"My knee hurts when I run. I haven't directly injured it, it's just agony when I run and I feel like I don't have confidence in it."
This is a very common scenario. When we experience pain that is not a result of direct trauma, then we have to look at the whole body to understand why pain has started in this area.
This is very important, because we can treat the pain and make it go away; but if it is not the primary cause then it will soon return.
This was the case for a runner I saw recently. He was experiencing severe pain in his right knee but had no clear case of acute injury.
Whilst exploring his history, we found that he had suffered a severe inversion sprain in his left ankle. This injury meant that his body did not fully trust his left side and therefore could not fully load it as he ran.
This was clear to see when observing his gait, because he could not shift his centre of mass to the left.
If the centre of mass cannot fully pass to the loeft, this means the right leg can never fully be unloaded. This is the cause of his right knee pain.
With the ankle inversion sprain corrected we introduced Left Strike and Right Shift, Elements of Gary Ward's Flow Motion Model, to restore this missing movement. This allows the pelvis to shift fully to the left kand unload that right leg, giving it some much needed breathing space.
We then treated the Quad Tendon and the Patellar Ligament, to ease the pain at the right knee.
For homework he we will have to strengthen his right side Quads and practice the left Strike, right shift phase of gait (as pictured) to ensure this is locked into his running pattern.
Always explore both sides of the coin. What is here but also what is missing?
Where is the pain but what movements can we not produce?
Don't just go after the pain, ask why it is here.