Ask Well: Assessing Knee Supports

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How effective is wearing a stabilizing knee support?

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When you say “effective,” I assume that you’re asking how well a knee support can stabilize a wobbly knee or lessen the pain of an arthritic one. The answer, based on a large body of science, is that nobody really knows.

“For each study that suggests wearing a knee brace can produce a clinical benefit in reducing pain or feelings of instability,” said Dr. Robert A. Gallo, an associate professor of orthopedic sports medicine at Penn State Hershey Medical Center in Hershey, Pa., “there usually is a counterstudy which demonstrates no difference in symptoms between those using a brace and those who are not.”

It’s important, however, to differentiate among the types of knee supports. Braces usually include rigid materials such as plastic or carbon fiber that physically press against the bones of the knee and provide firm external support.

Softer neoprene sleeves don’t provide the same mechanical support, precisely because they are soft. “Generally,” Dr. Gallo said, “neoprene sleeves are thought to function by aiding proprioception,” which is the body’s sense of where it is positioned in space. In theory, improved proprioception around the knee joint could augment knee stability by improving your balance.

But a 2012 study of people with knee arthritis found “no significant improvements in balance with the use of a neoprene knee sleeve.”

There is also little persuasive evidence that knee supports, worn prophylactically on healthy knees, protect active people against knee injuries.

Still, knee supports are much less expensive or invasive than knee operations to treat injuries or arthritis, so worth trying before resorting to surgery, Dr. Gallo said.

In particular, specialized knee supports, known as unloader braces, that take some pressure off the knee joint when you walk, have been shown in some studies to help people with knee arthritis remain active and put off knee replacement surgery, at least in the short term.

Knee braces, but not sleeves, may also help after certain types of knee trauma, Dr. Gallo said, especially a torn medial collateral ligament, an injury common during basketball, soccer, skiing and other sports. An M.C.L. tear generally heals without surgery if the knee is properly supported.

But arthritis and torn ligaments are conditions that should be formally diagnosed and not self-treated, Dr. Gallo said.

In other words, if your knee aches, don’t turn to an over-the-counter sleeve or brace. Talk to a doctor first. “Bracing is most effective,” Dr. Gallo said, “when the diagnosis is known and a brace can be applied to effectively match the wants and needs of the patient.”
