otal Performance Physical Therapy (TPPT) is a state-of-the-art physical and aquatic therapy center that was designed to cater to individuals of all ages and injuries. Each aspect of TPPT was formulated to make you – the patient – stronger, better, faster.
The #1 reason that patients seek help from a Physical Therapist is because they are in pain. In the ideal world, pain is a good thing. It tells our bodies that something dangerous has occurred, and immediately draws our attention to that area. Unfortunately though, sometimes the pain that we feel in a certain part of our body does not mean that something dangerous is occurring. Prolonged pain often leads to increased fear and anxiety, increased healthcare costs, and longer time away from work and other life activities. Understanding why you have pain can help to create the best plan to fix it!
Types of Pain
The International Association for the Study of Pain (IASP) defines pain as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” When we break this definition down, we can see that there are 2 types of pain: 1 in which true tissue damage has occurred, and 1 in which there may OR may not be true damage. The first scenario encompasses injuries from the moment they happen until ~3 months. This is called “acute pain” and is often associated with neck or back injuries, broken bones, or torn ligaments. Signals travel from the injured body part to our brains and tell us there has been damage. Our brain processes this information and then sends a signal back out to our body telling it to begin feeling pain. Typically when these things occur, we are often encouraged to seek proper medical attention, keep moving, and will soon resume normal life and work activity. When pain persists longer than 3 months, it is commonly called “chronic pain” and can happen for many different reasons. Chronic pain can occur when the damage to a certain body part is healed, but our brain continues to send out pain signals to the specific or surrounding area.
Acute PainVS.Prolonged Pain
Contributing Factors to Prolonged Pain
Pain that lasts for multiple months or years is a multifactorial problem. It may be helpful to think of your pain as a volume dial. All of the unnecessary pain signals that your brain is continuing to send out to your body cause the systems “volume” (or sensitivity to further signals of pain) to increase. Additional factors such as lifestyle habits (smoking, alcohol), nutritional habits, fear of movement, stress/ anxiety about pain or in other general areas of life, and limited activity levels all further increase the overall volume of the system. Working to understand areas of your life that may be turning up this volume is a crucial step in learning how to lower the volume, and decrease the overall pain sensitivity of the system.
As mentioned before, the time lines for acute & chronic pain are not always perfect. It is important to rule out the possibility of true tissue damage or potentially serious conditions if you have persistent pain. Although seeking care from your primary care provider is the best way to rule out any potential red flags, physical therapy is a great next step to put an end to your pain!
Trigger points are a small patch of muscle tissue in spasm, and they can occur for a number of reasons. When we develop aches and pains, our bodies automatically avoid using muscles that create the pain and start using other muscles a greater amount of the time. This is called a “compensation pattern”, which allows the pain to decrease for a period of time. Unfortunately, this causes increased stress on the muscles that are being used more than usual, and they can develop trigger points because of this increased stress. Other reasons that people may develop trigger points is because of prolonged postures, and repetitive stress to a body part from work or recreational activities. Once trigger points are formed, they can cause pain at and around the area where they are located. Healthy muscles usually do not contain knots, are not tender to pressure, and when relaxed they feel soft and pliable to the touch. Areas in the muscles that contain trigger points feel hard and dense when you run your fingers over it.
How Do You Treat Trigger Points?
The best way to get rid of trigger points is by performing trigger point release techniques. Applying pressure to the central location of a trigger point helps to break up the spasm, and in turn, decreases the pain that it may be creating. This technique may increase pain as the pressure is being applied, but will ultimately decrease the day-to-day pain experienced overall. Finding a physical therapist that specializes in these techniques is the best way to decrease trigger points, while also creating an individualized exercise program to further enhance the recovery process.
What Does a Foam Roller Do?
Foam rollers are a great way to start breaking up the trigger points on the surface of your muscles. They are relatively inexpensive, and they come in different sizes, which make it easy find one that fits best into your life and schedule. Foam rollers are also smooth, or have bumps on them, which help reach deeper muscles. Foam rollers with bumps will most likely benefit people the most, however if you find you are unable to tolerate this version, the smooth foam roller is your best option. In order to foam roll properly, apply moderate pressure to a specific muscle or muscle group using the roller and your bodyweight. You should roll slowly, no more than one inch per second. When you find areas that are tight or painful, pause for several seconds and relax as much as possible. You should slowly start to feel the muscle releasing, and after 5-30 seconds the discomfort or pain should lessen. As mentioned before, initially breaking up this tissue knot may elicit some discomfort, however this should decrease over time if you are consistently using a foam roller throughout your day.
If you are experiencing trigger point pain in North Wales, trigger point pain in Hatfield or trigger point pain in Norristown then call our office at 215-997-9898 for a free consultation!
Adhesive capsulitis, which is more commonly referred to as frozen shoulder, occurs in 2-5% of the population at one point or another. It typically occurs in adults ages 40-70, and is more often seen in women compared to men. It is also interesting to note that individuals with diabetes are more likely to develop frozen shoulder, with an occurrence rate of 10-20% of diabetic individuals. Considering how many people are at risk for this disorder, it is important to understand its progression and different ways to treat it.
Frozen Shoulder vs. Adhesive Capsulitis
Although “Frozen Shoulder” and “Adhesive Capsulitis” technically have minor differences between them, the terms are used similarly to describe the slow loss of motion in the shoulder joint, along with increasing pain during movements. The exact cause of frozen shoulder is unknown even though it affects so many people. One of the main theories is that it can occur after a period of immobilization, such as being in a sling after an injury or fracture in the arm. True Adhesive Capsulitis, or Primary Adhesive Capsulitis, may develop after due to inflammation from trauma, an autoimmune response, or autonomic dysfunction. True Frozen Shoulder, or Secondary Adhesive Capsulitis, occurs from something that originally happened outside of the shoulder joint itself. This can include rotator cuff tears, impingement, bursitis, biceps tendinitis, and arthritis. In both cases, there tend to be three main stages of progression. The first stage is called the Freezing Stage, and it is characterized by the increasing loss of motion of the shoulder and increasing pain. This stage can last anywhere from ~10-36 weeks, and it is very difficult to start treatment in this stage since there is a continued loss of motion. The second stage is called the Frozen Stage, which begins when the pain has stabilized and starts decreasing. This stage is characterized as the “stiff period”, and it can last anywhere from months 4-12 months. Finally, the third stage is considered the Thawing Stage, and occurs when shoulder motion increases and pain continues to decrease. This is the stage where treatments are most effective, and can last up to 12 months. Although the whole process can take anywhere from 6 months to 3 years to resolve, the good news is that the majority of people do regain most or all of their shoulder motion.
Taking a Deeper Look
So, what is actually happening in the shoulder joint to make it so painful and stiff? Although it is unknown exactly how frozen shoulder initially happens, we do know what is going on inside the shoulder once this problem begins. The shoulder joint connects your arm bone, the humerus, to a socket-like area of bone called the glenoid fossa. This creates a ball and socket joint that looks like a golf ball sitting on a tee. This whole structure is then encased in a capsule, which is like a bubble around the bones. This capsule has fluid in it, which helps to make shoulder movements easy and painless. Once frozen shoulder begins, the capsule shortens around the bones, becomes thicker, and eventually scar tissue can build up. The combination of these things can also decrease the amount of fluid inside the joint, and movements become much more difficult and painful.
Diagnosing Frozen Shoulder
Some key components to look out for that may help diagnose frozen shoulder are: random onset (no traumatic incident), unable to sleep on the involved side, restrictions with multiple movements (lifting arm above head, reaching to the side or behind back, dressing, etc.), increasing pain, normal x-ray appearance, and possible weakness. Since there is no direct way to diagnose this condition, it is important to rule out other possibilities such as arthritis, tendinitis, bursitis, or other pain syndromes. MRI can help to determine if any of these underlying issues are present. Once diagnosed, it is important to determine which stage an individual is in, since this will help decide the best treatment option.
As stated before, most people with frozen shoulder will see a spontaneous resolution of symptoms within 3 years, however exploring different treatment options may help to speed up the process. Three main treatment options include: steroid injections, physical therapy, and manipulation under anesthesia. Steroid injections, such as Cortisone, are powerful anti-inflammatory medicines that are injected directly into your shoulder joint. This may help to loosen up the tissues and capsule around the shoulder and restore some of the motion that has been lost. Physical therapy will include specific exercises to help loosen up the shoulder, as well as hands on treatment from the therapist, which will also include different stretching techniques. A physical therapist will be able to work with you to help perform activities of daily living, work, and recreation that may have become difficult. Finally, the last resort option would be manipulation under anesthesia, which has become an emerging treatment for this condition. During this procedure, the patient is placed under anesthesia for 10-15 minutes while the shoulder is forced through full range of motion in all directions. This breaks up everything in the shoulder that is causing it to be stiff. Following the procedure, patients are recommended to see a physical therapist daily for 2 weeks for aggressive stretching exercises, pain relieving treatments, patient education and review of home exercise program.
If you are experiencing shoulder pain in North Wales, shoulder pain in Hatfield or shoulder pain in Norristown then call our office at 215-997-9898 for a free consultation!
“Sports hernia” is a broad term that is used to describe pain in the lower abdominal or upper groin region, however it may or may not actually involve a hernia. Different structures can also be involved such as the abdominal wall, groin musculature, and pelvic floor muscles. A sports hernia should not be mistaken with an inguinal hernia, which is when part of the intestine pushes through the abdominal wall. The medical term for a sports hernia is “athletic pubalgia” and it is considered one of the most common injuries to occur with sports that require kicking or cutting, such as soccer, hockey, and football. It is also not uncommon to see this injury in runners, however it is not as common as the other sports.
What Exactly IS a Sports Hernia?
Unfortunately, although this syndrome is very common, there is little that is actually known about it. We do know that athletic pubalgia is a collection of signs and symptoms that may arise from multiple pathologies, and it can either be acute (a newer injury) or it can become recurrent, or chronic. It usually involves one of the three muscles; the abdominals, adductors (muscles that are located on the inner part of your thigh), or the muscles on the front of the hip, the hip flexors. Medically, it is vaguely defined as “pain in the groin region, medial thigh, lower abdomen, or pubic region that presents in athletes and may encompass the following pathologies: damage to the tendons, fascia, or sheaths in the defined region”. The injury is usually a gradual onset and tends to be triggered by quick movements such as twisting, turning, sprinting, bending forward, kicking, and performing sit-ups. A typical history of an individual with AP would be a young, athletic male who reports groin or lower abdominal pain.
Since AP has a very vague definition, it is extremely important for a physical therapist or physician to rule out other potential problems and injuries first before making a diagnosis. Other issues that should be ruled out include: fracture, hip or back injuries, infection, and urological or gastro-intestinal issues. A full examination should include observation and palpation of the area, strength testing, range of motion testing, and possibly functional performance testing. Treatment, such as physical therapy, should then be directed toward either pain control, regaining range of motion, or strengthening around the area depending on where the individual falls in the recovery process and their specific needs.
Returning to Sport
Similar to the diagnosis of AP, more research needs to be done in order to determine the best way to know when an athlete is ready to return to their sport after injury. Sport specific testing and functional outcome measures can help provide the clinician with objective information, and allow them to compare scores to normative values. As mentioned before, this is a problem that can occur over and over again so it is important to seek professional management in order to return to sport safely and decrease the likelihood of reoccurrence. For more information visit Total Performance Physical Therapy or www.totalperformancept.com.
If you are experiencing hip or groin pain in North Wales, hip or groin pain in Hatfield or hip or groin pain in Norristown then call our office at 215-997-9898 for a free consultation!
Runners are often overwhelmed by the amount of shoes there are to choose from, and have a difficult time finding the ones that will benefit them the most. When choosing a type of running shoe it is important to take into account the shape of your foot and your running mechanics. It is also important to identify the type of surface you will be performing most of your running on (trail, pavement, etc).
Types of Feet
Before buying a pair of running shoes, it’s important to understand your foot! First, identify characteristics about your foot that impact the way a shoe fits. This information may be easy to find since you may have figured these things out simply from buying shoes your whole life. Take note of whether your foot is more narrow or wide, and where you would prefer the shoe to be snug or looser fitting. Next, take a look at your arch height in standing, and determine whether they are low to the ground, very high, or if they sit somewhere in the middle. Finally, as you are running try to think about which part of your foot hits the ground first with every step – the heel, the middle of your foot, or the toes. This information determines where you have a “heel or rearfoot strike”, “midfoot strike”, or “forefoot strike”.
Choosing a Shoe
Often times, different brands of shoes are known for a certain type of fit. For example, Nikes are usually more of a narrow shoe. If you previously determined that you are going to prefer a wider shoe, you may want to look at other brands. Figuring out general characteristics of different brands of shoes prior to purchasing may be helpful to narrow down the choices. Another way to quickly narrow down shoe choices would be to determine where you run most often, since certain shoes are best for trail running while others hold up better when running on pavement.
Running shoes can then be broken down into three main categories: cushioned, motion controlled, and stability. During a lower leg evaluation, shoes are usually recommended to runners based on their amount of “pronation”, or amount of inward roll of the foot while running. Cushioned shoes are often recommended to runners who have high arches and a decreased amount of pronation. Since this type of shoe has more cushioning under the arches it allows for a greater amount of shock absorption that is lost due to the lack of pronation. Motion controlled shoes are exactly the opposite of a cushioned shoe. This type of shoe is often recommended to runners who have more of a “flat foot” or lower arch and over-pronate while running. Motion controlled shoes have a harder material under the arch, which helps to decrease the amount of pronation while running. Finally, stability running shoes are given to runners who have medium arches, and have a mixture of qualities of both the cushioned and motion controlled shoes. Since a majority of runners have medium height arches, most people typically fall into this category.
What Happens If I Pick The Wrong Shoe For My Foot?
In our last blog, we mentioned that although physical therapy may be one of the most important steps you can take to get back in the game stronger, better, and faster after an injury, you can actually help speed the recovery process by consuming the right vitamins and nutrients.
At Total Performance Physical Therapy, we’re committed to helping our patients find relief. But we also know that healing comes from within, too. So let’s take a look at the rest of the nutrients that help promote the injury recovery process, courtesy of the leading physical therapy center for sciatica in the Chalfont area.
All of the tissues in your body contain Zinc. It allows your body to utilize the proteins and fats that you consume to promote healing and growth of damaged tissue. Additionally, Zinc also helps to protect the body from viruses and infections.
What to Eat
You can get your Zinc from a number of sources, including chicken, nuts, seeds, and even oysters.
As toxins that exist in our bodies, free radicals are even prevalent in the presence of an injury. They work to make us weaker by taking away from our healthy cells. By ensuring we get enough antioxidants in our diets, we can help our bodies control those free radicals, so it can focus on repairing itself.
What to Eat
Prunes, tart cherries, blueberries, turmeric, and ginger are excellent sources of antioxidants. Ginger and turmeric have the added bonus of being containing anti-inflammatory properties as well.
When you injure yourself, it automatically increases the body’s need for protein. In fact, it’s required for the many processes that occur during not just the initial onset of the injury, but throughout the entire recovery period. Consuming large amounts of protein can actually determine how fast and how well the body heals, so it’s crucial to ensure you’re getting enough high-quality protein in your diet, especially if you’re recovering from an injury.
What to Eat
Meats like chicken, turkey, and grass-fed beef are excellent sources of protein, as is Greek yogurt and even almonds.
While physical therapy can be one of the most effective ways to help you heal from an injury, it’s essential you remember to eat the right foods to enhance your body’s recovery process.
Here at Total Performance Physical Therapy, we’re the go-to spot for physical therapy for sciatica in Chalfont and other nearby areas. And we understand that even the best physical therapy requires assistance from a good diet. If you’re not getting the proper nutrients, then you may be hindering your injury recovery. Our staff of physical therapists is dedicated to getting you back in the game stronger, better and faster. Let’s take a look at some of our most recommended foods to help aid your sports injury recovery.
A water-soluble vitamin, Vitamin C is not naturally produced in the body, which means you need to consume it on a daily basis. It plays a vital role in the healing process because it helps to build new protein for tendons, ligaments, blood vessels, scar tissue, and skin. It can also help the body maintain bone tissues and cartilage while offering internal protection against free radicals.
What to Eat
Vitamin C isn’t just found in citrus fruits like oranges. Kiwi, peppers, and even broccoli are terrific sources as well.
This vitamin aids in the production of white blood cells, which help fight off infection and viruses. This doesn’t just go for open wounds, but other injuries as well. The stimulation of white blood cells can actually increase the rate at which your body heals from an injury.
What to Eat
Swiss chard, spinach, carrots, and sweet potatoes all contain substantial amounts of Vitamin A.
Omega-3 Fatty Acids
Much research has been conducted about omega-3s. Studies have shown that it provided a tremendous amount of relief for patients with rheumatoid arthritis by significantly reducing their inflammation.
What to Eat
Salmon is perhaps one of the best sources of omega-3s, but walnuts and flax seeds also contain this essential fatty acid.
While physical therapy techniques are ideal and often necessary for recovering from injuries, eating the proper food and ensuring that you’re getting the right nutrients can work in tandem to help you speed up the recovery and get you back in the game. In our next blog, we’ll take a look at the rest of the list and why you should be including these foods in your diet right now, regardless of if you’re injured or not.
Jumper’s knee or also sometimes called runner’s knee is associated with a pain in the front of the knee. The knee is the hub of activity for the lower leg. It controls the activity between the hip and foot with many of the muscles of the hip and foot attaching at or near the knee. So when there is pain in the knee and it wasn’t from a fall or trauma then you have to pay attention to the foot and the hip in order to eliminate the pain at the knee.
Pain with jumper’s knee is usually right at the bottom of the knee cap, at the quadriceps tendon. This is where the group of quadricep muscles comes together and attach. The quadriceps are the group of muscles in the front of the leg and the hamstrings are the group of muscles in the back of the leg. These two muscle groups are often confused.
How to fix Jumper's Knee | Total Performance Physical Therapy | 215.997.9898 - YouTube
When you perform the single the squat you want to watch your knee. There are 2 things that you want to look for. Does it wobble? Does it go inward? If the answer to either one of these questions is yes, then you have hip weakness that is associated with your knee pain. When you lack hip strength it means that your hip has to work harder to keep your knee steady, specifically your quads have to work harder and that will cause an inflammation of the quad tendon.
This repeated wobble of the knee will happen every time that you run, forcing your quads and other muscles to work harder to stabilize the knee. With the muscles having to work harder, it will cause inflammation and pain with running and jumping. That is why hip weakness must be addressed when talking about jumper’s knee.
3 important exercises to do
Single leg stand – This is important to begin with because single leg activities will help you strengthen the hips. Start off by just standing on one leg. You can do this while you are brushing your teeth or doing the dishes. If you are able to do this for 30 seconds without touching the other foot to the ground then put a pillow under your foot and close your eyes.
It is important to note that poor balance is not inherited. Most people will tell me that their parents had poor balance so that is why they do. Whether or not your parents could balance has nothing to do with whether you can. Balance must be practiced in order to be good at it just like anything else.
Single leg squat – Here the testing exercise becomes the exercise to correct the problem. You want to go as low as you can but make sure that you not letting your knee wobble and you want to make sure that the knee is going right over the toes. The goal is to squat to the floor. But that is going to take some time. Start going as far down as you feel comfortable. Do 3 sets of 10 on each leg. You can also put a band around your knee to help stabilize it.
The standing figure four stretch – You can also do this exercise sitting down but this is just a different variation that you can do throughout the day. Cross your ankle over your knee and squat down. You should feel stretch in the hip or in the back of the leg. Hold this for 30 seconds and do 6 sets.
Remember it’s really important to understand that if your hips are not loose and if your hips are not strong or if there’s some type of restriction in your hips, that’s going to lead to your muscles being used differently in the legs and therefore inflammation to the quadriceps tendon and the development of jumpers knee.
If you are experiencing knee pain in Hatfield or knee pain in Norristown then call our office at 215-997-9898 to get a free consultation!
Summertime and the fair weather that accompany it offer us some terrific opportunities to stay active, social, and fit. In fact, we all know how enjoyable it can be to jump into that pickup game of soccer, squeeze in a few rounds of tennis, or finally conquer that 5k run. However, these summer sports and recreational activities can be risky — according to the Centers for Disease Control, over 8 million people get hurt in sports-related injuries each year, many during the summer season.
At Total Performance Physical Therapy, we provide physical therapy rehabilitation for patients throughout Hatboro and Horsham to get them back in the game stronger, better, and faster. And while injuries do occur, you can help your body to prevent them by properly training and preparing it for the rigors of the season. Let’s take a look at which summertime sports injuries are the most common, and how you can try to prevent them.
As our own Dr. Heather Moore mentioned in her recent article for the Philadelphia Inquirer, knee pain is among the most common types of injuries that occur during the summer season. These can include anything from simple strains to more serious injuries that could require a surgeon. Among the most common are Patellofemoral syndrome, otherwise known as “runner’s knee,” and IT band syndrome.
Runner’s knee is characterized by a painful sensation in the knee when the tendon below the kneecap becomes inflamed and irritated from overuse. Typically, runner’s knee will heal over time on its own. Cutting back on running can give it time to rest and recover.
IT band syndrome occurs when the iliotibial band that runs down the side of the leg becomes inflamed. The pain usually occurs at the knee where the tendon rubs against it. It is typically caused by muscle imbalances and can be treated with strengthening exercises and foam rolling, among other approaches.
These are actually quite common, especially for golfers and tennis players. Repetitive activities that can strain the forearm, wrist, and elbow can occur with people who perform motions like swinging a golf club or tennis racket. If you play either of these sports and experience this type of pain or discomfort, you may want to consider adjusting your form and taking some of the stress off the elbow. Additionally, you can ice the affected area to reduce swelling after vigorous activity and try some forearm strengthening exercises.
Muscle Pulls and Strains
When one of your muscles is suddenly stretched or pulled beyond its capacity, it can be a significant source of pain. Both groins and hamstrings are among the most common pulled muscle injuries, especially in runners and other athletes who incorporate sprinting into their training regimens. One of the most simple and effective ways to prevent a pulled muscle is to ensure that you’ve warmed up appropriately before engaging in any physical activity, particularly if you’re exerting yourself with high-intensity bouts of effort.
Sports like swimming, baseball, and others that involve overhead arm motions can put strain on the shoulders, especially the rotator cuff. Overuse in these areas can lead to inflammation in the muscles, pain, a reduced range of motion, and even a tear. These kinds of injuries are usually caused by a lack of flexibility, strength, or stabilization. To combat this, focus on stretching and strengthening the deltoid muscles, not just during the sports season, but all year round.
Runner’s knee is one of those catch all terms for runners and knee pain. It can mean several things like quadricep tendinitis or IT Band tendinitis (Iliotibial band) and so on. But most often the cause the pain for runner’s knee is a few things and that people fail in treating it because they look for only one thing that is wrong and treat that one thing.
One thing everyone who has knee pain and is a runner seems to have in common is the minute they have knee pain; they stop running thinking this is going to solve the knee pain. And some have even been told to stop running by medical professionals. Stopping running without treatment, and not just pill popping, the worst thing you can do.
Unfortunately, we do see a lot of this in our practice. Runners who have knee pain, who diagnose it as runner’s knee, and then they stop running and pop some Advil and then wait 2 weeks and go back out running again and feel great and then a month later, two weeks later, two days later, it got worse. This cycle can happen three, four, five, six times where the runner, will stop running when they feel knee pain when a few weeks and then go back and it feels better but then it hurts again. Eventually it hurts to the point that no matter how many days you take off allows the knee pain to subside. Taking time off running and not getting treated is a HUGE mistake and will ultimately fail and possibly cause you to never run again.
The truth of the matter is that most people can run while they are being treated because we are activity finding the cause of the problem and eliminating it. And most of it we can do while you are still running. So, what are the causes of runner’s knee.
It is not often one thing that causes runner’s knee. IT Band tendinitis which is inflammation of a muscle on the outside of the leg. This usually becomes inflamed because of overuse and has a lot to do with muscle imbalances throughout the hip and core. Runner’s knee could also include hamstring trigger points which is pain and tender points in the back of the leg, or it could be overuse of the quadricep muscle which is caused by weaker hips. There could also be problems with the foot and that is causing the knee pain. Identifying all causes of the pain in the knee is imperative for the pain to be eliminated.
The other factor that needs to be considered is depending on how long the knee pain has been going on will depend on how many muscles are affected. Generally starting in the hip, the back, the IT Band, the hamstring and so on all the way down the leg it is possible that every muscle has been affected and causing the knee pain and all the muscles will need to be addressed.
What can you do to treat runner’s knee?
First you should be icing for about 15 minutes every day.
The second thing you want to do is foam roll. There are several foam rolling videos on our You Tube channel that shows you how to roll each muscle. The video below will show you just a few you can do on the legs. You should concentrate on your hamstrings, piriformis and IT Band.
Physical therapy for runner's knee - YouTube
Foam rolling may hurt which indicates that you need to be doing it even more and get rid of the trigger points in the legs. Without getting rid of these trigger points you will not be able to ever run without pain.
You should foam roll for about 10 minutes a day.
The third you should be doing is you should begin strengthening. A few basic exercises you should begin doing are planks, side planks and reverse planks. You should hold each of these for one minute and perform 3 sets. Now those are just basic exercises, once we determine which muscles are affected, we can better form an exercise program that will eliminate your knee pain.