscles

Massage to break away adhesion and loosen tight fascia


To be successful in your rehabilitation process, apply the same rules you would follow in your sport.

Commitment, to yourself, your coach, your teammates.

Frequency, key to success, but do not over look rest period.

Application of knowledge no point learning if you do not apply, everybody can run, how many of us do run with proper technique?

Patience recovery may take time; your body is life time investment.

Be pro-active for long term injury prevention, learn from past experience and study how to balance the negative side of your sport.

The butterfly effect

A small change at one place can result in large differences in a later state. We believe that minor injury if not addressed can lead to major problem on the long term.

Franck Coubard

BSc Physiotherapy, BSc Sport Science and keen golfer.

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