Confused about knee braces

[HajiWasAPunk]

Though I've never had any knee problems at all, at 33 I was thinking about investing in some knee braces for the preventive measure. The thought was that at my age torn ligaments could end my riding or damper it for a much longer time.

Anyway, the more I read the more confused I am. Stories of how they increase the chances of breaking bones instead and how some ppl recommend them only if you already have bad knees have left me doubting if I should even bother?

 

[robwbright]

The recent Dirt Rider magazine says that all top pros except Kevin Windham wear braces on both knees.

After a partial tear of the ACL, I always felt better wearing one in soccer - even though I didn't really need it.

I can't speak to the scientific side of it - I've seen both arguments for and against.

 

[dante]

Even Doctors debate this topic...

 

[Chili]

I've seen this debate over and over and have been at the front line of it with my son. There is no doubt that the braces will create a stress riser at the top and bottom of the brace making you more susceptible to a broken bone. The common theme is I'd rather break a bone than have to undergo a knee reconstruction, my guess is very few of those folks have broken a femur. After breaking a femur two years in a row I can't honestly say my son will be wearing his braces when he lines up this year. I think we will be putting him in some sort of knee cup to protect the knee without the brace instead.

Should you opt for braces I think Asterisk is far and away a great product for our sport, they have also given us great service and I wouldn't hesitate to recommend them as a brace of choice should you decide to wear braces.

 

[firecracker22]

I've heard much advice to the contrary from doctors, therapists and one brace and prosthetic expert. I wore mine for a long time after having ACL replacements on both knees, and the Asterisk is a very comfortable, supportive brace, but I am now concentrating on building up muscle strength in my knees and not depending on the braces. Nothing can replace the support of healthy leg muscles.

 

[Okiewan]

I really don't see how you will "build-up" muscle by not wearing braces? The braces simply stop hyper-extension, twisting etc, they don't support weight, at least mine don't. Even if they did, wearing them while riding a couple times a week sure won't make a "muscle" difference.

There is NO CHANCE I will EVER ride without them. And yeah, I've had a knee done and NOT broken a femur, I'm sure both suck ... I do know my knee has been crap ever since. I wonder if the force it takes to break the biggest bone in your body was transfered instead to the knee, if they'd even be able to fix it?

 

[firecracker22]

I didn't mean that they prevent muscles from being built up. Only that is my focus now, above and beyond riding, by working out instead of relying on weekend rides as my only form of exercise and muscle toning.


Here are some interesting thoughts on knee braces that were posted on another forum:

I have been getting alot of PMs and emails asking about knee braces. I am an orthotist/prosthetist meaning I make and fit braces and artifical limbs. My training is not from the knee brace makers (that is a sales rep) I went to school specifically for limbs and bracing and do not work for any manufacturer.
I am going to try to answer the most common questions I have been recieving in one place. Remember, this is free internet advice, I may be a 13 year old punk in my mothers basement.
I am going to keep this explination simple and generalized.
The knee joint
These are the ligaments you are interested in protecting.
MCL & LCL
The MCL connects the inside of the tibia to the inside of the femur. It prevents the knee joint from opening up on the inside.
The LCL connects the outside of the tibia to the outside of the femur. It prevents the knee joint from opening up on the outside.
Together they help keep the femur from sliding side to side across the tibia.
They are injured or torn when a force moves the leg into extreme bowlegged-ness (LCL is torn) or extreme knock-kneed (MCL is torn).
Forces like this:
Would a knee brace protect against this type of injury?
Possibly. Knee braces are most effective in the side to side actions but as you can see, there is a lot of room for the femur to move inside the brace.
However, the condyles are captured fairly well and a knee unstable in the side to side motion can be braced very effectivly.
ACL & PCL
These are the ligaments that keep the tibia from sliding forward (ACL) and back (PCL) across the femur.
Inury to these ligaments come from hyperextension of the knee and/or planting the foot on the ground durring a heavy impact and the femur sliding forward or backward across the tibia ie...trying to correct a tiping bike at 30mph.
A knee brace is probably most effective at preventing hyperextension of the knee, however this is exactly the situation you want to avoid. When the knee attempts to hyperextend the femur and tibia are leveraged against the brace and a long bone fracture can occur. It is a very rare injury but I believe this is the exact injury KTMmissouri suffered from.
As for preventing the forward-back sliding of the tibia against the femoral condyles, a knee brace will do very little (if anything) to prevent this type of injury. They just cannot supply the amount of counter force required to keep the femur and tibia in alignment durring heavy impacts.
Twisting injuries, the tibia twists against the femur injuring some or all the ligaments. A knee brace will do nothing to prevent this injury.
So what are braces for?
1. Unstable knee joint. The most effective treatment is surgery, when surgery is not advised or wanted, a brace can help the patient return to activity. For instability in the ML (side to side) direction I recomend a DonJoy, Townsend style of brace. For instabilities in the ACL/PCL the CTi2 is a good brace. For off the self, nothing beats the asterisk/CTi brace for fit.
2. Recovery. When doctors used to use alot of donor ligaments for reconstruction, we would brace the knee until it recieved full strength. Atrophied quads and hamstrings cannot supply the support needed to control the knee and are braced.
3. Pain releif from cartilage damage or arthritis. A properly fit and designed brace can relieve pain associated with these problems. I highly recomend a brace called the Generation II for this type of unloading brace.
It should also be said that these principles govern all bracing. Your own muscle framework provides the best bracing possible. Using a brace on a healthy joint may cause a weakening of this framework and result in a higher risk for injury. On a heathy person stong abs and back muscles will do much more than a brace and the same can be said for the quads and hamstrings.
If you are injured and need a brace, use for support while strenghtening the involved muscles. When you are back to 100%, take it off.
As always, if you need help with bracing or any questions, I am happy to help.
Cy

 

[darringer]

As I am typing this, I am recovering from my 2nd left knee operation. I will be having a 3rd in a few years for a total knee replacement. I have also had and completely recovered from broken bones. Saying that, I will trade the possibility of broken bones willingly to escape knee injury. I NEVER ride without my Asterisks. It amazes me that there is even room for discussion. I have been living with knee problems for over 25 years, and if I could go back and wear braces from the beginning, I would at any cost. Saying that muscle tone suffers from wearing knee braces ia absolutely ridiculous! Braces only restrict HARMFUL movement of the knee. They do not interfere with normal movement or knee strengthening excercises. I am by no means an expert, but the experts I have talked to and seen recommend knee braces to protect healthy and injured knees.

 

[Okiewan]

Frankly, for every ortho that goes one way, there's another one going the other.
I'm not sure that it's anything more than a personal choice based on what YOUR doc tells you. That being said, I'll assume that the top MX'er's on the planet have good docs and they all (save one, that's KW and just something read here.. frankly I've seen pics of KW and would swear he was wearing braces), anyway... they all wear braces... why? Sponsorship dollars? Wouldn't sticker on their helmet cover that?

 

[Okiewan]

All that being said, I was there to see Lazyboy's broken femur (that Chili refers to above) ... tough to see.... I just wonder if it will bother him like a grenaded knee surely will later on? Only time will tell.

 

[robwbright]

Sponsorship dollars?

Incidentally, the same issue of Dirt Rider said that a company priced space on RC's helmet - the quoted price was $300,000.00!

 

[Okiewan]

I'll promise you this... Asterisk did NOT pay to put that logo on his helmet.

 

[XRpredator]

Knee braces offer relatively good insurance against knee injury.

That being said, I've never worn 'em (on a dirt bike -- I did wear them playing football), and the only knee injury I've ever had was more rotational, and I can't see how a brace would have prevented it.

Of course, its one of those things that's harder to explain than it is to demonstrate.

THAT being said, if you think you'd be helped out by wearing knee braces, I say go for it. I would also have to agree with the doc that Firecracker quotes in saying that one should also do all they can to keep the muscles around the knee stronger. This is especially true for women, for some reason (my wife -- a certified athletic trainer -- could explain this more), as there are several studies that show women have more knee injuries than men.

but, far as I can tell, Haji ain't a chick.

 

[Patman]

Personally I won't ride without them, mostly because I did in the past and have caused damage by hyperextending my knees. There are theories going both ways and I know Lazyboy had broken his leg which no doubt was a result of the brace but I also hate to think how mangled a knee could get with a heavy boot on the lower leg. I've had doctors give me opinion both ways and my current ortho strongly suggests them. Not as something to wear all the time such as running or playing most sports but when exposing the knee to a potential hazard such as riding. Building muscle to keep from having an injury while running or riding a bicycle or playing a sport like basketball or soccer where lots of running is involved is one thing, having heavy boots on, riding at speed, jumps, roots, lots of hazards you don't normally see on a court or playing field are something all together different.

Consider the opinion of the majority of people that have had or currently have knee problems people with real experience of their knee never being 100%. Now compare that to the so called medical exprets that think riding is a bad idea to start with and whom most likly don't see much more strain on their knee that a round of golf of racketball and get paid to treat the problem after it is a problem for you.

My money and my knees (and my son's) are in Cells (Rockets in his case).

 

[XRpredator]

. . . compare that to the so called medical exprets that think riding is a bad idea to start with and whom most likly don't see much more strain on their knee that a round of golf of racketball and get paid to treat the problem after it is a problem for you.

Good point

 

[robwbright]

I'll promise you this... Asterisk did NOT pay to put that logo on his helmet.

I don't think the money has anything to do with whether he wears a brace or not, but it may determine which brand he wears.

That said, I would be SHOCKED to find that he or any other pro advertises for any company for free. I wouldn't if I could get any money.

Those guys can have any brace company make a brace that fits and protects them perfectly - and get paid doing it. Thus, I doubt he's doing it for free.

 

[robwbright]

My bro had 2 torn ACL's from soccer. Dr. told him to forget about knee surgery and strengthen the muscles around the knee.

I recall seeing that an NFL running back is playing without an ACL, but I can't recall which one it was at the moment.

 

[Okiewan]

That said, I would be SHOCKED to find that he or any other pro advertises for any company for free

Prepare to be shocked :) At last word, Asterisk PAYS NO ONE to wear their braces. They wear the brace, they run the sticker. Could this have changed? Sure.

 

[robwbright]

Prepare to be shocked :) At last word, Asterisk PAYS NO ONE to wear their braces. They wear the brace, they run the sticker. Could this have changed? Sure.

Wow, Okie. If that's true, it would only be the 2nd company I've ever heard of doing that. The other being Martin Guitars.

Impressive.

 

[Patman]

The knee brace discussion comes up every so often and here's what I have figured out in my own little pea brain from the discussions and my experience.

There are lots of "studies" that are against their use for one reason or another.Generally these studies are not done by perople who ride nor even done with regard to riding! While basketball, soccer & even football have similar demands on a persons knees riding a dirt bike does not but this is never addressed. Usually those that are not doctors that suggest against them don't have any practical experience to back up their claim (Lazyboy is about the only exception I know of personally and agree in his case I'd shy away but you have to know everything to understand why). Those that support their use typically fall in to people that have experienced a blown knee or have partial damage and know how bad it really sucks. I know people that have both broken their leg and blown a knee and will take the broken bone every time, personally I'd rather have neither and can appriciate a person expressing their idea otherwise if they have had a broken leg but not a knee. In the end it really is going to come down to what you feel will work best for you. For me I abused my knees and never had the chance to obtain something like a CTi or Cells unless I actually did the damage first or had the $$ to buy them. I now have both the ability to pay for them so I shore up what I have left and try to prolong the day that I get them swapped out for new models. I also do not allow my son to ride without them because I know first hand the damage and how it really affects your life down the road and don't want that for him. When he plays soccer, or golfs or just is horsing around he does not have them on but when he rides he does.

 

[Thump]

Wow, Okie. If that's true, it would only be the 2nd company I've ever heard of doing that. The other being Martin Guitars.

Impressive.

That was the company policy as of last year. We can confirm that with Billy but last I heard Asterisk did not pay any sponsorship dollars to the riders. They give them whatever they need as far as braces or support and supply the Mobile Medical Facility but no money for a logo on a helmet.

 

[Chili]

I guess I should have expected my post to be a bit of a catalyst for this thread so let me be very clear where I stand. First we still haven't made the decision if he will be wearing his cells this race season or not, as I type this he is on the way home from the practice track where he wore his cells once again. When I told him I was considering him not wearing the cells this season he looked at me like I was nuts.

I have destroyed both my knees playing hockey and have had knee surgery twice. I don't recommend this as an option either. I have absolutely no doubt the brace contributed to the first femur break, I am also very convinced his knee would have been completely trashed had he not had the brace on. As for the second femur break or rebreak from last season I have doubts whether the cells played any role in that and would be more likely to look to the plate holding the femur together as the culprit, well that and the fact the kid flew over the bars before the bike landed on him.

I exchanged several e-mails with an orthopedic surgeon who rides earlier this year looking for guidance and of all the conversation the one thing he said that really caught my attention was "broken femurs have a mortality rate associated with them, torn ACL's do not" .

So I sit here as our race season approaches in two weeks and I really have no clue what we are going to do. If you had asked me last season prior to his second femur break I'd have told anyone that listened to get their kid in some cells. Now I just sit here like an indecisive clown terrified to make the wrong choice and see my kid get hurt again.

I'll add once again that Asterisk makes a great product and their customer service was second to none for us so I don't want to seem like I'm trying to bag on their product.

If I had to chose for me, it would be Cells in a heartbeat, for the kid I'm still lost.

So is that clear as mud yet? :bang:

 

[sandflyz]

Maby you answered your own question. Let the kid decide. After reading these threads over and over again and not being able to come to a conclusion, i bought a pair of cells myself. I feel that in at least 6 out of 10 instances, i would be better off in the cells. I have never broken a knee, but have twisted one pretty hard skiing once. I couldn't believe how much it hurt. I broke 3 fingers a few months ago on my dirtbike and although it hurt, it was nothing like the way my knee hurt when i twisted it. In fact after i broke my fingers i hung around and BS'd with the guys for half an hour before leaving the track to go home. Before this i hac never broken a bone in my life, i had just twisted my knee skiing. I diden't think my hand was broke because my knee injury while skiing was a whole other level of pain and nothing was broken. While talking to the doctor about my knee i asked how it could hurt so much and not be broken. He replied that soft tissue damage to the ligaments could actually be more painful than a brake as thats where the nerves are.
Anyway, I feel the braces inspire confidence, weather false or not, and more often than not will help to reduce injury than to promote it.
I think the type of riding we do is another factor in the potential for injury. Combined with the history of our injuries as well as age, and physical conditioning. All these things play a role.
Personaly i think, although i'm not sure, that i would rather be hurt wearing the braces, than not.
Anyway, thats just my 2 cents

 

[Thump]

Chil, the brace can prevent breaks too. I had a wreck at Nocona a few years back where I went over the bars and the bike slapped down on me. Actually the swing arm came down like a guiateen on the inside of my left knee. If it were not for the braces the head of my femur would have been crushed.

Check this out:
http://www.dirtrider.net/forums3/showthread.php?t=76156

Bottom line is this sport is dangerous. To me wearing braces is like wearing a helmet. It is just added protection. Knee braces can contribute to injuries, so can helmets and boots. Most of the time they help prevent them, but in rare cases they can contribute. I choose to place my bets following the best odds, and that is to wear them.

 

[Chili]

Maby you answered your own question. Let the kid decide

You don't have teenage children do you? :rotfl: In actuality that is likely what will happen.