Runners Knee and Obesity | E18 with Amanda Schennato

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Runner’s knee refers to a bunch of different conditions that cause knee pain in runners. However, it is most commonly used in reference to patellofemoral pain. The patella is the kneecap and the femur is the thigh bone. The articulation (joint) between them is the patellofemoral joint. Pain coming from this joint is usually experienced as if the “back of the kneecap” is hurting or as a diffuse (general) pain around the front of the knee. For this reason, it is also sometimes referred to as anterior knee pain.

Unfortunately, many runners are very familiar with this problem. We have quite a bit of research to guide us in the rehabilitation of this condition. Most of the research focuses on load management and strength exercises. However, I recently came across a study that suggested we should also consider whether a higher BMI (body mass index) or obesity could also be a factor.

The lead author of the study joins me on the podcast today to discuss her research and her other thoughts on the management of patellofemoral pain (runner’s knee).Amanda Schenatto Ferreira is a Physiotherapist and Ph.D. Candidate focusing on biomechanics and patellofemoral pain at São Paulo State University in Brazil. She recently published a paper entitled Overweight and obesity in young adults with patellofemoral pain: Impact on functional capacity and strength.

Follow Amanda:

• Instagram: @amandaschenatto
• Twitter: @amandaschenatto
• Facebook: @amanda.schenatto.3
• ResearchGate: Amanda Schenatto Ferreira

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In this episode we discuss…

• What is Patellofemoral Pain?
• Obesity and Knee Pain Running
• Female Runners with Knee Pain
• Strength Training for Runner’s Knee
• Lunges for knee pain!?
• Is knee creaking bad?

Music By The Passion HiFi

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changes runners can improve their
patellofemoral pain
so if you are a runner with patel
formula pain some chips
some tips such as do not make running
your own
activity go also to the drink to the gym
twice a week is very important and
another important thing is to avoid
running
downhill when the symptoms are bad
because we know that it’s very stressful
for the kneecap
and lastly when you are increasing your
training load
only change one thing at a time so
increase your speed running and the
running duration at the same time for
example
each week only add one thinking to not
overload the the system
but um could you i mean could you
introduce yourself to the listener and
then
just tell us a little bit about you and
your work and what you’re up to
yeah sure well um i am
amanda scanato fajita i am a phd student
from sao paulo state university um
actually i am almost finishing my phd
and the main topic of my phd
is the impact of overweight and obesity
in patel from roping so my my research
is mostly
about patellofemoral pain and
i have some collaborations with people
from
la trobe also my co-supervisor is
working there right now
his name is danilo de rivera silva
yeah and also my supervisor in brazil is
fabio nicholas jason
so yeah we work a lot and we research a
lot about patel formula pain
and my phd is specifically about
overweight and obesity
in patel from rope i’m glad you said
your name in the introduction as well
like because i’m going to go back
and listen to that and then practice uh
pronouncing it before i do your
introduction
on the on the show so because i was
reading and i was like i’m not going to
say it until she says it because i’m
going to totally butcher it
and so just for the listeners i mean i
think most would know what
patellofemoral pain is but could you
just describe it for you know someone
who’s never heard that term before what
it is
yeah sure well um patel from propane is
a pain in front around or behind the
kneecap
so it is any condition very very common
in adolescents and young adults there
are physically active or
two sports so uh people who have patel
for no pain
usually don’t know exactly how the pain
started
and because it is not linked to any
trauma
traumatic event like an acl
rupture for example so the
the pain is often linked to movement
like a patient will say oh um it’s
painful when i go up and down the stairs
or
when i walk or run long distance so
this is the typical presentation of a
person with metal from roping
and how does it you know how does it
feel
you know if you i don’t know if you’ve
ever had patellar thermal pain i’ve had
it a little bit
um over the years like it comes and then
it goes away and
it’s never really been a problem like
where do you feel it and like does it
is it really sharp does it come on like
gradually does it make you like hobble
and and not use your leg at all like how
does it feel
yeah usually uh it is uh the pain is
gradually
increasing and there is moments that the
pain are there and moments
that the pain are not so and
it’s very very related with movement so
maybe some people suddenly
increase their levels of running for
example
and then started to feel pain so
the pain is very um diffused so maybe
in front around behind the the bacteria
than it can
so yeah usually it’s something like that
yeah and i think that’s uh helpful for
the listener
um because it’s not like like if you’re
sitting on the couch or
in bed at night you know if you have
patella felt no pain it’s not going to
be hurting then
almost certainly it’s really like you
said it’s with movement it’s with
with walking with running with stairs
with getting up out of a chair like that
kind of stuff it’s
it’s when you’re using your knee right
yeah right
some people uh uh actually feel pain
while they are sitting for a long time
oh yeah
yeah yeah but usually very very usually
is like
when they do something some movement
with knee flexion
and weight bearing so yeah yeah and um i
don’t know if this is true
in brazil but in um in canada in the uk
we sometimes call patellofemoral pain
runner’s knee and i know that becomes a
little bit of a
an umbrella term because some people use
runner’s knee to refer to lots of
different knee pains but
um most commonly i see it used um
referencing patellofemoral pain is that
is that the case in brazil do you have
that term as well
yeah yeah we have uh other umbrella
terms
it’s very common like patellofemoral
pain syndrome or
chondromalacia yeah we have other temps
but
um at the last consensus about
definition
we the the the name the the better name
to that is but happens here in brazil
too yeah
yeah yeah because it became a syndrome
here and i think syndrome has gone out
of fashion now it’s not it’s more pain
i don’t know right yeah
yeah so and then yeah you did some
research uh the first study i came
across i was just mentioning um but that
wasn’t specifically on runners that was
if i’m remembering correctly that was
more on like adolescents like youngsters
who did all kinds of sports is that
right
yeah it is right this was um
well i participate in the study backing
my master’s degree
and yeah i study about adolescents who
do
sports and they have hotel female pain
and they also have many uh alterations
compared to
adolescents who do not have patel
formula pain yeah
but my my focus now is in young adults
with patel from rope
like 18 to 35 years in young what
uh young girls with patel from obeying
is my focus
what’s a coward sorry
you said young carrots i think
uh no young adults young adults sorry
sorry my pronunciation is not so good
it was fine it just i thought you were
switching to a
like a brazilian word that i wasn’t
familiar with
okay so young adults with their
telephone will play though
it’s okay we could edit that out oh we
can leave it okay
um and then okay so uh and that was the
the most recent
study i think you were looking at um the
influence of obesity or being overweight
on
on how patellofemoral pain behaves is
that correct
yeah it is uh well as
a society it is a common sense that
being overweight or obese
is not good for our general health right
and well it increased the risk of many
physical
and mental health conditions but uh
most of the research in patel former
pain so far
where in young people physically active
like runners
cyclists military or recreational
sports population so uh this motivated
our research team
to explore what happens with people with
patel from propane that are not
so active like the ones that are
overweight
our rvs ah okay and then
so what did you do in the in your most
in your most recent study that looked at
um obesity and i
don’t know what you call it being
overweight and yeah
yeah well our main questions uh
in that study are how will they compare
with
young physically active people that also
have patel from roping
and will they have a worse or a better
clinical
condition and outcomes so to answer
these questions we
we did a study aiming to first
investigate the proportion
of people with patellofemoral pain that
are overweight
or obese based on their body mass index
and then if being overweight are obese
have
any impact on physical function and the
inhibit
strength of people with metabolism and
uh
for this we recruited 100 young adults
with patel pheromone pain
aged 18 to 35 years
from the the general community and then
we conduct
assessments of bmi uh body composition
such as
body fat muscle mass and also some
functional tests and knee and hip
strength
yeah i mean that’s quite a quite a big
study there a hundred people that’s
that’s
quite impressive because i’m used to
reading a lot of studies on runners when
you know 30 is considered a good number
so
what how how did you decide you needed a
100
or did you need 100 you know what was
the thinking behind that
yeah well we uh how because we are
trying to
uh investigate the proportion of
overweight and obesity we try to
recreate as most people as i can with
metallica
so yeah this is why we we we reached
that number
and then so all 100 of these people
these youngsters they had patellofemoral
pain they had this knee pain that you
described this sort of diffuse knee pain
that comes on with activity
yeah correct all they have
and well the main findings uh we found
that from this a hundred people with
patel thermal pain
included in our study 62 percent
uh were normal weight based on their bmi
24 overweight and 14
were obese so this indicate that a large
proportion
almost 14 of young adults with pfp
are overweight so right okay
yeah so when you take a group of of
people who have patellofemoral pain
an unusually large amount of them have
are also overweight and i don’t know if
you looked into this when you were doing
your
preparations but is it is being
overweight like a risk factor for
getting patellofemoral pain or
do we not know that yet no well in
our study we we did not investigate that
it was a cross-sectional study
so but there is some studies about risk
factors for patel formula pain
the relationship between bmi and
the the onset of patel formula pain in
active populations so runners
the military is very common and we do
not find
an association between being overweight
and develop patel from european in the
future in this in that population
ah okay that’s interesting yeah and so
what are we what do we what did we learn
from your study on these
um 100 people because you took some
measurements of the different um
you know how much how many how much
how to what extent they were having
problems but then they
you looked at their strength and some
other things and what did you learn
was the differences between those who
were overweight with patellofemoral pain
and those who are um i don’t know what
you would call it
regular bmi yeah
they interestingly um people who have
a higher bmi and higher body fat and
lower lean mass
also presented reduced strength reduced
knee and hip strength
and poor functional capacity so uh
in other words the higher the body fat
and the lower the muscle mass
the worse the function and strength of a
people
a person with metal female pain and how
did you measure
function what what do you mean by that
uh well we
we do uh two functional tests the the
plank test so
the uh yeah just a
simple plane test also the the single
leg hub test
so the distance that they could
hop and with uh one leg yeah
and so from that we’re sort of inferring
how capable they are with other
tasks like sports and and activities of
daily living because
these are sort of general functional
tasks and if they’re struggling with
those they’re going to struggle with
other things as well is that the
thinking behind that yeah well we also
apply a questionnaire about
self-reported function so in discussion
are we
we have some general questions about
about function in different activities
so yeah maybe we can generalize but
uh i we only assess functioning this
two class two functional tests and with
a questionnaire
yeah okay and what kind of ques things
does the questionnaire
ask the the subject
uh well if people have knee pain when
up and down stairs during running
and if the the knee swelling or not
something like that yeah okay okay so i
think we’ve got a pretty good idea now
that
how you’re determining you know that
their
their function or their how much they’re
affected by the knee pain is is worse
amongst the the youngsters with
um who are also overweight
yeah and you also mentioned lean i think
you said lead muscle mass
um is that something else you measured
to look at
yeah yeah we we measure uh lean mass and
we found that lower limas are
are associated with poor function and
reduced knee and hip strength
so not only body fat but also lower lean
mass
were a bad thing for people with fatal
thermo pain yeah
and i think this is i mean that’s what
got me interested in it
it’s not something i’ve ever thought
about before you know when someone comes
in
to to see me in the clinic and they’ve
got patellofemoral pain
i don’t sort of really give much thought
to being overweight or bmi or any kind
of weight management strategies and
but i think that i mean from an
anecdotal perspective a lot of people
get runners knee because they take up
running because they want to lose weight
you know that’s often uh
you know when i ask my clients why do
you like running it’s like well i’m
trying to lose weight that’s a really
common
answer so um that you you’ve also
you’ve got this sort of um double-edged
sword unfortunately where you know the
more they run
potentially the more it hurts um
but you know that so is the takeaway
here that we should be applying
other weight management strategies to
people with
runner’s knee who who present with a
higher bmi is that what you
you think the takeaway is from your
research yeah uh
i think um it is more like a warning
that
we need to look at that and uh
sure more research are needed in this
field because
this findings are very novel uh we don’t
have much
studies about that in patel formal pain
but
yeah i think that it had some light that
we need to look at that and we need to
consider
runners with patel from roping and all
people with photo from european need to
consider
their body composition and bmi because
they uh
it may be detrimental to strength to
function
so yeah i think that is something that
we need to
to be aware yeah yeah and it’s nice to
have it’s almost like another lever to
pull
you know because um if you have got
i mean maybe they’re not trying to lose
weight but it’s like you could you could
draw
people’s attention to it’s like look
people with runner’s knee or
patellofemoral pain who have a higher
bmi
they have worse function they have more
pain they have less
uh muscle mass and they tend to have a
tougher time but uh if we can get the
bmi down potentially
those things would improve and may
lessen the impact of your
patellar femoral pain right yeah right
perfect
we we should not only look to
bmi but we need to look to body
composition
so need we need to reduce our body fat
and
improve our our muscle mass so
um these are our very important
components that we need to
to look at yeah i see so if you had a
very
if you were getting more muscular and
losing fat potentially your bmi
might not show that so what you’re
saying is we have to look a little
deeper body composition you know if we
have a very big
muscly uh runner that that’s not quite
the same problem so
we’re really not looking at high bmi
we’re looking at high body fat and low
lean muscle mass is that is that more
accurate yeah
perfect okay and then is that where
you’re going with this
is that because you said you’re you’re
hoping to finish your phd
soon is that is that what you’re doing
are you branched off in another
direction now
yeah we also investigate more things
about how overweight
and obesity impacts biomechanics
psychological factors and also pain
sensitization so
we have much more thing to to
to understand and to look at and we are
still
in process but yeah that’s a lot
that’s a lot i don’t know if you’re
going to finish a phd soon if you’re
going to do all of that
true are you doing any studies at the
minute i was sort of covered put a
put a bit of a damper on research
efforts currently
yeah well i uh now right now i’m
still working on my phd data so
this is my my focus now yeah
okay so you don’t need to collect
anymore you’ve got the you’ve got the
data to collect it
yeah i finished it and i think you um
like i looked back at some of your other
work and yeah looks like you’ve had a
interest in patellofemoral pain for a
while and i think you’ve done some work
looking at um
women with patellofemoral pain and um
you know their muscular um strength and
that kind of stuff what what did you
find there
yeah well uh back in 2016
i started my uh a master science by
research in vfb
and at that moment we knew that knee
and hip maximum muscle strain were
impaired in women with fetal femoral
pain when compared to being free women
however most of our daily activities
are performed at a fraction of maximum
muscle strain
so we don’t use our maximum strength to
walk
to climb a set of stairs or to run
so we decided to explore other
components
of muscle function beyond maximum muscle
strain
thinking that these components could be
more related to
daily activities so uh the main aim of
my master’s was to explore different
components of knee and hip strength in
people with patelloferal pain
such as power the that is defined as the
ability to
increase force from a low or resting
level as
quickly as possible and also the ability
to maintain a
steady contraction so for example muscle
power is very important for runners
for runners that have to that have a
very short contact time
on the ground and need to generate force
rapidly to keep moving forward
right so uh what what we’ve did i find
uh
we found that women with patel female
pain have deficits
not only in maximal knee and hip
strength
but also in power and in the ability to
maintain
a steady contraction compared to
pain-free women
so they presented deficits in all these
components
of muscle funds yeah that means i never
really thought about that because
people like if we take women with
patellofemoral pain they don’t say you
know it hurts when i
do loads of hops or when i when i
do my you know one rep max squat they
say
you know it hurts when i walk up the
stairs it hurts when i when i run for
five minutes like it’s like you say it’s
not these maximal effort things that are
evoking the pain so it makes sense that
there would be
deficits not only in maximal muscle
strength but in some other
uh factors so is that is that what we
found that you know you
take these women who already have
patellofemoral pain and they have
trouble with like power so that’s like
generating force quickly um as well as
the amount of force they can ultimately
generate
as well as the ability to to hold a
contraction
and statically uh without moving so
their deficits across the board
yeah yeah true yeah that’s it we we
found that
uh women with basal propane have higher
deficits in those components and not
only
maximum muscle strength and
and if we think uh about that
this means that runners with pfp also
need to include some gym
sessions in their training schedule so
strengthening is a really
powerful and important supplemental
training
to runners and at least
twice a week seek some guidance to
complete strength and power
training you know pick up a half dozen
of weight lifting
exercise and no more than that
exercise that focus on your calf muscle
time muscle
also exercise to your hips tensor
muscles
so make it simple work one work on with
heavy weights that you can lift more
than
that you cannot lift more than six to
eight times and keep your training
simple but heavy
so we need to to do some gene
sessions uh with the the
running training yeah so what will be an
example of because you’re a physio as
well right so if you had
um let’s say a woman with patellofemoral
pain and you wanted to
get you know that she’s likely got these
deficits maybe you can measure them or
maybe that that’s just sort of predicted
from
the research what would be an example of
a
strength program she might do i know it
would depend like how bad her pain was
and stuff i just want to give the
listeners some idea of what kind of
exercises we’re talking about and
how often and how heavy kind of thing
yeah well
we as i said we have to to focus
on exercise targeting
calf muscles thai muscles so something
like sweats
and lunges and something like that that
focus on our cough muscles thai muscles
hip muscles like our gluteal muscles
so maybe two two times a
week is important and
yeah i think also the key is to
keep simple no more than six to
six or eight exercises you know
only six exercises are very good
or are okay yeah yeah and
i think that’s um that’s a nice take
home for the listeners right because
we don’t need to get crazy complicated
you know the exercises you just
mentioned so cough exercises right
there’s like a
heel there’s a coffer is and then squats
lunges everybody knows what they are
and then you know maybe some other
things that target your your glutes and
your quadriceps um
you know typical gym exercises and just
keep it simple
and then make it heavy right so you
could you you can only do
six to eight repetitions and if you can
do
if you do your lunges and you can do
like 20 of them while you need some more
weight right
yeah right right perfect yeah and
i think it is important seeking guidance
preparing
their body before start running and
during running it is essential
so it is also important to say that this
preparation needs to be monitored by a
physiotherapist as
it must be individualized for the the
needs of each patient
so for each deficit we need a different
and a specific training so this is a
general
recommendation but we need to to
individualize our training yeah yeah and
i think that’s the thing once your knee
is painful then you really you need some
help with this because if you do a lunge
it might hurt straight away and then
it’s like well what do i do with that
and that’s where
physios or other such professionals can
be really helpful
but you know i guess i didn’t ask and i
don’t know
if this is the case because you took
runners
in this study and you were looking at
women who already had patellofemoral
pain
and do we know if the weakness
that you measured let’s just call it
weakness to keep it simple
is that is that like a a cause or an
effect
do we know did they get the knee pain
because of this weakness or is this
weakness coming on because their knee
hurts now and they’re not using their
leg as much or some other
such thing well uh what we know about
that
is that um weakness in quadriceps
muscles
are is a risk factor for pfp development
uh mainly military and
athletic population and it seems that
uh weakness at the heat are not
so is is more like a consequence
but uh yeah this is all we know about
that
it seems that weakness at the quadriceps
is a risk factor to
vfb development yep so if we if we sort
of put those
together you know we’ve got some studies
that indicate that weakness in your
quadriceps might make you more likely to
get patellofemoral pain
and then we’ve got your work that shows
that women who have
patellofemoral pain have weakness they
have um
they have loss of muscle power and then
as well in your
in your adolescent population we’ve got
a lower lean
muscle mass and lower strength in the in
the people who
have higher um who are
more in the more obesity um in the
in the obese sort of group and they
have worse symptoms so it’s all sort of
indicating that muscle strength around
the the glutes the quads the thigh
the cough is is a big factor when it
comes to
patellofemoral pain and something that
we should definitely be working on if
you have that
problem is that is that a fair sort of
summary
yeah perfect it is true we we
mainly look at young adults
aged 18 to 35 years so all this is true
for
for them we don’t know so much about
adolescence or older populations
so and also the exercise are are the
cornerstone to pfp management so
exercise targeting hip and
are the main recommendation at the
consensus about patel for rupee
so yeah it is the main focus yeah there
was a
i think it was ritually and some of his
colleagues put out some guidelines for
for the american physios um in a in a
sort of um
clinical practice guideline a couple of
years ago and and that was it that was
the main thing it was like the best
evidence says
strength training and various different
kinds has been shown across the research
to be the best
way to help people with this problem so
then it kind of tracks all the way
through right you can see
it can predict it this weakness it can
make it worse when you’ve got it and and
working on it can make things better so
it’s all starting to
we’re getting some sort of evidence and
story that
makes sense which we can which we can
work with right
i guess because something that’s um
i come across sometimes is you know you
got
a runner oh let’s say a female runner
comes in she’s got
pain on the back of my kneecap she’s got
patellofemoral pain and
you know then we’re like okay you’re
gonna do some lunges you’re gonna do
some squats and she’s like
what the back of my d hurts like what
why would i do that
so how do you get around that problem in
the clinic
is it how do you explain that to people
and to help them get on board with this
this plan you’ve got for them
yeah usually when the symptoms are
really bad
we the recommendation is to
start with some hip exercises
and then uh as soon as the
the the symptoms uh come down
we started with knee exercise
yeah so this is a a very strong
recommendation
and and yeah i think that’s it so people
need to understand that the pain will
um we overdose with
exercise so we need to strain we need to
to focus on that
but um we will avoid
any exercise that cause pain so if
people report more than
uh three four uh in a
scale of zero to ten we need to stop
that
exercising and do other
yeah something like that i’m glad to
hear you say that because that’s exactly
what i do with people so
what i often say is you know the trick
here is we’ve got to get you strong
without annoying your knee
so we’ve got to work around it we’re
going to make your muscles stronger but
we can’t the knees
angry so we can’t make it more angry so
we’ve got to work around it and then
it’s just similar to what you just said
we’re going to work away from it
initially and then
move towards it as it calms down and
then
i think that can be a good way because
you know if you give people exercises
that hurt
i mean it’s just common sense they’re
not going to do them after a while um
i mean as long as it’s they do it if it
hurts a little bit
you know like you said one two three out
of ten maybe a four but it once it gets
higher it’s just
it’s common sense you just kind of stop
doing it because it’s like well this is
hurting
um and then i i think i don’t know if
they were
so much um i don’t know how heavily
involved you were but i saw you had some
studies or reviews looking at uh knee
crepitus
um is that right yeah it is uh
well this is such an interesting topic
uh many people with bfb are really
worried about practice can we um just
before we get into it can we explain for
the listener what we’re talking about so
what is crepitus
yeah sure sure uh well first uh this
great body of
res research was led by dr danilo de
oliveira silva that
i mentioned before and but
many crafters in simple terms is
a crackling or popping sound that
somebody’s make when they move
so they’re more common in loading tests
like
running or sweating but we don’t know
exactly
what causes annoy’s knee some research
say
it is due to a buildup or bursting of
tiny bubbles
in the synovial fluid or
snapping of ligaments something like
that so
it is hard to say what causes necrosis
so we focus more on its implications
for people with patellofemoral pain in
our studies
and what did you find is it is it
important is it something to be
concerned about
yeah well uh we found that women with
patel formal pain
are more likely to have necrotis than
pain-free women however 33 percent
of pain-free women had necrotis so
this is not an exclusive finding
of people with nipping but more
importantly uh
is that people with patel formal pain
who have necrotis
have similar levels of pain function
fear of movement and knee strength
compared to those with patel formal pain
without
necraxes so in other words
if a patient has patellofemoral pain and
a necrasis it doesn’t mean their
condition
is worse than those who have patel
formal pain and no knee crutches
so i think that the take-home message
about this
these studies is just don’t worry
about your noisy needs or they are just
noisy yeah
but that’s really nice to hear because i
i get that question
every single time someone has knee
crepitus the the crackling the grinding
they sometimes call it
um and whether these are people
you know who you know they just mention
it because maybe we do some tests and
they’re not there
they’re not in to see me about
patellofemoral pain it’s about something
else that they’re like oh my knees
always grind what is that
like should i worry about that um
and it is like a worrying thing for
people but
i think what you’re saying is yeah it’s
you get if you have patellofemoral pain
your knee can grind or not and it
doesn’t really seem to make much
difference to your overall
outcome yeah it is exactly like that
uh it doesn’t mean that you will have a
worse function or worse clinical
condition
it is just annoying yeah and i don’t
know if we have the research
on this at the minute but do we know if
having that
knee crepitus um is that a bad sign for
the future
people who have that more likely to have
problems or is that something we don’t
quite know yet
yeah we don’t know yet for sure
but uh well if
it is not a problem right now we don’t
think there may be a problem
in the future but we really don’t know
uh about
it because we we don’t have this this
data yet
yeah and i think the um the important
thing to remember for anyone who does
have crackly d’s when they go down the
stairs or whatever is that
you know you said in your studies that
you had people with
knee pain you and they they
yeah you had people with knee pain with
crackling knees and people with knee
pain without crackling knees so it’s
like
it’s it’s not sort of a death sentence
um
you can get to the point where unique
and crackling not hurt you know because
the crackling can be annoying but really
what we’re worried about is the
implication of it doesn’t mean that
we’re having
some trouble in there that’s gonna you
know stop us running or whatever in the
future i think that’s what people are
really worried about and
i guess your take home would be probably
not it’s but you probably don’t need to
worry about it too much
yeah perfect it is right there
okay cool um well i think that uh i
think that’s a sort of nice
positive note to end on is there
anything else you wanted to um
share with us that you’ve learned about
patellofemoral pain that our our
listeners might be interested in just
just before we sign off well uh
i think that although my research is not
specifically
focused in our running population we can
take some
important lessons for for runners so
considering that overweight and obesity
are modifiable factors
and may be detrimental to strain to
function
so runners who have patel for no pain
should consider
this finest and although we still need
more research
in this area it is possible that by
reducing body fat
and increasing muscle mass and strength
pfp symptoms may be improved
regardless of the the physical activity
you do
you know so uh and also although patel
formal pain is
very common in brothers uh the good news
is that
through some changes runners can improve
their patellofemoral pain
so if you are a runner with patel
formula pain
some tips some tips such as do not make
running your own activity go also to the
dream
to the gym twice a week is very
important
and another important thing is to avoid
running downhill when the symptoms are
bad
because we know that is very stressful
for the kneecap
and lastly when you are increasing your
training load
only change one thing at a time so
increase your speed running and the
running duration at the same time for
example
each week only had one thinking
to not overload the the system so
yeah i think that these are my my big
take
homes for for the listeners and for
runners
yeah and i think that’s a very nice you
know evidence-based sort of summary of
okay this is what we know these are the
steps you can make to take to try and
avoid patellofemoral pain and to
rehabilitate it if and when you when you
develop it
is there anything um you know if people
wanted to
uh follow your work is there any way you
would like to point them to
and anything in particular yeah well
first i hope that people find it helpful
and
if you have any questions or want to
know more about my research i am on
twitter
so my twitter handle is amanda amanda
underscore scanado i think you can put
there in somewhere
i’ll put it in the description yeah and
i’ll put a link there so that
people don’t have to remember it yeah
thank you
and so well feel free to to contact me
there
i will always be available so
yeah thank you thank you so much for for
having me
well thank you very much for making the
time for us it was very informative and
keep up the good work we’ll uh we’ll
keep an eye on your reach
research get profile and affair if and
when that phd
is finished we might get you back on to
talk about it and then
yeah best of luck with it thank you
thank you so much
all right thanks amanda thanks bye
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