A Very Common Cause of Knee Pain
This is very common, and I believe that Medics can both diagnose and treat it. When Soldiers walk miles for Land Navigation in the dark on uneven terrain, ruck march 9-12 miles, and conduct patrols- they can definitely get some knee pain. This is one common reason why knee pain is seen so much in Ranger School, Pre-Ranger programs, and other exercise-intense courses. I think it is also why there is so much research into “exoskeleton” knee braces – a study is underway soon at Fort Benning.
Patellofemoral syndrome, of course, can only be diagnosed with a good knee exam. It is not a result of trauma, but usually a gradual onset. Therefore, a good history and a good knee exam is important before making this diagnosis. Future posts will detail more on knee history and exams.
Patellofemoral Syndrome is one of the most common knee pain diagnoses that I see. I often treat it acutely with Ice packs (compressed with Ace wrap), NSAIDs, and an open patella knee brace to aid with patella tracking. And, if there is time, I send them to physical therapy to strengthen their quads.
Typically, physical therapists, physical therapy assistants, or athletic trainers will focus on quad stretching and isometric or other strengthening exercises. Some recommend foam rolling the quad also. In orthopedics, we would often prescribe short arc knee extension exercises, with little to no weight and with higher reps, if physical therapy was unaffordable. In short arc knee extension exercises, the knee only bends to approximately 30 degrees and then is extended fully on the knee extension machine. Or, alternatively, one can perform isometric quad strengthening exercises.
Below are a few videos describing some of these exercises. Again, this is posted to really get you the first few days of therapy until you followup. Or, if you are deployed to a remote location and have no other option. The last video is from Tom Brady’s body coaches detailing a good resistance band workout.
I think it is reasonable to eventually advance to functional exercises. I believe that this exercise below by TB12 is one that could build the endurance needed to sustain prolonged load bearing during increased and/or consecutive mileage. Ideally, Soldiers would complete these exercises in order to prevent injuries.
I have future plans to enlist the help of some physical therapists and athletic trainers to help on these issues. Look for that info to come over the next few weeks.
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