What Kind Of Knee Brace Do I Need? | Case-by-Case Recommendations From a Physical Therapist

There are several types of knee braces. One of the most common questions I get from my knee patients is: What kind of knee brace do I need?

This depends on several factors. These include your symptoms, whether you had a knee injury or not, and if so, how severe it was.

For example, you’ll probably only need a knee sleeve for mild knee pain. But, a hinged knee brace is going to be better for ligament issues. An unloader brace might be the most useful for arthritis.

I can go on and on. But, remember that wearing a knee support is only one piece of the whole treatment.

That said, here’s a summary of what you’ll find here:

• What kind of brace do you need?
• How to choose a knee brace?
• What to expect from your brace?
• When should you use your knee brace?

What type of knee brace do I need?

Healthcare professionals will use the following factors to decide what’s most suitable:

• Your symptoms
• Your age
• Lifestyle
• Other related factors

That said, it’s always best to talk to your doctor or physical therapist before buying a knee support. Plus, they will give you precise instructions to make sure it provides the best results.

But, here are a few general guidelines that we use, according to some of the most common knee injuries:

For general knee pain

The type of brace will depend on the cause of knee pain. But, we usually recommend wearing sleeves for pain relief.

They wrap around your knee, providing support and compression.

Most people that wear a knee brace for pain relief tend to feel less knee pain. Yet, this depends entirely on the cause of the symptoms.

For knee arthritis

This is considered an overuse injury, where there’s some wear and tear on your knee joint. This may cause some swelling and pain with daily activities like walking.

Depending on the severity of the knee osteoarthritis, we might recommend (1):

• Sleeves with or without a patellar hole. It may help reduce pain and swelling.
• A hinged brace, if you have knee instability.
• Or an unloader brace, if you have arthritis on one compartment of the knee and your ligaments are healthy.

Related: Reviews of the top knee braces for osteoarthritis

For meniscus injury

Meniscus injuries are common in sports, the military, and occupations that need constant squatting and/or kneeling. (2)

Depending on the type of injury and location within the meniscus, we might recommend:

• A sleeve for mild tears in the non-athlete population.
• A hinged brace, if the tear is moderate or severe.
• An unloader brace, if you had meniscus surgery.

For ACL tear or ligament sprain

The ACL is the most commonly injured ligament in the knee. The injury usually happens during activities or sports with sudden changes in direction, like football or soccer. (3)

Depending on the severity of the injury, we might recommend:

• A hinged sleeve for mild tears on the knee, to prevent worsening them.
• A hinged brace, if the tear is moderate or severe.
• A brace that restricts the range of motion, if you had ligament surgery.

For pain around the patella

The patella or “kneecap” is the bone at the front of your knee. It looks like an inverted triangle.

The patellar area can get painful for several reasons: weakness, overuse, patellar tendonitis… That’s why it’s important to define the root cause of the pain. This will help you know which knee brace will be best for your needs.

However, for this type of injury, we usually recommend:

• Wrap-around braces.
• Knee braces with patellar straps.
• Open patella knee supports.

Types of knee braces

As you can see, there are several types of knee braces. Let’s take a look at each one and how they help:

Knee sleeve

Most sleeves are made of neoprene, a compression material that also retains heat. This has several benefits:

• It increases the blood flow to the knee joint. This helps the healing process.
• It provides some support and a sense of safety.
• The compression can reduce pain and swelling.

Some sleeves may have a patella hole, others may have removable hinges for more support.

These benefits make knee sleeves a great option for issues like:

• Mild to moderate knee pain.
• Knee arthritis with mild symptoms.
• Mild pain and swelling after working out.

But, their level of support and protection is very little. They won’t provide much help in these situations:

• Moderate or severe ligament and/or meniscus tears.
• Advanced knee arthritis.
• Immediately after knee surgery.
• Persistent knee instability.

Hinged knee brace

Using knee braces with hinges will provide a high level of support and protection to the joint.

It has metal or plastic hinges on one side of the knee, or both – depending on which ligaments you want to protect. The straps help keep it in place. These are why hinged knee braces are best suited to stabilize the knee.

They’re usually worn:

• In moderate or severe knee injuries, like an ACL tear or a meniscus injury.(4, 6)
• After knee surgery. Some hinged knee braces have a dial that restricts the range of motion. (4, 5)
• By athletes during practice to prevent direct impact injuries.
• During the early stages of knee rehabilitation.(4, 5, 6)
• By people with persistent knee instability.

But, a hinged knee brace may be excessive for:

• Mild to moderate knee injuries.
• Working out in the gym.
• Persistent knee pain.

Unloader brace

This type of knee brace is usually custom-made. It’s designed in a way that helps shift the pressure and weight on the knee joint to reduce pain.

Unloader braces are best for people with (4, 5):

• Severe arthritis in one or all compartments of the knee.
• Meniscal injuries with healthy ligaments.

They don’t protect the knee from direct impact or promote stability.

Learn more: Pros and cons of unloader braces.

Brace with a patellar hole

This can be a sleeve or a hinged brace with a patellar opening. It helps the kneecap by:

• Reducing the pressure on the area.
• Keeping the patella in its place.
• Cushioning the knee.

That’s why they’re best for people with pain around the patella or prone to kneecap dislocation.

Custom knee braces

This will obviously be the best knee brace for you because it’s designed specifically for your needs.

However, a custom brace tends to be very expensive. That’s why they’re recommended for chronic knee problems, like persistent instability or knee arthritis.

Your doctor may write a prescription for it and refer you to an orthotist. The orthotist will take your leg measurements and build the brace in a few weeks.

What to expect from knee braces?

You must have clear expectations of what a knee brace does and doesn’t do.

Most knee braces are designed to:

• Support the knee in different levels.
• Help reduce the pressure from the upper leg on an injured knee.
• Increase the blood flow to the injured area, which promotes healing.
• Provide protection to the knee.
• Restrict the range of motion.

But, if you’re planning on wearing a brace, knee braces won’t:

• Restore natural leg strength and stability.
• Replace proper technique.
• Make you heal faster.
• Cure your knee problem.

Unless your therapist or doctor tells you otherwise, you shouldn’t be wearing a knee brace all your life.

That’s why the best knee brace is the one that makes it easy for you to do your rehabilitation program.

When should you use your knee brace?

Your therapist will give you instructions on how to wear a brace and for how long, according to your symptoms. Wear the brace according to those instructions.

However, here are some general recommendations for wearing a knee brace:

• If you’re not wearing it enough, you may delay your recovery process.
• Unless you’re recovering from surgery, take it off for sleeping.
• Wear it during the activities your therapist told you to.
• If you have to shower with it, don’t get it wet.
• It may not be necessary if you’re only sitting for a while.

FAQs:

Conclusion: What knee brace do I need?

Knee braces can be found almost anywhere. But, it’s important to check with your doctor to see whether you need one. If that’s the case, your doctor will know which knee brace is best for you.

But, in general:

• For severe knee injuries, a hinged brace will probably be your best option.
• For a mild or moderate injury, there’s a variety of sleeves and braces to choose from.

And remember:

Using a knee brace is not a replacement for natural strength and stability. Wear a knee brace as an addition to the skills you already have.

Resources

1. Chuang, Shih-Hung et al. “Effect of knee sleeve on static and dynamic balance in patients with knee osteoarthritis.” The Kaohsiung journal of medical sciences vol. 23,8 (2007): 405-11. doi:10.1016/S0257-5655(07)70004-4
2. Raj, Marc, and Bubnis, Matthew. “Knee Meniscal Tears.” [Updated 2020 Jul 19]. StatPearls. Retrieved on July 6, 2021 from: https://www.ncbi.nlm.nih.gov/books/NBK431067/
3. Evans, Jennifer, and Nielson Jeffery. “Anterior Cruciate Ligament Knee Injuries.” [Updated 2021 Feb 19]. StatPearls. Retrieved on July 6, 2021 from: https://www.ncbi.nlm.nih.gov/books/NBK499848/
4. Kalra, Mayank et al. “The effect of unloader knee braces on medial meniscal strain.” Prosthetics and orthotics international vol. 43,2 (2019): 132-139. doi:10.1177/0309364618798173
5. McGibbon, Chris A et al. “Biomechanical Study of a Tricompartmental Unloader Brace for Patellofemoral or Multicompartment Knee Osteoarthritis.” Frontiers in bioengineering and biotechnology vol. 8 604860. 28 Jan. 2021, doi:10.3389/fbioe.2020.604860
6. Paluska, S A, and D B McKeag. “Knee braces: current evidence and clinical recommendations for their use.” American family physician vol. 61,2 (2000): 411-8, 423-4
7. Yang, Xiong-Gang et al. “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.” Orthopaedics & traumatology, surgery & research : OTSR vol. 105,6 (2019): 1107-1114. doi:10.1016/j.otsr.2019.04.015