knee pain after starting a foam rolling routine

[Kaisa]

Hello,
I have been reading this forum for a while and am learning a lot from all of you. Thank you!

Now I have a question about a new client. She came to me for a general at home program to support her current activities and improve what ever areas of fitness we found lacking during her assessment. She didn't complain of any pain anywhere and has been running for some years 2-3 times a week as her main exercise. I did an overhead squat assessment (among other tests) and she exhibited severy turned out feet and knees that caved in so much they touched (probably the worst feet out, knees in combo I have ever seen). So, I gave her some foam rolling to do for her calves, TFL, adductors, and some activation stuff for her medial ham, glutes, anterior tibs, and core to get her started. She continued her running. Well, now 10 days later, she has anterior knee pain!

Could this routine really have caused this?

What should I do with her now?

Any other thoughts?

I appreciate any insights and comments.

Thank you.

Kaisa

[Aoife]

I am by far nothing in the way of an expert or even professional, but…

I'd look at the running being the culprit, personally, esp running form

I mainly wonder if after working out some tightness/flexibility/mobility issues, if then the running with non-great form somehow is the issue. Like, her body finally starts chaining the way it's supposed to, and then she puts herself back into old movement patterns.

If she's been compensating for weak/tight/imbalanced/etc spots in her chain, fixing that is gonna reveal other issues as well.

I hope that thought was coherent.

[UConnJulie]

I would agree with that Aoife.

I would not blame the rolling etc, instead I would say that it decreased any other compensations she has going on and it exacerbated an underlying condition.

There are probably lots of threads here about anterior knee pain. Most are caused by inefficient gluteal function, tight quads, tight TFL/glute medius/ITB. Her overhead squat says that her glutes and adductors are probably not strong/firing properly.

What's her running form look like? Is she one of these "I'll die if I can't run" types or is she willing to take a bit of a break?

[Kaisa]

Thanks for your responses! I was thinking along those lines. I will research the previous posts about anterior knee pain for more information.

I will suggest she takes a break from running for a while and we'll work on the weak links in her kinetic chain.

It's just hard for me to feel confident again... To her, all she knows is she was pain free and now after starting to work with me, she has pain. Kind of like I started to "fix" what "wasn't broken"... Hopefully I can get her to understand that in the long run it's much better that we address these compensations now even if it slows down her running for a while.

Words of encouragement? More things I could mention to her to turn this challenge into a positive situation...?

Thanks a lot for your input.

Salut,
Kaisa