What is the ‘ideal’ exercise programme?

Here's a great beginner workout for anyone looking to improve their strength and mobility with a few simple circuits. All from the comfort of your own home! There are four circuits in the programme: Upper body Lower body Core Balance Simply click on the workouts below to download or print them.

What is it? This is a common condition, often described as the most prevalent overuse injury of the knee. Symptomatic pain arises behind or around the kneecap, also known as the patella, and is likely to have a gradual onset rather than result from a single incident of injury. Pain is likely to be associated with activities like squatting, running, using stairs, and potentially any movement where the knee is loaded in a flexed position, though it can also occur with prolonged sitting with the knees bent. Patellofemoral pain is a clinical diagnosis reached by excluding alternative and more specific conditions (e.g. patellar tendinopathy, bursitis, osteoarthritis). What causes it? There are likely to be signs of reduced muscular control and strength that are believed to contribute to biomechanical impairment of the patellofemoral joint. However, given the slow onset of pain and its potential to then become persistent, like other overuse injuries, symptoms can be complicated with a growing belief that the condition is worse than it is (‘catastrophisation’) and fear avoidance (‘kinesiophobia’). This introduces the need to consider and resolve aspects of pain sensitisation and wider psychological factors to successfully treat the condition. Rehab There is a body of high-quality evidence showing the effectiveness of combining knee and hip exercises in the treatment of patellofemoral pain syndrome. In the short-term, patellar taping, foot orthoses (to counter biomechanical issues, for example, relating to excessive rear-foot eversion and mid-foot pronation), stretching, and some hands-on therapy may be useful for reducing pain. These are not, however, believed to help beyond the short-term and exercise is currently seen as the critical element in a treatment programme. Similar to other conditions described as overuse injuries, the complete avoidance of pain-provoking movement and a ‘wait and see’ approach are not seen to be effective at improving pain and function. Summary Often referred to as an overuse injury, rather than the result of a single incident. Pain can be felt behind or around the kneecap. Pain can be associated with running, squatting, using stairs and/or prolonged periods of sitting. It is important to speak with a therapist about strengthening the muscles around the hips and knees. The therapist will also assure you that complete rest is not the answer and movement is both ok and vital.

What is it? A painful overuse condition presenting as lateral knee pain, often brought on by running or cycling. The iliotibial band (ITB), is a thick area of fascia (connective tissue) which runs from the lateral aspect of the pelvis and inserts into the lateral aspect of the tibia. There is some debate as to which tissues are affected, however it is thought that the tightening of the muscles around the hips, results in the ITB becoming taught, which in turn creates pressure upon the lateral tissues around the knee. Typically the pain will feel sharp, and may appear at the same point or duration of the run, walk or cycle ride, it may feel like the tightness is building and forcing the individual to stop. The pain may also come on during a squat or walking down stairs. What causes it? It is very important to understand that there isn’t an issue with the tissues of the knee. The pain is being caused by the pressure being placed upon the tissues below the ITB, not the tissues themselves, rather like pressing down upon a bruise. Rehab Your therapist will need to know what activities you have been undergoing and how this may have increased, or changed since you began experiencing the pain. With this information it will be a case of load management or bringing any changes, such as hill running back in slowly. Filming your running gait is a useful tool, this may show you and the therapist that there are some movement patterns which are leading to the pressure build up. Running drills and/or strengthening exercises will then be offered as a treatment. Most importantly though, don’t stop running! ITB syndrome can be painful, however pain doesn’t always equate to damage and speak with us at ParnellHarper about your running programme and how much the knees are being loaded.