Many patients I see regards knee bracing as an option between conservative management of their knee condition and surgical intervention. Somehow, putting on an additional form of support around the knee provides patients with additional confidence to carry out their daily activities.

However, does it really provide support to the knee and how effective can it be? In this article we discuss the types of knee braces available on the market, what they are usually used for and if they actually contribute to the knee condition.

Introduction

A knee brace is part of a larger group of devices know as orthotics. Orthotics are devices that are applied to the body so as to support, align, prevent or correct the function of that moving body part. Knee braces can be divided into a soft sleeve support or a structural brace.

They both serve different functions. A knee sleeve is traditionally thought to support the knee and prevent injuries from occurring while a knee brace is used when there is already an injury in the knee that requires some from of support to assist in the function of the knee.

Compared to the soft material that a knee sleeve is made from, knee braces usually have some form of hard bars (made of metal or plastic) on the side or around the knee and connected by hinges.

Soft knee sleeves are probably the most common knee support. It can be easily found at any pharmacy or specialist sports shop. It is made of softer compressive materials such as neoprene or woven elastic materials.

1. Velcro Atraps

Velcro straps incorporated into the sleeve allow additional adjustments to increase or decrease the compression and provide more comfort for the patient. They help to provide a counterforce to the patella.

(kneecap) and help it to remain in the central position. This has been shown to be helpful to athletes who experience minor kneecap instability (subluxation). Soft knee sleeves (above) is used for demonstration purposes

2. Improve Joint Proprioceptive Control

They have been shown by various studies to improve the patient’s joint proprioceptive control. Proprioception is defined as the capacity to feel the position of a joint in space as sensed by the central nervous system. By improving the proprioception control, it allows the athlete to be more aware of his movement that has been attributed to how the knee sleeve serves its purpose of protecting the knee from injury or risk of damage in various sports.

3. Control of Patella Tracking

Soft support sleeves can help in the control of patella tracking. People who experience knee pain in the front of their knees while exercising may have the problem of patella maltracking. Which is when the kneecap tilts or moves excessively to one side when the knee is flexed and extended. This leads to excessive stress and eventual wearing out of the lateral kneecap cartilage.

Advantages:

• Comfortable, so more likely to be worn
• Does not restrict movement much and can be worn while playing sports
• Can keep the knee warm in a cold environment
• Easy to purchase and fit
• Provides patients with sensation of support and comfort
• May help in increasing the mechanical output of specific exercises through stored elastic energy.

Disadvantages:

• Lacks the structural material to provide functional support or alignment correction to the knee
• Does not restrict knee movement which may be necessary to prevent knee injury
• May alter the way an exercise is performed and cause the knee to be more prone to injury if used inappropriately.

You may think of these sleeves as a brace, but it is not technically regarded as one. It lacks the structural components that allows it to perform most of the functions of an actual brace. As it is made of soft material, it is unable to align, prevent or correct the functions of the knee, especially one that has injuries in it.

Before selecting such a brace, one should get the anterior knee pain diagnosed accurately by a medical professional as there are many other causes (eg. Fat pad impingement, patella tendonitis etc) that can also produce similar discomfort but would be less likely to improve with a patella control sleeve.

If you are in doubt of your particular condition, it may be preferable to discuss it with a medical professional to help you make the decision.

References:
1. Lake JP, Carden PJ, Shorter KA. Wearing knee wraps affects mechanical output and performance characteristics of back squat exercise. J Strength Cond Res. 2012 Oct;26(10):2844-9.