Category Archives: Fitness

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A Core Stability Exercise that Anyone Can Do

Proper core and lumbar extensor strength is the key to preventing an episode of low back pain (LBP) as well as an important component to treating LBP. Low back pain is estimated to affect nearly 80% of the U.S. population at one time or another. In general, most of us don’t spend enough time properly strengthening our core muscles. In this video post, you will learn how to engage your abdominal muscles with a simple ball exercise that I recommend to all of my patients initially in my LBP rehabilitation program.

The core muscles are part of the body’s natural method of stabilizing the spine. The core muscles, along with intra-abdominal pressure, help to form the round cylinder that is utilized to support the spine. Ligaments and boney articulations are also important in spinal stabilization. Most people don’t realize that the core actually consists of two separate groups of muscles, the inner and outer core muscles, and neither group involve the rectus femoris muscles (the six pack).

The Multifidus Muscles

  • The inner core consists of the muscles of the pelvic floor, the transversus abdominis (TVA), diaphragm, and the multifidus muscles (which span the vertebrae along the back side of the spine as shown above). The TVA wraps all the way around the stomach and attaches to the spine. This is what helps to form the cylinder. When contracted (in conjunction with the pelvic floor and diaphragm), it helps to increase the intra-abdominal pressure to support the spine.
  • The other muscles that help to support the spine are known as the outer core muscles. These muscles are responsible for movement of the trunk and spine as well as aiding in stability. The inner core muscles do not actually produce any trunk or spine movement. The outer core muscles consists of the following muscles:  lumbar paraspinal muscles; the quadratus lumborm; the internal and external obliques; and the psoas major and minor (hip flexors). Some may also include the glutes (buttocks muscles), hamstrings, and quadriceps as part of the outer core muscles.

Those working on core strength may not be performing the correct exercises. Performing proper core exercises (and particularly, lumbar stabilization exercises) are the primary treatment modality for LBP.

In this video, I demonstrate an easy and effective way to actively engage the inner core abdominal muscles. This exercise is typically safe even early on during the rehabilitation process for low back pain. 

For more information on how to effectively exercise and work the core muscles in order to prevent or treat LBP, be sure to check out my book, Treating Low Back Pain during Exercise and Athletics. You will learn how to address specific causes of LBP as well as the best practices on how to prevent and self-treat when you experience an episode of LBP. In this step-by-step LBP rehabilitation guide (complete with photos and detailed exercise descriptions), you will discover how to implement prevention and rehabilitation strategies to eliminate pain and get back to training and exercise sooner.

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In addition, check out this sample video, Segment 2: What are the Core Muscles?, taken from my Treating Low Back Pain (LBP) during Exercise and Athletics Video Package which you can purchase HERE.

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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Epigenetics: Choose to Optimize Your Aging Process

How you age will in part be determined by genetic forces. These forces are strongly influenced by the lives we have led and the choices we continue to make. The key to successful aging is to be prepared and intentional as to how you want the journey to unfold.

With the sequencing of the human genome, we continue to learn more about epigenetics. Epigenetics is the science of how the modification of gene expression (rather than the alteration of the genetic code itself) can lead to vastly different outcomes in disease processes or a successful aging process.

What this new scientific field has really taught us is that nothing is known for sure. How we treat our bodies, effectively the choices we make, will potentially lead to different outcomes. In other words, we get to have a say in how we age. Our genetics are not set in stone, but instead can be influenced by our lifestyle choices. With this knowledge, we can choose to optimize our aging process. Continue Reading

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Is Resiliency the Key to Aging?

Resiliency is defined as an object’s ability to return to an original form or position after being bent, compressed or stretched. When this definition is applied to a person, it gives us a clue as to why some people recover quickly after illness or injury. It can even help describe why some people age well while others do not. This more scientific definition helps us understand why resiliency is nothing more than your own margin for error in life. The greater margin for error you have, then the less likely something catastrophic will occur.

However, for this definition to be useful, we must have an understanding as to what makes a person resilient. Are there tried and true methods in making a person more resilient? Discussing resiliency in an object is quite easy. You just have to understand the characteristics of the object in question. Understanding what make a person resilient is a very complicated discussion because of the multifaceted nature of being human.

Resiliency in humans is not just a physical characteristic. It’s comprised of emotional (psychological), mental (cognitive), social (relationships), and spiritual characteristics.

Each characteristic of human resiliency impacts the others. Understanding the interplay of the five different aspects helps in understanding a person’s true resiliency. The patterns of resiliency in others can offer valuable clues on how we can all become more resilient and age well. Continue Reading to discover how to improve your resiliency.

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Getting in Shape while Avoiding Overuse Training Syndrome (OTS)

New Year…New You! With the beginning of a new year comes the drive to want to do something different and better than the previous year. Resolutions, new changes, new outlooks, and new workout routines are on the top of many people’s resolution list for the new year.

Getting in shape is important for your physical and mental health, but as with everything, you can do too much. As we get into our new routines with fresh motivation, we push ourselves harder–we run faster, swim further, and lift more. Yet while our new workouts may seem outwardly healthy, we may actually be doing ourselves harm in the long run.

Why? For some of us, the exercise routines we have been inspired to take on have turned from ‘healthy’ to ‘unbalanced’. It may be that we progressed too fast or our volume or intensity of training is too high for our present conditioning.

More commonly, there was not enough attention put into the recovery portion of training. In other words, as we’ve pushed ourselves on the court, in the pool or on the bike, we’ve lost track of our personal limits. We’ve fallen prey to what is generally called Overuse Training Syndrome (OTS). It’s also referred to as Overtraining Syndrome.

Overuse Training Syndrome is pretty much exactly what it sounds like: it occurs when the body is pushed too far during exercise and/or training–over and above its limits for too long–thereby causing it to lose its ability to recover in a sustainable and safe way. For obvious reasons, this wreaks havoc on both your health and your training routine, not to mention to your mental endurance. The training cycle should consist of a balance of training, recovery, and then adaptation. Too much training and not enough recovery means no adaptation and in the case of OTS, a regression of health and training status.

Overtraining typically leads to worsening performance and results. Unfortunately, the most common reaction to OTS is an even greater commitment to training harder, faster, and more often. The effects typically end in disaster.

Overuse Training Syndrome (OTS) Symptoms:

  • OTS makes you tired–not in the traditional ‘good workout sense’, but fatigued in a way that throws your training and muscle wellness off balance. This type of exhaustion is often confused with a sense of demotivation or laziness, thus leading many people to push-through and push harder. Sadly, this approach does a lot more harm than good as it delays recovery for longer periods which places even more stress on your overall health, stamina, fitness, and body. This is typically due to over fatigue in either the sympathetic or parasympathetic nervous system depending on your most common form of exercise/training.
  • OTS feels a little like the flu: a dull aching in your muscles and joints, lightheadedness during exercise, slight nausea, and overall grumpiness follows its onset. In general, OTS leads to the lessening of enjoyment during exercise as your goals aren’t met and your motivation declines. OTS is thus mentally and physically debilitating. Yet apart from fatigue and an overall dampening to your exercise routine, OTS and its resultant drive to push harder and faster may actually lead to a number of serious and harmful consequences.
  • Exercising too much and pushing certain areas of your body to the brink and beyond often leads to disturbances which may cause short and long term damage. Examples of these types of injuries include: tendinitis; carpal tunnel syndrome; plantar fasciitis; and patellofemoral pain. Indeed, if the names don’t scare you away, then the pain associated with these conditions will.
  • Perhaps more common when it comes to OTS are symptoms you may in fact already be experiencing. These include insomnia, elevated heart rate, appetite loss, decreasing muscle mass, dwindling performance, and muscle soreness. None of these symptoms are particularly enjoyable. While you may think that exercise may actually alleviate the symptoms, the truth is that increased activity will only worsen them exponentially.

So, what can you do? You love training, your routine is magnificent, and you’ve finally mastered the art of waking up early enough to get the right amount of activity in before work. How could you possibly change anything at this point?

It’s time to start being very honest with yourself. Exercise is wonderful for you, but too much of it may actually be putting you at a disadvantage. The key is–as with so much in life–balance. It’s very important to balance the duration, type, and pace of your routines in order to make sure that no one part of your body is constantly under fire.

Although it may be difficult to accept at first, rest is just as important as exercise. It’s absolutely crucial that you give your body time off to recover and rest. This will allow your muscles to repair themselves, your joints to heal, and your endurance to be prolonged. The training cycle should consist of the right balance of training, recovery, and then adaptation.

Working out is as much about the ability to listen to your body as it is to push it to be its best. Adding a rest day (or two) to your week will actually be more beneficial to your workout than skipping them. As an extra bonus, you can sleep a bit later on those days! Balancing exercise and rest is the most effective way of staving off the risks associated with Overuse Training Syndrome. Knowing how to do this is, however, tricky for many of us.

For more information on overtraining, be sure to check out my 12 Tips to Prevent Overtraining Syndrome and 10 Tips to Self-Treat Overtraining Syndrome. In addition, you can find more recovery tips in Muscle Cramping & Spasms – Treatment Options.

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If you are interested in a more thorough look at Overtraining Syndrome and how to use overreaching as an effective training tool, be sure to check out my book on Amazon, Preventing and Treating Overtraining Syndrome. I show you how to recognize the risk factors and symptoms of OTS. You’ll learn how to utilize prevention strategies to help you develop a personal training strategy that will allow you to push past your limits and prior plateau points in order to reach a state of what is known as overreaching (your body’s ability to “supercompensate”). This will speed up your results, so that you can train harder and more effectively than ever before! In addition, learn how to use the foam roller (complete with photos and detailed exercise descriptions) as part of a health optimization program, recovery program, rest day or treatment modality.

Nothing can derail your best laid training plans and goals like an injury or suffering from OTS! If you develop OTS, you will need to take specific steps to speed up your recovery in order to prevent injury and return to a normal training schedule. Be sure to check out my book today in either paperback or on Kindle!

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Aging Well Takes Initiative

Successful aging is a worthy goal for all of us to strive toward. To be successful in the aging process, great initiative is necessary as we are solely responsible for our health. Each person’s journey will be different. Those who choose to rely on others or our modern day healthcare system will likely miss the mark and unfortunately, the opportunity for a wonderful journey of aging well.

Differences in backgrounds, life experiences, upbringings, and genetics are what make us all so unique and wonderful. It also means there is not a set path to aging well, but instead options to do it differently (to do it your way). In order to age successfully and well, be intentional and take initiative. Although each person’s path is different, consider the following in order to insure a successful process. Continue Reading

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7 Strategies to Renew Your Health in the New Year

I often hear others comment, “It’s too late to make a change now. I’m too old!” Worse yet, so many people actually believe that, but I don’t! I believe that it is never too late to change. You are never too old or out of shape to make improvements and renew your life. Being healthy and aging well is not a single choice to be made once and then never re-visited. It is a series of constant choices that add up to a way of living and constant renewal.

Aging well encompasses all of the following aspects of our being: physical, mental, emotional, and spiritual. It also includes the community around us. This year, choose to make small consistent choices to renew these areas of your life. This will make all of the difference in aging well. Each person’s physical journey as he/she ages is different. Taking consistent and appropriate action now can vastly change future outcomes.

7 Strategies to Renew Your Health in the New Year: 

Walk more!

Walking is one of the most fundamental activities we perform as humans. Research is very clear that frequent movements (like walking) are the key to avoiding many chronic conditions. Walking lowers your risk of Alzheimer’s disease, heart disease, stroke, and diabetes. It can lower blood sugar levels when performed directly after meals. Elevated blood sugar levels are a major contributing factor to excessive internal inflammation which is associated with most chronic illnesses. Walking can also be an essential component in psychological well-being. Walking as exercise and generally walking more during the day should be considered the first line defense in slowing the aging process and maintaining functional independence.

Embrace fashion.

The first step in adopting a new healthy behavior is to envision and feel what it would be like as if you had already adopted that new behavior. This allows your brain an opportunity to already feel what it would be like to make a change without fully doing so. This can be very motivating. Investing in gadgets or new work out attire, including new walking shoes, can be both motivating and fun. Get in the mindset of adopting the new behavior. Envision how you will look and feel once you have made the changes. Then go for it!

Take control.

There is nothing more important than your health. You have control over most of the aspects in your life that affect your health and well-being. Take charge, and empower yourself. You must be your greatest advocate. Western medicine is designed to keep you alive, not to help you thrive. Taking a passive role in your health is not a wise choice in America’s current health care environment. Only you are responsible for your health. Decisions now will determine how successful you age in the future.

Make the decision.

Research on willpower has shown that it is a finite resource. We actually use up our willpower during the day and have to replenish it daily. This is why you are more likely to “fall off the wagon” later in the day rather than earlier. Decide on the change and commit to the decision. Then implement structure to your day that causes the behavior to be more automatic. Therefore, eliminating the need to rely solely on willpower.

Maintain your strength.

Although all muscle fibers decline some as you age, the fast twitch (Type II) fibers show the most declines. Some loss of strength is anticipated as you age. Losing strength to the point of complete debility or loss of mobility and independence is not a normal aging process.

Strength training is a critical component to maintaining and growing additional Type II muscle fibers. The stronger you are, the more resistant to injury you are. You are more likely to maintain proper functional mobility. Also, strengthening of the core area (the abdominals and back extensors) helps to manage low back pain.

Perform high intensity training (HIT).

The research on the effectiveness of HIT continues to grow. Even more impressive are the findings that HIT can be safely performed at any age and with almost every medical condition. It is now even being implemented in many progressive Cardiopulmonary Rehabilitation Programs, where people are recovering from all kinds of cardiac and pulmonary disorders such as COPD, heart attacks, and heart valve replacements.

Perform your cardio activity in short bursts (ranging from 30-60 seconds at a time) followed by a one to two minute recovery. The 30-60 seconds should be at a high intensity, meaning your rate of perceived exertion (RPE) is high. You should be breathing heavy. Accommodations can be made for almost any type of medical condition. For example, HIT may be performed while using a stationary bicycle, an upper body only bicycle, a rowing machine or in the pool. You can also walk uphill at a quick pace, then stop and rest. The point is to get your heart rate up, and then bring it back down for a full recovery prior to repeating.

If you feel unsure as to how to safely perform this type of training, please seek the help of a competent cardiopulmonary trained physical therapist or exercise physiologist.

Get started!

Make 2021 your year to renew your commitment to make the necessary changes that will empower you to age well. Most importantly, just get started! It’s never too late to maximize your health and well-being in 2021 by implementing these 7 strategies.

Which strategy can you implement in order to age well in 2021? Please leave your comments below.

Thank you for supporting The Physical Therapy Advisor! I look forward to serving you in 2021! If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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My Top 3 Most Popular Posts of 2019!

As 2019 comes to a close, more and more people are realizing the value of taking control of their health care and personal well-being. In today’s health care environment, we all need to learn how to treat common aches and pains proactively instead of reactively. We must get to the root of the issue instead of placing a Band-Aid over it. We must realize that our individual health is our responsibility. We cannot rely on others to make decisions for us. Our present health care system in America is not designed to help you optimize your health–that is your job!   

The purpose of The Physical Therapy Advisor is to help people like you to take control of your health and to save money by learning how to safely self-treat and manage common musculoskeletal, neurological, and mobility related conditions safely and effectively.

My Top 3 Most Popular Posts of 2019:

5 Tips to Ease Neck and Shoulder Pain – Neck and shoulder pain are one the most common ailments faced by people these days. That having been said, it can be mysterious, too. Pinpointing the exact cause for shoulder or neck problems can be particularly tricky as the underlying cause of the pain may be due to many differing factors. Discover the most common causes of neck and shoulder pain and tips on how to prevent and eliminate the pain.

Aging Well is Aging Gracefully – Aging gracefully is possible and will be different for everyone. You must be your greatest advocate. You have control over most of the aspects in your life that affect your ability to age well and gracefully. Start today by implementing these 4 tips to help you stay active and age gracefully!

An Easy Exercise to Prevent and Treat Shoulder Pain and Instability – Proper rotator cuff and scapular muscle strength is critical to preventing and treating shoulder pain. In this video post, I demonstrate one of my favorite rotator cuff and scapular stabilizing exercises using an exercise band. It works the lower trapezius, deltoid and rotator cuff muscles.

2019 has been an exciting year! Thank you for supporting The Physical Therapy Advisor!  I look forward to serving you in 2020! If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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Aging Well is Aging Gracefully

What it means to each generation to age well has changed throughout the decades. As societal norms change, expectations for how people should feel or act also change. The goal of successful aging is always to age gracefully.

So what does it mean to age well or gracefully? Aging gracefully is finding the optimal balance between the physical, social (friendships), mental (cognitive), psychological, and spiritual aspects of aging. Each aspect of aging is important and interacts with the other.

We must be intentional in how we grow, develop, and maintain these five aspects of aging because of the multifaceted nature of our beings. Each aspect will likely be a focus at different times and seasons. Like a garden, our lives (and specifically these five basic attributes to graceful aging) go through the necessary seasons and cycles.

As a physical therapist, my primary role is to help older adults improve their physical abilities so they can continue to participate in the other aspects of living a full and graceful life. Daily activity and maintaining strength are vital components to aging well. Continue reading for tips for staying active and aging gracefully.

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Do I Have a Pulled Muscle or Something Else?

Unless you’re gifted with extraordinary medical abilities, you probably can’t immediately tell the difference between a pulled muscles or something else. Hey, let’s face it, most people aren’t doctors. Not everyone can instinctively tell where their pains are coming from. And, if you’re reading this post, my guess is that you might be one the ones who struggle a little. The good news is, though, it’s absolutely normal not to know the cause of your pain; both people who suffer from sudden, fleeting pain, as well as those who experience ongoing, chronic pain, are often dumbfounded as to its cause. More often than not, though, people jump to the conclusion that they’ve pulled muscles. The effects of this type of ill-informed opinion can be life-changing, and that is why we’re about to expose the hidden answers behind what it means to have a pulled muscles, and whether or not something completely different might be going on.

What are pulled muscles, actually?

This is a good question, and it is the best place to start on your journey to discovering the true source of your pain. Remember, if you have an informed understanding of your ailment, you’ll be able to heal the source and permanently eradicated the pain. With that in mind, here is some information about what pulled muscles actually are and whether or not you have one of them, or, something completely different:

  • Pulled muscles are muscles which are forcibly stretched and pulled beyond their capabilities. In other words, a pulled muscle is the result of a forceful movement exerted on that muscle. Take an elastic band as an example: as the band is stretched beyond its elastic means, it will eventually knot up or snap. This is exactly what happens to a muscle under the same conditions; a pulled muscle is the painful result of forced overextension.
  • Alright, so how do you damage your muscles in this way? The most common activities leading up to pulled muscles include overuse, improper form during workouts, a failure to warm up and down before and after exercise, and skipping over stretching routines. Muscles need to be primed for exercise, and if this crucial step is neglected, they tend to be less flexible and more prone to damage and pain.
  • That’s all good and well, but how can you then tell if you pulled a muscle or if you’ve done something else? Well, the biggest distinction between a pulled muscle and a different source of pain is the fact that your flexibility is limited after you hurt yourself. Essentially, this means you struggle to bend, stretch, or generally move the muscle. The muscle is tight and sore. In addition, you may experience swelling in the pulled area. You’ll most likely also experience stiffness and weakness in the muscle following the damage and, eventually, (if you don’t receive treatment for the correct diagnosis) you’ll become ‘knotted up’ in the area around the muscle as a greater amount of muscular tissue succumbs to stiffness and overuse.

Here’s the problem, though: you may be experiencing all this and yet you’re still unsure whether you have a pulled muscle, or something else like, for example, a structural issue or pinched nerve.

Luckily, there is a way to tell. Pinched nerves, in particular, effect different areas of the body and produce different sensations. Take a look:

What is a pinched nerve?

  • Unlike a pulled muscle, a pinched nerve occurs when the body tissue around a nerve applies too much pressure to it. In other words, a pinched nerve has nothing to do with stretching or pulling: it is, in fact, the restriction of the nerve by its surrounding tissues and muscles. Let’s use another metaphor: a garden hose. Running through the garden hose is water vital for the plants in the garden. In the same way, your nerves carry vital information about the condition of your body to your brain. Let’s take it a step further: when the garden hose bends or is pinched, the water runs out and the plants suffer. Similarly, when the tissues around a nerve impede its ability to function correctly, the body is effected and you feel pain.
  • Now, you may be thinking, ‘sure, but how is this pain different from a pulled muscle?’ First of all, the origin of the pain is different: discomfort from a pulled nerve is traced back to the nerves themselves, all of which are found inside the cartilage, tendons, bones, and muscles of the body. It is not the muscle which is sore, it is the actual nerve. Furthermore, the symptoms of a pulled nerve are different from pulled muscles, in that one may experience tingling, numbness, sudden bouts of weakness, burning sensations, and an increase of discomfort when trying to sleep.

Both pulled muscles and pinched nerves are painful; they both decrease mobility and increase suffering, yet it is absolutely vital to understand that these two problems are treated very differently. The biggest mistake most people make is that they muddle the two, thereby exacerbating the pain and prolonging the healing process.

The thing is, if your discomfort goes untreated – or is treated incorrectly – you risk prolonged bed rest, extended periods off of work, a decrease in activity and mobility, weight gain, muscle weakness, and daily, extreme discomfort. None of these sound particularly appealing and, if you’re reading this, it’s most likely that you’ve already experienced one or more of these results. It’s time to take action.

So, if you’re unsure why you are experiencing pain or you feel as though you’re not getting any better, it’s time to get help. Physical therapy offers you the chance to find and heal the true cause of your pain, thereby allowing you to access the pain-free life you deserve.

Physical therapists can help you improve, restore or maintain your ability to move and function in your daily life. To learn more about physical therapists, visit the American Physical Therapy Association (APTA).

If you have a question that you would like featured in an upcoming blog post, please comment below or submit your question to contact@thePhysicalTherapyAdvisor.com. In case you haven’t already, be sure to subscribe to my e-mail list and YouTube channel as well as join our community on Facebook by liking The Physical Therapy Advisor!

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Battling Athletic Overuse Pain in the Knee

There are many different types of lower extremity injuries that could affect a person throughout his or her lifetime.  Common among runners and sports enthusiast may include knee sprains, patellar tendinitis, and patellofemoral pain syndrome.

Frustrating for Patients and Providers

A knee sprain could affect one or many ligaments.  Ligaments that could be affected with a knee sprain include:  the medial collateral ligament (MCL); the lateral collateral ligament (LCL); the anterior cruciate ligament (ACL); and the posterior cruciate ligament (PCL).  A ligamentous sprain can be from either direct contact or via non-contact injury.  Meniscal injuries within the knee are also very common and can be via direct contact or non-contact.

Patellar tendon pain (often called patellar tendinitis or patellar tendinosis) occurs when the tendon connecting your knee cap (patella) to your shinbone becomes inflamed and irritated.  Patellar tendinitis is often called “jumper’s knee” because it occurs so frequently in sports like basketball and volleyball.  It also affects runners, primarily due to poor lower extremity biomechanics during running, which can lead to an overuse syndrome affecting the patellar tendon.  Continue Reading to learn about treatment options for knee pain.