Charlton first came in to visit Dynamic Sports Physical Therapy in New York City after experiencing pain in the middle of his knee. He first noticed the pain while on a training run about eight weeks before his first Ironman Triathlon in Cambridge, MD, and said that he had never dealt with any knee issues up to that point.
To determine what was causing these symptoms, Charlton’s therapist put him through an SFMA screen, a diagnostic system that assesses movement to pinpoint the problem. Results showed that Charlton had dysfunctional movement patterns in his ability to touch his toes (multisegmental flexion) and rotate to the right and left (multisegmental rotation). He also demonstrated a reduced ability to stretch his hamstring and calf muscles, decreased stability of his core, and reduced hip strength. Based on this assessment, the most likely source of his knee pain was found to be patellofemoral irritation due to valgus collapse in his running form. This essentially means that the lack of hip strength and core stability resulted in poor alignment of his hip and ankle, which led to irritation of the knee.
Overcoming a tight timeline for treatment
The main challenge in prescribing Charlton’s physical therapy was the proximity of his race and the need to balance strength training with training volume. His treatment plan consisted of a manual (hands-on) therapy technique called soft-tissue mobilization combined with the Active Release Technique, which was applied to his calves, iliotibial band in the knee, hamstrings, and other thigh muscles called the adductors and tensor fascia lata. The strength program focused on achieving optimal alignment of his lower extremity while squatting and running. A variety of exercises were also utilized to increase the strength of various muscles that supported his hip and core muscles.
Even with the short timeline, Charlton was able to complete his treatment and finished the Ironman Maryland in a time of 10:40:17, which put him in 108th place overall, 99th in his gender, and 16th in his age group. He had this to say about his experience at Dynamic Sports Physical Therapy: “I felt supported and confident going into the race making sure the sharp pains were not a season-ending injury. My experience with everyone at Dynamic Sports was hassle-free and the team made me feel welcome and ultimately excited going into the race!”
Experience similar results at Dynamic Sports Physical Therapy in New York City
His case highlights the importance not only of a proper evaluation—as his knee pain was due to hip weakness and core stability issues—but also how strength training can create an environment that can tolerate load. As noted earlier, the challenging part of Charlton’s rehab was that his race was only a few weeks away when he first came in to see us. Proper strength gained during the offseason would have helped to create normal alignment, which helps the body disperse force optimally as the miles of training needed for an Ironman gradually add up. If your training regimen has been thrown off by injury or you’re dealing with any other new pain, we can create a treatment program that works, regardless of your schedule. Contact Dynamic Sports Physical Therapy in New York City at 212-317-8303 to schedule an appointment today.
