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Knee Brace Selection Guide - How to Pick the Right One for You!
By Dr. Paul Anderson, M.D. Sports Medicine Expert
A knee brace or support is a device worn around your knee or knees to prevent injury, reduce instability or relieve pain. If possible, it’s best to have your knee brace properly fitted by a medical professional. Some knee braces are sold by prescription-only and require casting for a custom fit.
There are four main classifications of knee braces
1. Prevention or Prophylactic - These braces are worn to reduce and prevent knee injuries such as tears of the anterior cruciate ligaments as well as the medial and lateral collateral ligaments. Generally, these knee braces are not recommended and are considered by some professionals to be dangerous. This type of knee brace alters your knee joint mechanics which may result in new knee injuries and other body parts.
2. Protective or Functional - These knee braces protect injured ligaments and help with stability.
3. Rehabilitation - These knee braces limit the range of motion and protect the knee during rehabilitation or physical therapy.
4. Unloader or Offloader - There knee braces reduce the force on the arthritic cartilage of the knee by shifting the joint load to healthy cartilage.
General Bracing Guidelines:
Knee Instability - Your knee brace must prevent your knee from slipping and keep it stable. Otherwise, the brace is not helping you. Poor-fitting knee braces allow for re-injury. If you wear a knee brace for stability, make sure it keeps your knee from instability and ligament gapping!
Proper Fit and Size - Finding the right size to ensure a proper fit for your knee is critical. The right brace choice is the one that fits you well and is comfortable while supporting and protecting your knee. Custom or off-the-shelf? It doesn't matter - the most important factors are fit and protection. Your knee or leg should not go numb and your ankle should not swell – if that happens, then the knee brace is too tight or isn't fitting right.
Movement - You must be able to flex and extend your knee reasonably well (except during rehab when your knee’s motion may be intentionally limited for healing). You will have some limited mobility with a knee brace.
Hinged Knee Brace - Hinged braces are best for knee ligament injuries and arthritis because the hinge adds strength and stability.
Right and Left - Braces should be fitted for your right or left injured knee.
Which knee brace is correct for your knee injury?
This depends on your diagnosis, where you are in your treatment and how old you knee injury is. Generally, a knee brace works well under the right conditions for ligament tears, compartmental arthritis and not quite as well for Pre-arthritis, Patellofemoral Syndrome or Chondromalacia.
Here are some general guidelines -
Acute or Chronic Anterior Cruciate Ligament Tear (ACL) with Instability - This requires either surgery or a proper-fitting ACL knee brace, especially during sports or activities where your knee is unstable or it buckles. If you don't stabilize your knee with a sports knee brace or surgery, you will develop early arthritis as the bones grind off your knee joint cartilage.
Old or Chronic Medial Collateral Ligament Tear - This requires a proper-fitting MCL knee brace, especially during activity where you feel unstable or your knee collapses inward (valgus). If you don't stabilize your knee, you will develop early arthritis.
New or Acute Medial Collateral Ligament Tear - If you have a complete MCL tear, surgery is often the best option. If you have an incomplete tear, this requires a proper-fitting MCL knee brace while your ligament heals. The brace should be worn during activities or sports where there is risk of re-injury and when your knee feels unstable or it collapses inward (valgus). If you don't protect and stabilize your knee, you risk re-injury. Depending on how severely or how slowly you heal, the knee brace may be needed for 3 - 12 months.
Arthritis – This requires the unloader type of braces. What they do is shift the load or joint force off your damaged cartilage onto healthy cartilage. These braces can be effective - but only if your arthritis is limited to one part or compartment of your knee. Generally, there are better first- choices for controlling knee arthritis such as natural anti-inflammatory supplements and treatments, knee exercises and an anti-inflammatory diet.
Post-Surgical Ligament Repair - You will need a good rehabilitation brace for protection, while healing.
Pre-arthritis, Patellofemoral Syndrome or Chondromalacia - These braces are designed to adjust the mal-tracking of the knee cap (patella) which is the main problem for this condition. There are much better treatment choices including: McConnell taping, foot orthotics and knee exercises.
Construction - Common knee brace materials included plastic, leather, neoprene, rubber and steel. Correctly-designed hinges are very important for normal knee joint movement.
Return - make sure you can either return for adjusting and re-fitting; or, if you buy online or from a store, that you can return for a refund.
Knee Exercises – Generally, if you need a knee brace, your knee muscles (from quadriceps to hamstrings) have become unbalanced and are often weak. Strengthening your knee, hip and calf muscles reduces the load on your knees and helps protect them
Recommendation - At this time, my #1 recommendation is to see a qualified medical professional specializing in knee braces. He or she will help you find the right knee brace and get a proper fitting. That is usually the best way. Your medical professional should be familiar with a range of knee braces that would be suitable for your knee injury and offer a guarantee
