Patellofemoral pain (PFP) rehabilitation doesn't end when your patient gets stronger. The real challenge is getting them back to running, training and racing without triggering another flare-up. In this final episode of the four-part series, Tom Goom (Running Physio) and David Pope explore the fourth pillar of successful PFP rehabilitation: a planned return to running. Continuing Alice's journey from the previous episodes, a HYROX athlete preparing for competition, Tom and David break down exactly how to rebuild running volume, progress training safely, and help runners hit their goals, or return to racing or competition, with confidence while minimising the risk of recurrence. You'll discover: How to structure a return-to-running program that steadily rebuilds running capacity without overloading the knee A simple progression strategy that makes increasing running volume practical and easy to implement Why recovery weeks are just as important as progression weeks, and how to use them effectively How to use a simple "traffic light" system to decide when to progress, maintain or reduce training When gait analysis and running retraining should (and shouldn't) be introduced during rehabilitation Why sleep, recovery and anxiety can have a major influence on running injury recovery, and practical ways to address them How to manage the inevitable flare-ups that occur during rehabilitation without losing progress or confidence How the same four-pillar framework can be applied to virtually every running injury, from tendinopathy to bone stress injuries Throughout the episode, Tom shares the practical clinical reasoning behind every decision, from mapping out a patient's weekly training schedule through to progressing running distance, introducing recovery weeks, and eventually returning to continuous long-distance running. Whether you're treating recreational runners, competitive athletes or patients training for events like HYROX, you'll come away with a clear framework you can immediately apply to help your patients return to running safely, confidently and with a much lower risk of recurrence. This is the fourth and final episode in Tom Goom's four-part podcast series on patellofemoral pain. Together, the series provides a complete framework for assessing, educating, rehabilitating and returning runners with PFP back to the sport they love. Timeline: 0:00 - Introduction 3:07 - Introduction and case recap 6:03 - Weekly training structure 8:10 - Progress and recovery 11:03 - Gait analysis and the four pillars 12:13 - Recovery, sleep and anxiety 14:40 - Alice's progress and flare-ups 18:32 - Four pillars for all running injuries 20:52 - Free assessment form and webinar Free resources Running injury assessment sheet — Tom's go-to assessment sheet for every runner, giving you the structure to gather all the key information you need. It includes his screening questions for past medical history, a weekly training structure block, the key physical tests he performs, and a QR code to an energy availability questionnaire. Free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" — Join Tom's free webinar to see his assessment and treatment in action, with visuals of the assessment tests, gait assessment and the traffic-light and sweet-spot approaches, plus the exercises, evidence and best-practice guidelines behind treating patellofemoral pain. Improve running injury assessment & treatment now with the Running Repairs Online course with Tom Goom at clinicaledge.co/runningrepairs. Links associated with this episode 179. Patellofemoral pain 3 - Effective rehab that won't flare their symptoms. Physio Edge Track record: Running repairs podcast with Tom Goom 178. Patellofemoral pain 2 - What to do when runners won't reduce their training. Physio Edge Track record: Running repairs podcast with Tom Goom 177. Patellofemoral pain 1 - Why it has such a high recurrence rate, and what most rehab plans miss. Physio Edge Track record: Running repairs podcast with Tom Goom Download your free running injury assessment sheet Register for the free "Patellofemoral pain masterclass: The four pillars of lasting recovery in runners with Tom Goom (Running Physio)" Improve your running injury assessment & treatment now with the Running Repairs Online course with Tom Goom Click here to download your podcast handout Improve your confidence and clinical reasoning with a Clinical Edge membership here Download and subscribe to the podcast on iTunes Download the podcast now using the best podcast app currently in existence - Overcast Listen to the podcast on Spotify Join Tom live on Facebook & ask your running-related questions Tom Goom - Running Physio Tom Goom - X David Pope - X Tom Goom - Instagram David Pope - Instagram