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 pricey 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 which has metal on the inner and outer sides of knee will help prevent excessive motion of the knee moving side to side.
Patellar Dislocation (subluxation) or Patellar 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 which has a cut out for the patella to sit in, and a buttress which forms a J on the outer aspect of the patella, can help 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 bow legged will most likely have excessive wear on the medial aspect of the knee due to the 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 which is located directly below the patella. A patellar strap, which is a narrow band that wraps around the leg just below the patella, can help reduce forces on the patellar tendon and help to 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.
For more information on our Sports Medicine services at Somerset Medical Center please call 855-SPRTS-MED or visit www.somersetsportsmedicine.com
Brian Borer, PT