The Best Knee Braces – Should You Use One?

Disclaimer: This is not advice but simply my opinion as a Doctor of Physical Therapy in the clinic. Please reach out to your local health professional or primary care provider for more information. 

We often get asked

“What is the best knee brace for my (enter past/ current injury here)?”

The truth is, it is nearly impossible to answer this without seeing the client move and hearing more about their history. 

In the rehabilitation realm, like most industries, there is a lot of Bulls*** floating around. Marketing is king and most people are eager to find a quick fix or avoid pain at all costs. The one caveat to all of this is the power of placebo. The mind is extremely powerful and can provide a sense of confidence when all you really needed was proper education and plan of action. 

What I am getting at is knee braces come in shiny colors, fun shapes, and the ‘latest and greatest’ technology. Do not be fooled as most knee braces hold one function, that is to provide a bit of support TEMPORARILY so you can proceed with your activity minimally pain free.

Now, there are times when knee braces are absolutely appropriate such as:

• Acute Injury (Within 6 months)
• Post Surgery
• Protecting a joint during high impact activity (Football, rugby, etc.)

If you do not fall into any of the above categories, maybe below is more appropriate. I would ask why and what are you doing about it?

• Protect the joint after past injury (years)
• Protect the joint from past or current pain
• Prevent an injury because it feels good
• Performance

This study provides a perfect example of just how powerful knee braces can be with kinesiophobia (fear of movement) after an injury versus minimal intervention. Within the 2 week and 6 week mark, the knee brace provided mental confidence with acute injury and movement but beyond this, nothing more.

Here a list of great studies (Randomized controlled trials, meta-analysis, systematic reviews) showing that knee braces provide minimal protection and use 

Decreased Pain and Improved Dynamic Knee Instability Mediate the Beneficial Effect of Wearing a Soft Knee Brace on Activity Limitations in Patients With Knee Osteoarthritis.

Can a Knee Brace Prevent ACL Reinjury: A Systematic Review.

The effect of knee bracing on the knee function and stability following anterior cruciate ligament reconstruction: A systematic review and meta-analysis of randomized controlled trials.

Effect of using knee valgus brace on pain and activity level over different time intervals among patients with medial knee OA: systematic review.

Braces and orthoses for treating osteoarthritis of the knee.

Two Weeks of Wearing a Knee Brace Compared With Minimal Intervention on Kinesiophobia at 2 and 6 Weeks in People With Patellofemoral Pain: A Randomized Controlled Trial.

These all pretty much say the same thing stating with the thousands of participants studied, there is inconclusive evidence for the benefits of bracing for pain, stiffness, and quality of life IN THE LONG TERM. More research is needed…

Conclusion?

So, what is the moral of the story? Use a knee brace if you have an  acute injury but do not rely on it. They were never meant to be long term solutions, only short term band-aids. Strengthen the knee through targeted exercises, flexibility, and appropriately progressed powerful movements. 

If you want to move forward with a knee brace, these are my suggestions. It does not need to be fancy, just supportive (affiliate links). The reality is, ALL knee braces slide down with active movement. If one is claiming that its does not, red flag…

Don Joy Hinged Brace
https://amzn.to/3voQT2g

Don Joy Webbed Compression Support
https://amzn.to/3suxKKv

Don Joy Patellar support
https://amzn.to/3ht9cew

Techware Basic Knee Support
https://amzn.to/3tjlMSV

Lastly, if you really want to strengthen your knees you need the right plan of action.

Our robust knee guide found here is a great start.

References:

Waddington G, Harlaar J, Dekker J. Decreased Pain and Improved Dynamic Knee Instability Mediate the Beneficial Effect of Wearing a Soft Knee Brace on Activity Limitations in Patients With Knee Osteoarthritis. Arthritis Care Res (Hoboken). 2019 Aug;71(8):1036-1043. doi: 10.1002/acr.23722. Epub 2019 Jul 12. PMID: 30099859; PMCID: PMC6771793.

Marois B, Tan XW, Pauyo T, Dodin P, Ballaz L, Nault ML. Can a Knee Brace Prevent ACL Reinjury: A Systematic Review. Int J Environ Res Public Health. 2021 Jul 17;18(14):7611. doi: 10.3390/ijerph18147611. PMID: 34300065; PMCID: PMC8303933.

Yang XG, Feng JT, He X, Wang F, Hu YC. The effect of knee bracing on the knee function and stability following anterior cruciate ligament reconstruction: A systematic review and meta-analysis of randomized controlled trials. Orthop Traumatol Surg Res. 2019 Oct;105(6):1107-1114. doi: 10.1016/j.otsr.2019.04.015. Epub 2019 Jul 3. PMID: 31279767.

Alfatafta H, Onchonga D, Alfatafta M, Zhang L, Boncz I, Lohner S, Molics B. Effect of using knee valgus brace on pain and activity level over different time intervals among patients with medial knee OA: systematic review. BMC Musculoskelet Disord. 2021 Aug 12;22(1):687. doi: 10.1186/s12891-021-04513-0. PMID: 34384421; PMCID: PMC8362244.

Duivenvoorden T, Brouwer RW, van Raaij TM, Verhagen AP, Verhaar JA, Bierma-Zeinstra SM. Braces and orthoses for treating osteoarthritis of the knee. Cochrane Database Syst Rev. 2015 Mar 16;2015(3):CD004020. doi: 10.1002/14651858.CD004020.pub3. PMID: 25773267; PMCID: PMC7173742.

Priore LB, Lack S, Garcia C, Azevedo FM, de Oliveira Silva D. Two Weeks of Wearing a Knee Brace Compared With Minimal Intervention on Kinesiophobia at 2 and 6 Weeks in People With Patellofemoral Pain: A Randomized Controlled Trial. Arch Phys Med Rehabil. 2020 Apr;101(4):613-623. doi: 10.1016/j.apmr.2019.10.190. Epub 2019 Dec 10. PMID: 31830433.