Patellofemoral Syndrome

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.

A Quick 3 Minute Video from bellinhealth on Patellofemoral Syndrome

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.

Once able to advance, Consider these exercises to improve quad function and/or prevent Patellofemoral Syndrome

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.

All content is intended to be educational only. Medics should operate under the supervision of a medical provider and abide by all local laws while stateside. Medics should only practice at the level credentialed, and only at the level allowed. This content is not intended to treat or give a substitution for any credentialed provider. Content is intended to aid in a deployed prolonged care setting. Take guidance from your leaders. Utilize these posts as preparation and as a supplement to your provider’s direction and teaching.

This content is the author’s opinion alone and does not necessarily reflect the opinion, official position, or stance of the Department of Defense, or any other branch of the United States Military.

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Published by Medic Mentor

An Army PA seeking to share knowledge and skills to medics in order to better prepare them for the next fight, and to bridge the gap between future expectations and initial entry training. These posts are samples of similar training I share with my own medics, and are made available here to a wider audience. I am no expert. There are others more qualified, I'm sure. I am simply looking to contribute. Feel free to provide feedback and leave comments to help others.

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