Some physical therapists have long considered knee braces as detrimental to future knee health. Afterall, why do we want to teach our patients to be dependent on knee braces when we can solve their knee pain through knee strengthening and teaching proper biomechanics? Some physical therapists may also purport knee braces causing perpetual weakness in surrounding knee mucles through dependency on external support, which could lead to knee injuries.
However, a recent research study made by Callaghan et al. proves the opposite. They measured the effects of a flexible knee brace on maximum contractions of the quadriceps muscle on 108 participant over 3 months. What they found was that there was no measurable significant difference in maximum voluntary contractions between brace and no-brace-wearing groups.
Effectively, we recommend knee braces and wrist/hand braces when a patient comes in with suspected ligamentous and tendinous damage/strain. The brace helps not only to cue and remind the patient to watch their biomechanics, but may aid them in attaining this a little easier. Also, braces supplant external support to joints, that are originally stabilized by tendons, muscles and ligaments. This external support usually helps the injured patient alleviate some of their pain as they are going through the healing process.
What is consistently found in the clinic, however, is that disuse atrophy (muscle weakness from non-use) is more the reason for perpetuating weakness in the limb. This occurs when patients turn off muscles of the affected extremity because they want to ‘baby’ or ‘rest’ the limb to prevent further pain. Though bracing has an indirect relationship with this disuse, research shows it is not a causative factor.
To prevent this disuse atrophy, muscles have to be continually retrained and strengthened so the joint gains its support system back. The most effective healing scenario is when the body is strengthened and retrained using healthy body mechanics. This is done through physical therapy and series of graduated exercises.
So in conclusion, when you suspect you might have injured a joint, do not hesitate to use a brace to alleviate some of your discomfort – but make sure you do the necessary steps to retrain the appropriate muscles so you get back to a healthier way of moving as you heal.
-Callaghan et al. Journal of Orthopedic & Sports Physical Therapy, 2015. Vol: 0 Issue: 0, pp. 1-24.
By Alice Holland, DPT.
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