Imagine battling runner’s knee pain for three years, trying everything, and still being stuck. That was Jeff’s reality. But in our first session, we solved one of his long-standing issues in just 45 seconds, and ultimately, got him back to running pain-free.

Jeff, a male runner in his 60s, contacted me about his persistent right-sided runner’s knee pain. For over three years, it had been a constant companion, sometimes completely stopping him from running.

He’d seen his local doctor, and when they couldn’t find anything definitive, he turned to a physiotherapist. Jeff had one session every week for three months! Think about that for a moment: 12 weekly sessions, a significant investment of both time and money, all hoping to get back to the sport he loved.

Sadly for Jeff, 12 sessions of physiotherapy made no difference to his knee pain at all. In fact, Jeff also had very tight hamstrings, a problem he’d lived with since his younger years, and the physiotherapy hadn’t solved that either.

Jeff told me he’d managed to get back to running himself by using a neoprene sleeve over his right knee. This allowed him to run almost pain-free, which was incredibly intriguing. He actually had three different knee sleeves: a thin neoprene one, a more robust one with a small hinge, and an even thicker one with a stronger hinge. None were solid, just varying thicknesses of neoprene. While these sleeves allowed him to run almost as far as he wanted, they were a real inconvenience to lug around and wear on every run.

Unlocking the Nervous System: The First Breakthrough

So, Jeff came in for a running and movement assessment. We went through a thorough, personalised set of tests and observations. As with all my assessments, some tests are designed to discover the effectiveness of certain drills or sensory stimulation methods. As part of this, using specific drills and sensory stimulation, we actually solved Jeff’s long-standing tight hamstring issue in about 45 seconds! No joke – 45 seconds! This immediate improvement hinted at the power of working with his nervous system.

His knee pain, however, was a different story. Satisfied that the various scans Jeff had undergone over the past three years showed no specific tissue issues, I carried out extensive sensory testing around Jeff’s right knee. We discovered he couldn’t feel the sensation of cold on a small patch of skin on the outside of his knee. This was a crucial clue, suggesting that his brain wasn’t getting clear signals from that area, almost like a ‘blurry GPS signal’ for his knee. When your brain doesn’t have a precise sense of where a body part is, it can’t control and stabilise it properly, often leading to pain. We confirmed this by doing some squats; his right knee pain was instant, and I could see his control was poor.

There was a possibility then, that when Jeff wore one of the knee sleeves, his skin was heating up, and this extra warmth was making up for the lack of cold sensation, helping to sharpen the brain’s map of his knee. I applied cold sensory therapy to Jeff’s knee for the rest of the assessment, and we retested the squats. This massively improved his squat control, and there was virtually no pain. Running on the treadmill was also much better with less pain. I sent Jeff home with some cold therapy drills and other knee-mapping exercises.

In our next session, Jeff reported he could now run a couple of kilometres pain-free without the knee sleeves, but any longer, and it became very painful. However, he could now walk completely pain-free. I felt we were on the right track with sensory input, so I did more testing and re-testing. I gave Jeff some more mapping exercises to do at home. At his next session, Jeff said he could run a bit further now, but was still lugging one of the knee sleeves around in a backpack because beyond 3 or 4 km, he was still getting terrible pain.

Decoding the Knee Sleeve: The ‘Aha!’ Moment

So, I took to my large whiteboard, and together, we reverse-engineered exactly what the knee sleeves might be doing. Now, Jeff was like a lot of runners I see in that when he has pain, he immediately associates it with some form of tissue damage. Even though I had spent considerable time explaining and demonstrating that actually, it was his nervous system reporting false alarms of threats, Jeff struggled to move away from “it must be a tissue-issue, and I might be making it worse by running on it without the sleeve.” This made it even more important to figure out what the sleeve was actually doing.

Given that the sleeves were all made of neoprene, they offered minimal muscle bracing or structural support. This was a tough concept for Jeff to grasp initially. But by demonstrating how his knee could still freely move in all directions, even with the thickest sleeve, he started to understand that it wasn’t providing the external structural support he assumed.

So what was it doing for him? We knew his knee was probably heating up a bit, and therapy around the cold sensory deficit helped, but there was something else more important for his brain. Then Jeff mentioned something that made my brain go into overdrive: sometimes he would stop his run and massage the outside of his knee, and this helped reduce the pain. Bingo! It suddenly clicked.

Through a specialist technique, I tested how his brain responded to different types of touch on his skin – specifically, how it reacted to skin being stretched and skin being compressed. I discovered that by applying decent pressure directly onto his skin, compressing it in that specific spot, he could squat completely pain-free. This included single leg squats, which he could never do before due to pain and lack of control. This was it! This was the missing piece!

The Ingenious Solution: A Small Piece of Tape

But obviously, I wasn’t going to follow him around pushing on his knee! So I came up with an ingenious, simple solution: a small, 6cm strip of kinesiology tape. I applied the tape in a very specific way, creating that precise skin compression in just the right spot. Jeff tested this on the treadmill, and just like that, he was pain-free! I cut some more strips for him to take away and taught him how to apply it, sending him a supporting video of him applying it to his own knee for reference.

At his next session, he was over the moon! He could now run more than 21km completely pain-free without hauling around those bulky knee sleeves. All he needed was a small, easily portable piece of tape. He carried several pieces with him when he went for a run; they’re so easy to pop into his pocket – no more heavy backpack!

We did some other mapping work at that session, but Jeff decided that now he could run pain-free and race half marathons again, compromising by sticking a small bit of tape onto his knee was the perfect cost/benefit ratio for him.

Your Brain is the Key to Pain-Free Running

I love stories like Jeff’s because they illustrate that even when someone holds onto the ’tissue damage’ belief, their running and their life can be profoundly transformed by working with their brain and nervous system. You don’t need to be a “believer” in neuroscience for it to work!

So, if you’ve been battling pain for more than a few months, and scans show no specific injury, or perhaps a past injury has long healed, it’s time to look beyond the obvious and start exploring the incredible power of your brain and nervous system.

To help you understand this often-overlooked aspect of pain, I’ve created a completely FREE mini-course specifically for runners which you can find here.

To access the FREE course you will need to create a free account on the course platform.

Important Note:
Jeff had already seen medical professionals before he came to see me. He had also undergone several scans so was confident there was no physical injury.

It is very important that if you suspect at all that you may have a physical injury then you must go and get it checked out by a medical professional. Nothing in this article nor in anything that I teach, suggest or recommend, replaces the knowledge and experience of a trained medical professional when it comes to acute injury. Please do not ignore the fact that physical injuries do happen, so ensure you receive the care you need.