Which knee brace should I use?June 25, 2015
There are several different types of knee braces out on the market to help decrease knee pain or improve stability at the knee joint, but it has been questioned whether these knee braces are truly effective. Some of the most common braces you will see are the prophylatic knee brace, the functional knee brace, and the patellofemoral knee brace.
Prophylatic knee braces are commonly used to help protect the medial collateral ligament of the knee from injury when playing sports. The medial collateral ligament is located on the inner aspect of your knee and is injured when the knee is hit from the outside and driven inwards. You may see this type of brace commonly worn by football players although there is no evidence supporting its use in preventing injuries. Some studies have even reported that it may place them at increased risk of injury.
Functional knee braces are designed to help improve the stability at the knee joint and are commonly used after individuals have undergone ACL reconstruction surgery. These are usually metal on the outside. These are very cumbersome and usually require a doctor’s script. They have large opening and go up into the middle of the thigh. They used to be commonly used for athletes who had knee instability and were required to make quick direction changes when playing their respective game. It has been reported that this type of knee brace may give athletes a false sense of confidence that may place them at increased risk for injury.
Patellofemoral knee braces are thought to help decrease pain and improve how the kneecap moves. Patellofemoral braces are ones that have the hole in the middle for your knee cap. Individuals commonly use this brace when they experience generalized knee pain. These types of braces are commonly bought at drug or medical supply stores.
There are two knee braces that are not actually braces but people confuse them as such so they need to be presented here. There is the knee sleeve. This have no metal pieces and are made of neoprene. They can be purchased at a local drug store. They provide little support to the knee and just offer more of a ‘hug’ and allow certain receptors to fire so your knee feels better. These should not be used long term or when playing sports as they can compromise your proprioception which in the loosest terms means balance.
The next knee brace that is not really a brace but that most people refer to as a brace is the knee strap. This is a band that goes around the knee, right below the knee cap. This is used in people who have been diagnosed with jumper’s knee or knee tendinitis or general knee pain. This also can be purchased at any drugstore. The design for these braces is to take the pressure of the quadriceps ligament that attaches to the bottom of the patella. People find relief with these but often depend on them too long. They should be used for a limited period. If the pain does not go away then you should seek professional help.
While certain braces may be helpful in the immediate short term, braces should not be used at all or not be used for prolonged periods of time. For all knee braces, there is high subjective evidence, meaning the patient reports improvement in knee pain and function, but there is little to no objective evidence, meaning that there is no real difference in measurements looking at knee function. Knee braces such as the prophylactic or functional knee brace may even give some individuals a false sense of security and place them at increased risk for injuring the knee.
The best way to improve knee stability and or decrease knee pain is to address the underlying causes of the problem. It is important to look at overall lower extremity strength and identify any strength deficits that may exist. Strengthening the muscles around the knee will help improve knee stability and help off load the joint decreasing pain. For athletes, it is also important to look at their technique when performing specific tasks for their sport and to identify improper form that may put them at increase risk for injury. Making correction to any of the deficits found, whether strength or technique, will improve a patient’s knee pain or instability better then any type of bracing.
For more information on knee pain visit Total Performance Physical Therapy.