"Choosing the Right Knee Brace" by Brian Borer, PT, MSPT
Feb. 20, 2012
Choosing the right brace for your knee problem is instrumental
in reducing pain and improving function. With several
types of knee braces on the market, how do you begin to choose the
proper one for you? First and foremost, you must have a clear
diagnosis for your injury and then you can begin to understand how
each brace works. A physical therapist can be essential in
determining the cause of your knee problem and can help guide you
in selecting a beneficial brace and making sure it properly
fits.
The following are common knee conditions that may benefit from
bracing:
ACL/PCL Injuries - Following a tear to the
anterior cruciate ligament (ACL) or posterior cruciate ligament
(PCL), a brace may help to provide stability and prevent the tibia
and femur from sliding forward, backward, or rotating. Braces
specific to this type of injury can be used on someone who with ACL
or PCL deficiencies as well as on those who have had reconstructive
surgery. For those who have had surgery, the brace can
protect the knee from excessive forces, especially when returning
to sports or activities that put additional stress on the
knee. Options for these types of braces include a custom-
made brace or an off-the-shelf brace. A custom-made brace
requires a special fitting by your physical therapist, but will fit
your knee exactly, however; they can be quite expensive, especially
if insurance won't reimburse for it. An off-the-shelf brace
comes at a significantly lower cost, and only requires a
circumference measurement of the thigh. While it isn't custom
fitted, it is malleable and can be adjusted to properly fit the
leg. Again, your physical therapist will help determine which will
be more beneficial.
MCL/LCL Injuries - A sprain or tear
to the medial collateral ligament (MCL) or lateral collateral
ligament (LCL) may result in instability on the inner or outer
aspect of the knee. A hinged knee brace with metal supports
on the inner and outer sides of knee will help prevent excessive
side to side motion of the knee.
Patellar Dislocation (subluxation) or
Maltracking - Injuries to the patella
(kneecap) can include a traumatic event such as a patellar
dislocation (subluxation). In addition, many patients suffer
from patellofemoral pain syndrome, which may be due to the patella
not tracking (moving) correctly in the joint. A lateral J
brace has a cut out for the patella to sit in, and a buttress which
forms a J around the outer aspect of the patella, to provide
stability and keep the patella centered in the joint. In some
cases, it may be determined that weakness of the hip musculature
and excessive rotation of the femur may be contributing to patellar
pain or instability. In these cases, a strap may be
recommended which wraps around the thigh and waist to control
motion at the femur, thus helping to keep the patella in the proper
position.
Knee Osteoarthritis (OA) - Bracing for knee
osteoarthritis (OA) can be helpful by reducing the compression
forces on either the inner or outer aspect of the knee. These
braces typically work well for patients with OA that is more severe
on the medial (inner) or lateral (outer) aspect of the knee.
For instance, someone who is bowlegged will most likely have severe
wear and tear on the medial aspect of the knee due to excessive
compression forces. OA braces can be custom made or
off-the-shelf, and different choices are available depending on the
severity of the condition.
Patellar Tendinitis - Patellar tendinitis
(jumper's knee) is typically caused by an overuse injury leading to
pain and inflammation of the patellar tendon, located directly
below the patella. A patellar strap, a narrow band that wraps
around the leg just below the patella, can help reduce forces on
the patellar tendon and decrease pain.
As you can see, without the proper knowledge of your injury, you
could easily end up with a brace that may not be helpful at all.
However, with a little bit of information and guidance, a knee
brace can be a great tool in pain reduction, increased knee
stability, and injury prevention while performing sports or even in
your daily activities.