How to Choose a Knee Brace?

[Whiteman]

I was wondering about the experience people have had with different knee braces. I took my girlfiend for her first major trek (Mt. Moriah, what a great view). Her history is arthroscopic knee surgery twenty years ago for ligament problems. No significant problems since then. She got pretty stiff coming down, and the good news is the stiffness did not last 24 hours. The extra growth rings which are perceptible in my mid-section also make me wonder from time to time whether it might be wise to get a little extra support for my poor old joints.

So, what do people like to use for knee braces?

We'll probably hike again before she gets an orthopedic opinion, so hopefully our random selection of a brace, guided by the experts at VFFT, will be beneficial, not harmful. (Oh, yes, she is a lawyer, but I would not worry about liability!)

Thanks!

 

[trailbiscuit]

I'm not doctor, blah, blah, blah...

Depends on the knee ailment. In my case, I have use the Cho Pat Dual Action Knee Strap, as recommended by a PT.
http://www.amazon.com/gp/product/B0000E5U8O/102-9571539-9641722?v=glance&n=3375251
They helped me through 1500 miles of the AT last summer, so I'd recommend them based on both function and durability. They are good for IT problems and patella tendonitis.

That being said, the best knee brace is properly strengthened muscles and other parts around the knee. (Which is the solution I'm working on now, and highly recommend.)

 

[Dugan]

There's a good selection of them here:
http://www.kneeshop.com/

I opt for one like this:
http://www.kneeshop.com/proddetail.asp?prod=11-0378-X&cat=16
a neoprene sleeve, with patellar support, and hinged side splints. I use mine sometimes for hiking, and almost always for alpine skiing.

The sleeves can be incredibly difficult to remove after a day of hot sweaty hiking (not to mention the smell ). I've tried a strap on, but I don't like it as well. It didn't feel like it distributed the pressure as evenly. For winter, I wear it over a thin base layer - no problems removing.

 

[DougPaul]

The best brace depends on the details of the ailment.

That said, I have used a neopreme wrap-around brace with velcro fastenings at times. (No wire bones.) Most comfortable if worn over long underwear, or a wrap with a 5-6 in ace bandage. Available at many drug stores.

Stronger leg muscles have proven to be even better.

Doug

 

[Kevin Rooney]

If you buy one at the drugstore, just make sure it has a cut-out for the kneecap. You don't want pressure on it, just support around it.

 

[kmorgan]

I'm not doctor, blah, blah, blah...

Depends on the knee ailment. In my case, I have use the Cho Pat Dual Action Knee Strap, as recommended by a PT.
http://www.amazon.com/gp/product/B0000E5U8O/102-9571539-9641722?v=glance&n=3375251
They helped me through 1500 miles of the AT last summer, so I'd recommend them based on both function and durability. They are good for IT problems and patella tendonitis.

That being said, the best knee brace is properly strengthened muscles and other parts around the knee. (Which is the solution I'm working on now, and highly recommend.)

I have this Cho Pat dual action brace and can testify to its effectiveness. In my case I had ACL replacement surgery on my left knee back at the end of 2000. I also had some meniscus damage. Last year my knee began bothering me and at times I was unable to walk or put any pressure on that leg.

I started using this brace and found it to help a lot. I was able to strengthen my legs hiking and now no longer need it.

Good luck,
Kevin

 

[SherpaKroto]

Whitelief: definitely have the knee checked. I put it off and could have saved myself a ton of aggravation and pain. I hike with a Generation 2 Extreme brace. Without it, I would not be able to hike for any distance to speak of. I can recommend a great doctor, who understands folks like us if you need info. I tried the ChoPat, and it only helped me for about 4-5 hikes, but YMMV.

 

[WhiteMTHike]

That said, I have used a neopreme wrap-around brace with velcro fastenings at times. (No wire bones.)

I'll second that. I use the exact same thing and find it effective.

 

[shadowcat]

Cho Pat Knee Brace

I HIGHLY recommend these. They work and are comfortable to wear hiking unlike some of the larger stiffer ones. And, they pack nice. I got mine off ebay for almost half what you'd pay elsewhere - they were sold in a pack of 2. If you are interested let me know and I'll go back and look at the seller I got them from - quick shipping and you'll def save some bucks.

 

[dave.m]

My suggestion is to turn of the computer and run, don't walk, to the nearest sports medicine orthopedist and physical therepists.

It's well and good to get feedback from us other hikers but there's really no telling what's going on inside of those knees. Some pains may be the kind you manage and live with. Others may be indication that you or she is doing lasting damage. Here are my loose thoughts...

1) Expect to be disappointed with the results of the first 2 or 3 doctors and PTs you visit. Some are good and some are horrible. For knees, I would start by calling atheletic departments of big colleges in your area and asking who they use. I know some names I trust in Boston. Just PM me. A very good clue about an ortho, imo, is a general desire to avoid surgery. PT, PT, PT, braces and more PT all happen way before cutting.

2) My understanding is that support type braces do little to "suport" the knee. The vast majority of their benefit is by keeping the knee joint warmer and thus increasing circulation. That is, they feel good, do little/no damage and have some benefit, but not in the way they are usually described.

3) Get 2 hiking poles and take a year (or so) to get used to them and to fully incorporate them into your hiking. Learn how to properly use the straps in XC pole fashion to support the palm of your hand against the straps, especially on descents.

4) Investigate the use of lower weight boots when possible.

5) If you are not already doing so, get on a regular program of strength training for your legs. Compression braces can not compensate for a lack of muscular strength and muscular strength (or imbalances) can be a major cause of knee pain.

6) Talk to your doctor about the prophelactic use of anti-inflamatories like aspirin and ibuprofen to minimize damage done when hiking with inflamation. I generally take them 1/2 hour before a long descent. You do more damage when things are inflamed.

7) As a last resort, there are corrective mechanical braces. I wear one on my right knee and it's sort of the last hope against having my miniscus scoped. This is only something to be pursued with a very good sports medicine orthopedists though.

Hope this helps,

 

[DougPaul]

1) Expect to be disappointed with the results of the first 2 or 3 doctors and PTs you visit. Some are good and some are horrible. For knees, I would start by calling atheletic departments of big colleges in your area and asking who they use. I know some names I trust in Boston. Just PM me. A very good clue about an ortho, imo, is a general desire to avoid surgery. PT, PT, PT, braces and more PT all happen way before cutting.

My experience with doctors and wear-and-tear problems has been rather disappointing. I've done better at figuring out how to deal with it myself in several cases--I've found them to usually be far better at diagnosis than treatment. (An accurate diagnosis is still very valuable.) Maybe I just gave up on trying new doctors too quickly...

2) My understanding is that support type braces do little to "suport" the knee. The vast majority of their benefit is by keeping the knee joint warmer and thus increasing circulation. That is, they feel good, do little/no damage and have some benefit, but not in the way they are usually described.

Think of the forces on a joint (and the leverage increases some of them by an order of magnitude or so...) and compare them to the forces exerted by one of these braces. 1000+ lbs vs ~2 lbs. These braces have a very limited direct mechanical effect. And they do keep the joint warmer. But I believe the biggest effect is the gentle pressure keeps the swelling down and prevents the tissues from being stretched by fluid pressure. (The stretching can be a continuing source of injury and we perceive the stretching as pain.)

Best to think of the braces as an aid to healing, not a long term solution.

5) If you are not already doing so, get on a regular program of strength training for your legs. Compression braces can not compensate for a lack of muscular strength and muscular strength (or imbalances) can be a major cause of knee pain.

Hear! Hear!
Building my quads (with a no wear-and-tear exercise) is what ultimately saved my knee from chondromalacia patella.

Weak muscles can also cause one to compensate (eg limp) which increases the stress elsewhere and can cause other injuries. The domino effect...

6) Talk to your doctor about the prophelactic use of anti-inflamatories like aspirin and ibuprofen to minimize damage done when hiking with inflamation. I generally take them 1/2 hour before a long descent. You do more damage when things are inflamed.

Anti-inflamatories can help with such problems, but can also damage the stomach and kidneys. Unfortunately the relatively high doses are required for the best anti-inflamatory effect can also threaten the stomach and kidneys... See, for instance, "Medicine for Mountaineering", by Wilkerson.

Been there, done too much of the above...

Doug

 

[SAR-EMT40]

That being said, the best knee brace is properly strengthened muscles and other parts around the knee. (Which is the solution I'm working on now, and highly recommend.)

Yes, yes. The correct solution IMHO.

I do use poles and recommend them but, ANY brace, or especially poles for that matter, actually works by taking the weight off the knee (ligaments, tendons and muscle) and is making the knee WEAKER. I personally only used a brace once a long time ago for a very short time and have never used it again. Practice by walking on uneven terrain without a brace to help strenthen the muscles. That is your best defense, AFTER seeing a doctor (dave.m has some good advice as well as others) to make sure I am not full of c**p.

This is what I do and what I believe. YMMV.

Keith

 

[Pamola]

I've shot my knees at 24 years old, due to too much swimming through h.s. and college and hiking. I use neoprene/velcro wraps as DP and WMTH do, with no metal inside.
They're the cheapie Mueller ones any joe shmo can buy at walmart. I love em and they've allowed me to get back to 15 miles a day, while without them my knees start tweaking at less than a mile. My only issue with them is that they chafe the back of my knees if not put on exactly right.

 

[DougPaul]

They're the cheapie Mueller ones any joe shmo can buy at walmart. I love em and they've allowed me to get back to 15 miles a day, while without them my knees start tweaking at less than a mile. My only issue with them is that they chafe the back of my knees if not put on exactly right.

My fix for the chafing is long johns (the standard polyester ones) in winter and a wrap with a 6in ace bandage in summer. They also help to take care of the sweat which accumulates under the brace.

Doug