The knee comprises three bones – the femur (thigh bone), the tibia (shinbone) and the kneecap. The entire joint is held together by 2 cruciate ligaments that pass through the centre of the joint and also by two collateral ligaments situated on the inside and outside of the joint. A patellar tendon connects the kneecap to the tibia.In addition, there are 2 C shaped pieces of cartilage between the thigh bone and the tibia (known as menisci). These bones, ligaments and tendons are all illustrated in the diagram to the left.
However, there is a vast variety of braces available on the market today. If a medical professional has advised you to wear a knee brace, you may be in need of additional guidance as to which is the best for you.
What Type Of Support Can A Knee Brace Provide?
Knee braces can provide either lateral support or kneecap support. Lateral support protects the knee joint against forces that can push it either inwards (towards the centre of the body) or outwards (away from the centre).
As we have explained above, the knee already possesses four ligaments to protect against such forces (see the diagram at the start of this page). However, if these ligaments are overstretched, torn or ruptured, a knee brace can supplement the protection they provide and allow them to heal more quickly than they otherwise would.
Knee braces can also provide patellar support (i.e. support to the kneecap). The kneecap sits in a narrow groove in the thigh bone known as the trochlear groove. Some types of knee disorders can result in the kneecap being unable to remain centrally positioned in the groove. Instead, the kneecap may tilt either to the inner or outer side of the knee.
Knee braces can provide direct patellar support by keeping the kneecap centrally positioned and preventing this tilt.
How Else Can A Knee Brace Reduce Knee Pain?
In addition to patellar or lateral support, some knee braces can provide direct compression to the joint to control pain and/or inflammation. In some cases, the compression is needed not directly to the joint but to a specific area just above or below it.
For example, the patellar tendon connects the kneecap to the tibia and can sometimes become injured or inflamed (for example, if you develop a case of patellar tendinitis). In this situation, it can be therapeutic to apply compression to the tendon to stabilize it and reduce the pain.
Knee braces can also, in some cases, change the point of contact between the thighbone (femur) and the shinbone (tibia). This is useful if the cartilage between these bones has deteriorated for one reason or another and you are starting to experience pain as the two bones make direct contact with each other.
Finally, a knee brace (or splint) can also provide soothing warmth for additional pain relief if it uses neoprene or some other heat retentive material.
Choosing The Best Knee Brace Design
When selecting a knee splint, we suggest that you ask yourself whether you are looking for a brace to provide support and, if yes, the type of support you will need (lateral or kneecap) and the amount of support.
Essentially, there are six types of knee brace design – hinged knee braces, knee stabilizers, knee compression sleeves , knee straps, patella stabilizers and unloader knee braces.
Hinged Knee Braces
Hinged knee braces offer the strongest lateral support possible while allowing your knee to maintain the most natural range of motion. Importantly, hinged braces can also protect the knee joint against hyperextension (excessive straightening of the joint, placing stress on the back of the knee joint). This type of knee brace is most useful in combating injuries like severe knee ligament sprains or damage to the knee menisci. They can also be useful in speeding recovery post surgery to correct knee problems such as a completely ruptured ligament.
Knee stabilizers use metal springs or plastic stays on either side of the knee to provide another form of lateral support. However, this support is not as strong as that provided by hinged braces. In addition, knee stabilizers cannot, in general, protect against knee hyperextension. If you have a mild knee ligament sprain or suffer from knee joint instability, this type of knee support may be the most appropriate for your injury.
In general, stabilizing knee braces are a little more comfortable and lightweight than hinged knee braces.If you have injured your knee in the past and are looking for a knee brace to provide more support while you participate in sport or work out, this type of brace may again be appropriate.
Knee Compression Sleeves
Knee compression sleeves do not provide any significant lateral or kneecap support but instead apply general compression to the knee joint. Like knee stabilizers, you may find them appropriate for injury prevention during physical activity or for treating mild general knee injuries. Many knee sleeves also retain body heat and can serve as a source of therapeutic warmth to the knee, particularly if they are made from neoprene.
Knee straps offer no lateral or kneecap support but can help provide targeted compression to relieve certain conditions. As we have mentioned above, patellar tendinitis is one such condition. IT Band Syndrome (when compression is required just above the knee joint) is another.
Patella stabilizers possess a buttress that surrounds the knee cap to keep it properly oriented and prevent patella tracking problems such as partial or complete dislocation, tilt or glide. In some cases, this feature may be incorporated in one of the other types of design e.g. some hinged knee braces also have a patella stabilization feature.
Unloader Knee Braces
As mentioned above, unloader knee braces are designed to shift the point of contact between the femur (thighbone) and the tibia (shin bone). This type of brace is useful in combating a type of knee arthritis known as osteoarthritis in which the cartilage between the bones deteriorates. It is also useful in treating meniscus tear injuries, which can sometimes have osteoarthritis as the root cause. Shifting the point of contact to an area with healthy cartilage can be effective in reducing knee osteoarthritis pain.
What Other Knee Brace Design Considerations Are There?
In addition to the type or degree or compression of support from your brace, you should also give some thought to the type of closure mechanism. In addition, you should also consider whether you would prefer an open or closed patella design.
There are two types of knee splint closure mechanisms to choose from – slip on and wraparound. While slip ons are usually sized, wraparound braces are usually more adjustable and can be placed either in front of or behind the knee. If you suffer from compromised manual dexterity or strength, you may prefer the wraparound design. In some cases, the wraparound design is more adaptable to unusual knee shapes or sizes.
Open vs. Closed Patella
Another important categorization is open vs. closed patella. Closed patella braces provide the same amount of compression to the knee cap as to the remainder of the knee. Open patella braces are more comfortable and will also relieve pressure on the patella.
Correct sizing of your knee splint or brace is extremely important. Each will come with specific instructions as to the measurements you need to make for a proper fit. We suggest you follow these closely. If your measurements place you in between sizes, we suggest you choose the larger of the two.