Knee braces

Sorry I've been otherwise quite occupied with moving and work…blech. No, knee braces don't work. What you are describing could be ITB syndrome, or patellofemoral pain syndrome. See my blog post on this very thing (backpackerPT.com) If it's the former, compressing the ITB against the bony bits on the outside of your knee is going to make it much worse. If it's patellofemoral pain syndrome the brace does nothing. So why spend the money? no need to get any imaging, don't waste your money – unless you have a fracture then an X-ray or MRI is pointless to figure out what actually hurts. Go see a PT and have them check your biomechanics, hip strength, etc.

I use knee braces frequently, for skiing and hard hiking (not for light walking or short easy day hikes). I could not do some of the activities I do without them. I have seen doctors and physical therapists and none had answers for me, even after spending thousands on PT. Braces were $30 and when I wear them, I return home injury free. I hiked a marathon in September – a hard one – with braces, and recovered in a couple days.

Karen, that's great for you, glad you found something that helps. Same with anyone else who thinks knee braces help. But biomechanically, physiologically, and neurologically a knee brace (except those huge metal monstrosities to help with ligamentous laxity) do absolutely nothing. Psychologically? now that's a completely different animal. So for those who are thinking of trying them, if literally EVERYTHING else fails, go for it – maybe all you need is the FEELING of security with your knee braced. But at the beginnings of an injury, before you have had a chance to actually see what your mechanical fault is, etc etc, there's no point.

Hey Jennifer, If you don't mind my asking, What's your take on the Cho-Pat knee bands? Same as for the full on braces? I always felt better running with it than without it, but it may have been psychological like you say. Thanks in advance for any insight you may provide, Sam

Interestingly the cho-pats actually can help when the problem is either the patellar tendon or quadriceps tendon. it subtly changes the forces through the tendon and sometimes that's enough to make things not hurt so much. So much of these things hinge on WHY something hurts – and interestingly enough that psychological component can be hugely important! I felt better wearing my ankle brace after my fracture long after it was physically doing me any good, and I could swear it made my ankle hurt less even though I didn't actually NEED any bony support for my fractures anymore. For example – if your problem is, say, the medial collateral lig in your knee is lax/strained, wearing a neoprene sleeve is probably going to feel really good – even tho it literally does NOTHING for support of that ligament. But the contact all around your knee gives your brain a little more confidence if you will and can actually help make the muscles work more appropriately. But in the case of ITB syndrome, which is what I suspect the OP is talking about, the brace is actually going to make it hurt more because the problem is that of too much friction across the lateral aspect of the knee – compress that even more with a knee brace and you are just making matters worse.

Well heck, here I'd convinced myself that the Cho-Pat I wore was purely psychological and you go telling me it might actually have helped! Just can't win with you professionals. :P

I definitely felt as though the ChoPat helped with my knee issues, so it's good to hear it wasn't purely psychological. I haven't needed it for a couple years now after rehabbing my knees though. And I think it's great we have a PT as a member here providing awesome advice for hiking related injuries. Jennifer, thank you very much for your expertise. :-)

How about if you have a torn meniscus? Knee brace?

Torn Meniscus is a pretty generic term. Consider a "bucket handle" tear at the edge, sometimes with one end detached, to "micro fractures" extending to the interior all along the periphery, to "cookie cutter" holes in the middle of the structure, to "floaters". (Been there, done them all.) I'm sure there are many more variations on this theme. So specifics Might be useful. None the less, IMHO, a brace will do nothing to keep damaged cartilage in place. It might supplement weak muscles to help stabilize the knee and help it move as designed. YMMV.

"…and can actually help make the muscles work more appropriately." "It might supplement weak muscles to help stabilize the knee and help it move as designed." It would seem to me that you are saying a knee brace can work. I've certainly heard of compression helping weak or damaged muscles. Is that not true? Is that back brace I got to help when I haven't done my exercises like I should not really helping when I lift heavy stuff? I seems like it does, but then when I wear it I am likely more aware of proper posture, I think more often to engage my core muscles first, etc. The knee brace for my wife I've always believed helped via compression of the muscles. You stated that they don't work, but subsequent statements seem to indicate that they can help, or is my interpretation wrong?

The best that a knee brace is going to do – again, other than those huge metal contraptions for ligament tears – is mental. If that's what you need, then great. But the likelihood of it being enough to actually change biomechanics is pretty slim. Not saying it never works, but generally speaking they are just superficial effects. And whatever you do, don't ever wear a back brace. The rate of injury for people who wear them is actually higher than those who don't. Those braces are actually quite effective at "bracing" your back (unlike a knee brace), and what that means is that your body doesn't need to use its core…the brace is doing the work. So even though you may be THINKING about contracting your core, the fact is that the brace inhibits you from actually doing it. Those things are terrible…..

Hi Jennifer, I am recovering from ACL surgery in my left knee. The docs at Stanford used cadaver tissue and left my MCL "as is" so as not to put me through undue stress. Still a year out from any serious hiking. Any tips for strengthening my left knee? Thanks. Eric

HAMSTRINGS HAMSTRINGS HAMSTRINGS…. your best exercises for post ACL repair is to make sure your glutes and hamstrings are super strong. Don't worry too much about the quads, they'll come along just fine in your daily life. But look up hamstring exercises and butt exercises and go to town.

Thanks for the suggestion. Eric

Physio and walk, walk, walk.