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There are different styles of knee supports which all offer a variety of benefits in managing specific conditions. In general they are designed to offer additional support following an injury and allowing you to remain mobile for longer. Knee supports are generally used in conjunction with other treatment pathways, with many seeing them as extending the life of your physiotherapy session, offering protection when you’re not working with your physio on stretching and strengthening exercises.
A knee support can offer compression, stability, immobilisation or a combination of these.
Compression is recommended following an injury as it helps to control swelling which in turn can offer pain relieving benefits. These types of braces are normally sleeve based by design so that they can be pulled into the correct place.
Stability is recommended where you have suffered ligament damage and the joint is not fully stable so you need a helping hand when active. Stability is offered through the use of a hinge in conjunction with straps which act as external ligaments.
Immobilising knee braces are normally used post-operatively whereby it is essential that the knee remains completely static to ensure the work of the surgeon is not undone. A patient will normally be in this type of brace a few weeks before transitioning to a different type when they are up and more mobile.
It is also important to note that the sport you wish to use your brace in can determine the brace you are able to select so check the rules before you make a purchase as the last thing you want is the referee asking you to take it off, as if you can’t play without it then you’re in trouble. The normal rules forbid the use of rigid braces or where damage could be caused to an opponent in a challenge. If you are wearing a carbon fibre brace and go into a tackle then your opponent is likely to come out of it worse off.
When you see knee braces on the shelf you’ll notice that there are a range of materials available, from the tubular bandage material to neoprene.
Tubular bandages are something we have all used and have had applied to us following an injury. This type of material doesn’t really offer any benefits from a compression or stability perspective, but it is not designed to do this and is a first aid tool.
The majority of supports on the market are manufactured from neoprene as it is breathable whilst still being compressive. Breathable material is essential, especially when you’re playing sport.
Knee bracing in extreme sports is growing increasingly popular, whether that is through prophylactic (prevention) use or in protection post injury (so it doesn’t happen again). These products are rigid by design to offer maximum protection following falls or crashes and manufactured in materials like carbon fibre which are extremely strong and able to withstand huge impact forces.
The knee joint is extremely complex and is one of the most important joints in the body, responsible for holding your entire body weight whilst allowing you to walk, run and jump. The joint is formed where the thigh bone (femur) meets the shin bone (tibia) with the knee cap (patella) sitting at the front. There are four ligaments (tough bands of tissue connecting the bones within a joint) which connect these bones located at each side of the joint and are responsible for offering stability so that you can remain mobile.
Injuries to the ligaments are fairly common and vary in their severity (grading) as any unnatural movement (slip, trip, fall, tackle) of the knee can put strain on one or more of the ligaments (just ask Kurt Zouma).
At the end of the 2015/16 Premier League Season a total of 84 players were spending their time in the treatment room for a variety of reasons. The most common form of injury was in relation to the knee, accounting for 26 of the total, with thigh injuries in second place with 12 and groin injuries in third with 10.
If we look at the 26 knee injuries the most common is damage to the ACL, accounting for 9 instances followed by 4 MCL injuries. In fact 18 of the knee injuries listed at the end of the Premier League season were ligament based with the others relating to meniscal tears and even a dislocated knee which is an uncommon injury. There are varying degrees of severity in ligament damage, with all sprains graded from one to three.
A grade one is a minor tear and whilst it can be painful you should be back on your feet within the week.
A grade two is where there is a partial tear to the ligament and can take a few weeks to over a month to fully recover from.
A grade three is a complete rupture or tear of the ligament resulting in a complete loss of stability. Whilst it is possible to continue, ligament surgery is often used to repair or even replace it (graft from the hamstring or groin) but you’ll be on the sidelines for almost an entire season.
The ACL is located at the front of the knee and is one of the most important ligaments, preventing your knee cap from moving forward beyond its normal range of motion. Any damage to the ACL can compromise your ability to bear weight, let alone running up and down a football pitch.
The recommended knee support will be determined by the extent of the injury you have sustained. In serious cases you may be placed in an immobilising knee brace to start with (obviously you won’t be able to play in this) before moving into something else.
If you’re returning to the game then you might consider a hinged based knee support (check with the referee) which will help offer stability when you’re on the pitch with the straps acting as external ligaments and the compressive material helping to manage any inflammation experienced.
The MCL is located on the medial (inside) of your knee and injuries here typically occur following impact to the side of the leg, pushing the knee joint beyond its normal range of motion and damaging the ligament as a result.
As with ACL injuries the severity of the injury itself will determine the treatment options available and the brace which may be recommended to you. Stability and compression are important here to keep you mobile and manage inflammation but the list of braces available are very similar to those used to treat ACL injuries.
This is one of the rarer injuries a footballer may face but can happen where there is a sudden change in direction of the knee leading to the patella popping out of the groove it normally sits in, resulting in the dislocation. Pictures of dislocations show that it is quite an obvious injury to diagnose.
Medical advice suggests that you should visit a hospital to have the condition looked at and the patella realigned, with recovery time set at about 6 weeks.
Following the injury if you feel your patella needs additional protection then there are specific braces available for this, with these braces having the added feature of a buttress to house the patella (cushioned opening at the front of the brace).
This is one of the more common injuries sustained and particularly common amongst the over 65 population who account for over 6 in 10 in those diagnosed. Meniscus is part of the cartilage structure which acts as a shock absorber in the joints and prevents bone on bone contact (a painful condition known as osteoarthritis). Damage to the meniscus can occur following a trauma to the side of the joint or a sudden change in direction, noticeable by a popping sensation in the knee.
Treatment will vary depending on the size of the tear, with minor tears being allowed to heal naturally compared with larger tears which may require surgery.
From a bracing perspective, there are a number of different options available depending on the price you wish to pay and the level of support you require.
With so many options in the market selecting the right brace for you can be difficult but before you pick one ensure you have a professional diagnosis. With this diagnosis you will be able to confidently select the right brace for you, ensuring it is designed to manage your condition. If you are unsure then speak with your doctor or clinician for some advice before opening your wallet. If you’re on a website then check that your condition is listed on the product page and if you’re unsure ask someone at the company as you need to be confident that what you have selected will offer a benefit.
It is also important to note that the use of a soft knee brace is not considered a long term solution but to be used as part of your overall recovery. Once you have worked on strengthening exercises the idea is to take your knee support off and carry on. Soft knee supports are mentioned here as their rigid counterparts are designed to be worn in extreme sports for continuous protection and is a long term solution.