Injuries that involve the musculoskeletal are seen often in family practice offices and there are several joint disorders pertaining to the knee among them. This is because the knee is the body's largest joint and its open location makes it especially susceptible to being injured during athletic events. Historically the biggest parts of managing a knee injury have always been building flexibility, strength and pain management techniques, but now knee braces have been becoming more popular. Knee braces are being used as adjuncts, both for therapeutic and preventive measures.
The American Academy of Orthopedic Surgeons outlines the three different types of knee braces that are most often used. First, there are prophylactic braces that are used to assist in the prevention and reduction of injuries that can be obtained during contact sports. Second, functional braces that are used to give knees that are unstable support. Third, patellofemoral braces that were created to give relief to anterior knee pain and help the patellar tracking. While knee braces are believed to lower the chances of an injury occurring to the knee, the debate is still open on just how effective they really are.
Prophylactic knee braces were first tested in the NFL with great success. This lead to athletes in other sports asking how they could obtain these knee braces to help protect their knees. The prophylactic knee brace was originally designed to give protection to the medial collateral ligament, or MCL, and to give support to other important ligaments. As their effectiveness has come into question, their popularity as gone down. Many feeling they are simply not worth their cost.
The American Academy of Pediatrics as well as the American Academy of Orthopedic Surgeons have both come the same conclusion regarding the prophylactic knee brace. Both organizations feel the evidence to support the theory that the knee brace reduces the severity or chance of a knee injuries involving the ligaments is lacking. While the knee brace can give a personal sense of safety, in the end it may be unable to give the MCL protection when there is a lateral hit. Research has shown that the most powerful tool in the prevention of injury to the MCL is strength training. Also, studies that are better designed will be needed to show how the prophylactic knee brace can play a significant role in injury reduction.
Joe Namath started the trend among football players using functional knee braces after he used one to during a successful comeback after an injury to his knee. Functional braces are made to keep the instability of the knee to a minimum after the knee has sustained an ACL (anterior cruciate ligament) injury. A functional brace was also designed to keep the knee from having further injury. Initially this knee brace was designed for athletes who have had unstable knee joints and whose sports require them to make direction changes rapidly. Recently, functional knee braces are also suggested to be used after surgery to reconstruct the knee to lessen an ACL graft strain.
Functional knee braces have shown themselves to be effective as part of rehabilitation and treatment for knee ligament instability. They give the knee more control over the anterposterior joint translation and external knee rotation. They also offer some protection during the rehabilitation of muscle after an ACL reconstruction. Functional braces need to be used in conjunction with modification to activities and flexibility training to be really effective.
One of the most common knee disorders that is seen through all ages is anterior knee pain that is usually caused by an injury or a breakdown of the patellofemoral joint. This issue is what the patellofemoral brace was designed to help. It works by supporting the joint and maintaining its alignment, which lowers the amount of knee pain. They have become very popular due to their low expense, availability, and widespread use. In the end, however, many of the claims of effectiveness that the makers of patellofemoral braces make are not valid.
Patellofemoral braces are a low cost part of therapy for anterior knee pain, although how much they help is subjective. How they work exactly is still not completely clear, but they do seam to make patellar tracking better when faced with a medially directed force. Other factors that effect their usefulness are going to be temperature changes, feedback from the neural-sensory region of the brain, and circulation to the knee. They should always be used with other types of rehabilitation such as flexibility and strength training.