Knee Pain

Have you ever suffered from knee pain?  You are not alone.  In fact, knee pain is one of the most common types of musculoskeletal pains in athletes. 

Typically, knee pain present on the front of the knee, under and below the knee-cap (patella), this is commonly referred to as patellofemoral pain or runner’s knee, accounting for 25% of knee pain in most athletes.  For example, in a sample of 1500 runners from the SunRun patellofemoral pain was the most common source of runner injury.

The pain can present with many different kinds of activities, some of which are:  sitting for long periods, running, jumping, and especially squatting.

What causes knee pain?

There are two general categories of factors that play into knee pain (1) factors below the knee and (2) factors contributing above the knee.

(1)    Numerous authors have explored the relationship between excessive or prolonged foot pronation during sports and increased stresses at the knee.

(2)    Hip abductors and external rotators of the hip (turn the leg outward) are weak and cannot stabilize the knee and direct forces going through the knee joint appropriately

How do I fix it?

Some evidence-based interventions for patellofemoral knee pain are:

1)      Protect, rest, ice, compression, and elevate

2)      Manual therapies and soft tissue therapy/acupuncture

3)      Hip stability exercises and core stability

4)      Kinesiology taping for short term

5)      Foot orthotics and knee braces for short term

6)      Anti-inflammatory creams such as Traumacare


Patellofemoral knee pain can be difficult to manage, it can become a chronic condition that may fail to respond to conservative care.  If you are struggling with consistent or chronic injury consult with a qualified practitioner such as your chiropractor, physiotherapist, or medical doctor. 


Be active, be healthy, and be injury free.  Cheers! 😊

 My favorite homeopathic pain relief cream:

Return to Running

How do I tell if I am ready to return to running after an injury? Most athletes will use the presence or absence of pain to assess whether they have healed completely.  Using pain as a sole outcome measure can be detrimental.  A more robust and detailed tool that assesses the runner’s biomechanics, pathomechanics, function, and pain is needed. 

The “running readiness scale” developed by Dr. Blaise Williams is a great tool to assess whether or not an individual is run ready.  The running readiness scale consist of five tests, all of which are one minute in duration and a 30 second rest between each exercise.  The five-step test is quite intense, it stresses many of the major muscles and tissues a runner will use.  It seems to be a simple, yet effective tool, that can confidently predict if you are ready to return to running.

The tests are as follows:

1) Hopping on both legs at 160 beats per minute tempo at 4 inches’ height
2) Plank (on elbows)
3) Single leg squats at moderate pace (30 seconds each leg)
4) 6-inch stair step-ups (leading with right leg 30 seconds and vice-versa) at a fast pace
5) 90-90 squat position with a Bosu-ball behind the back against the wall (held statically)

The runner must pass all five portions of the test.  Any significant loss of form, compensation, or pain is a fail.  If a runner is to fail this test its best to continue to rest, rehab, cross-train, and consult with their health professional. If you pass the test, remember to gradually ease your way back into running.

If you have any questions or feedback, feel free to contact me.

Happy running 😊

Note:  Dr. Blaise Williams is an Associate Professor in the Department of Physical Therapy and the Director of the Virginia Commonwealth University (VCU) RUN LAB

Running Injury Free

One of the basic rules of health is ‘Listen to your body.’ I am responsible for my health, and to respond to my body I must listen to it, learn from it.”
-George Sheehan (1978) cardiologist, senior athlete, best-selling author

With so many exciting races in the fall and spring, drawing ever closer, many runners are either beginning or increasing their training programs.  The goal of any training program is to gradually condition your body for the physiological demands of running.  Many of us will train to ‘just’ finish a race, others train intensively to set a personal best in a race.  Whatever your motivation to run a race, whether you are a veteran runner or a beginner runner, you want to run your absolute best.

Unfortunately, so many runners will not have the opportunity to train and race as well as they had hoped.  Injury is all too common in the sport of running.  If you speak to almost any runner, they likely have been injured at some point in their running career, even elite runners are prone to injury.  So, what causes injuries?

A study that gives us some insight into Vancouverites’ running injuries was conducted by Dr. Jack Taunton between 2000 and 2001.  The study examined 1265 runners participating in a 13-week training program.  The study took many different variables into account to see which variable contributed most to running injuries.  Some of these variables were:  running shoe age and type, running surfaces, previous training history, previous history of injury, weekly running frequency, and cross-training frequency.  Shockingly, 31.6% of all runners reported injuries in these 13-weeks of Sun Run training! 

Dr. Jack Taunton concluded from this study there are two things that predicted injury more than anything else: previous history of athletic injuries and incomplete or poor rehabilitation of previous injuries.  Interestingly, “runner’s knee” was the most common source of injury in the group of 1265 runners.  Achilles tendonitis, plantar fasciitis, and iliotibial band syndrome were common injuries as well in the group.

So, how does one stay injury free?  There is no simple answer; however, here are some good rules to go by:

1)  Make sure you don’t have any pre-existing or lingering pain/injuries before and during training.  If in doubt, rest and consult with a professional such as your chiropractor

2)  Do not increase your training volume by more than 5% or 10% per week, your body needs time to adapt to the demands of training. Too much, too fast leads to injury

3)  Above all, listen to your body and what it’s telling you!  Work in rest days to your training schedule


Happy running 😊

If you are looking for an awesome group of people to train with my personal favorite running clinics and clubs are:

Vancouver Falcons Athletic Club:

Forerunners training clinics: 

If you are looking to run your first half-marathon this is perhaps one of Vancouver’s best half-marathons… coming up soon: 

Pacific Road Runners First Half-Half Marathon:


Dr. Jonathan Lloyd trains with the Vancouver Falcons Athletic Club.  His favorite distance was the half-marathon with a personal best time of 1:16:00.  In his spare time, Dr. Lloyd enjoys running the Stanley Park Seawall and the North Shore trails.