Brace Yourself for Sports Injuries by Pat Munro

I recently had a sports injury in which I tore my anterior cruciate ligament. I have never felt that much pain in my life. Every movement which required use of my knee was excruciating. Apparently, the anterior cruciate is among the most important structures in the knee because it provides 86% of restraining tension to the joint. The ACL has mechanoreceptors that are sensitive to all knee movements and are important to trigger the muscle reflex actions. This would explain why I had such painful aching in my whole leg not just my knee. Apparently a torn ACL is actually referred to as an ACL deficiency, and affects timing of my knee muscle contraction. My body was trying to compensate for the ACL deficiency by using other muscles, namely my hamstrings. My hamstring reflex contraction has lengthened, and now my knee has limited anterior tibial displacement. In other words, a torn ACL affects the whole leg and can lead to some very serious long term damage.

I have been booked for surgery, but in the meantime I wanted to stave off fatigue, and stay somewhat fit. I was referred to a physiotherapist by my surgeon. He suggested I use a knee brace. It was explained to me that one of the most important factors of sports medicine and rehab management is the use of braces and supports to prevent injuries and further existing ones. It can be used in conjunction with a rehabilitation program that incorporates strength training, flexibility and activity modification. It can provide mechanical protection to the knee area and stability to the joint while I am putting pressure on it. Since the goal of my physiotherapy is to strengthen the muscles around my knee to make up for the absence of an intact ACL, I took his advice very seriously.

Knee braces are made from combinations of metals, foams, plastics, elastic materials and straps. Each brace has a specific purpose.

- A prophylactic brace is designed to protect the knee from injuries in contact sports. A simple brace which is made of neoprene and elastic, it is easily found in most pharmacies and sport stores.

- Functional braces give support to knees which have already been damaged, or injured. These are mostly neoprene and elastic, and can be found online and in medical supply stores.

- Rehabilitative braces limit the knees movements while it's healing, and offer stabilized knee support. It has metal bars to keep the knee from experiencing any torque while healing. Must be fitted properly when purchasing.

- Unloader/offloader braces provide relief to arthritis sufferers and consist mostly of neoprene.

For my particular needs, I was told I needed a rehabilitative brace to provide control and protection before and after knee surgery. Rehabilitative braces are used more than functional and prophylactic braces combined. They are used only to protect injured ligaments and control knee flexion and extension angles during the healing process. These braces are cost effective, especially compared to casting. They allow easy access for treatment and monitoring; their large frame limits excessive movement and sends a message to others to avoid nearing that area. Furthermore, they allow for my therapist to adjust range of motion based on my rate of healing. Rehabilitation braces help my physiotherapist keep pace with the ever changing healing process.

I have been using my brace in conjunction with physiotherapy for a month and the pain is already better. The first 10 days were very difficult, it hurt and I had to apply ice to the area and stay off it in order to allow the injured ligament to reattach to the bone. After a few weeks I was allowed back in the gym with my brace and my therapist, and have begun strengthening exercises. I have no range of motion even after such a short athletic interval. I am not to put excessive weight on that leg while exercising, so I have started swimming and walking in my own time, always with my brace. It is the most important investment I have ever made. I intend to be physically fit my whole life, and will probably need to continue using my brace in order to not hurt my ACL again. That's okay with me. Whatever works, I say.