It came up again in conversation earlier this week: am I wearing a brace on my knee now that I’m starting to get back to my normal sports? It’s easy to understand why you might think you need one judging by the number of manufacturers and retailers touting their benefits. The trouble is, I can’t find any controlled studies suggesting that there is any benefit to wearing a brace after ACL surgery. Braces have not shown to reduce post-op reinjury or complications. And they do not increase function or stability.
The first study I found from 1997, followed patients for 2 years. In that time two people suffered re-injury – one in the control group and one in the brace-wearing group. No other substantial differences were found.
About the time that this study was finishing, another study came out confirming that the use of prophylactic braces in sport did not prove to be effective. This study is especially important because it was a meta-study, aggregating data from multiple clinical and experimental studies. The authors concluded that no evidence of a significant bracing effect could be demonstrated.
Okay, you’re saying, those studies were a long time ago. ACL surgery and rehab has changed since then!
Right. In 2007, another systematic review of evidence confirmed that using a brace did not affect pain, range of motion, graft stability, or protection from subsequent injury. A year later, a fourth study compared functional knee braces to neoprene sleeves for protection of ACL injured knees. This study actually began with the assumption that knee braces were effective and hypothesized that functional braces would be more effective than neoprene sleeves. Know what the found? Current evidence does not support the recommendation of using an ACL knee brace after ACL reconstruction.
I’m not telling anyone to not follow doctors orders with respect to wearing a brace (especially immediately post-op). And I’m not telling anyone they shouldn’t wear a brace if they want to. I just wanted to show that long-term, there isn’t any evidence supporting their use. If your doctor or PT recommends one, show them these studies and ask them to show you the counter-evidence that demonstrates they are effective. You should only have to to pay for medical treatments and devices that actually work!
I’ll finish by saying that I’m always open to changing my mind if evidence swings the other way, so please leave me a comment if you’ve found something that I didn’t!
In case you don’t follow my other blog – What Carry Eats – you might want to hop over there and check out my recipe for Anti-Inflammatory Chai Tea. Who couldn’t use a little comfort in a cup when they’re laid up on the couch?
Originally posted on What Carry Eats:
The first type of inflammation is good and will go away with rest and maybe an over-the-counter NSAID. The second form usually begins when our bodies’ defense system runs out of control, like a rebel army bent on destroying its own country. What few people understand is that systemic inflammation run amok is at the root of all chronic illness we experience — conditions like heart disease, obesity, demntia, depression, cancer, and even autism.
Thankfully, the list of things that cause inflammation is relatively short: poor diet, lack of exercise, stress, and hidden allergens or toxins.
Ever have a bad feeling about something and ignore it? Me too. The most recent instance involved going to the dentist a month after surgery.
It shouldn’t have been a big deal, really. Just a routine tooth-cleaning. Except as the appointment approached, I didn’t feel “up to it.” I couldn’t put my finger on why; it just didn’t seem like the right time to go. I contemplated postponing it a month, but decided just to go anyway despite my misgivings. Bad idea.
My mouth was super tender and my gums bled like crazy! Nothing had changed in my tooth cleaning routine, so the only explanation that the dentist, hygienist and I could come up with was overall inflammation in my body due to the surgery.
The lesson here is two-fold: 1) listen to those intuitions about your body; and 2) it’s a good idea to postpone going to the dentist for a few months after surgery.
Photo by @Doug88888, used with permission.