Knee Support: Types, Proper Application, and Key Considerations

How Do You Put On a Knee Support?

Properly applying a knee support is crucial for maximizing its effectiveness in providing stability, reducing pain, and aiding recovery, requiring attention to sizing, alignment, and the specific design of the brace.

Understanding the Purpose of Knee Support

Knee supports, also known as knee braces, are designed to provide various levels of support, compression, and stability to the knee joint. Their primary functions include:

• Pain Relief: Reducing discomfort associated with conditions like osteoarthritis, patellofemoral pain syndrome, or tendonitis.
• Stability: Limiting excessive movement or providing external support to ligaments (ACL, PCL, MCL, LCL) following injury or surgery.
• Proprioception: Enhancing the body's awareness of the knee's position in space, which can improve motor control and reduce the risk of re-injury.
• Compression: Reducing swelling and improving circulation, especially with sleeve-style supports.
• Patellar Tracking: Guiding the kneecap (patella) to move correctly within its groove.

The method of application varies significantly depending on the type of knee support, which is why understanding the different categories is the first step.

Types of Knee Supports and Their Applications

Knee supports are broadly categorized by their design and the level of support they offer:

• Compression/Sleeve Braces: These are typically pull-on, elastic sleeves that offer mild compression and warmth. They are often used for general support, mild pain relief, swelling reduction, and enhanced proprioception.
• Patellar Straps: Smaller straps worn just below the kneecap, designed to apply pressure to the patellar tendon. They are commonly used for conditions like patellar tendonitis (jumper's knee) or Osgood-Schlatter disease.
• Wrap-Around/Adjustable Braces: These supports wrap around the knee and fasten with Velcro straps. They offer adjustable compression and moderate support, often featuring an open patella design or side stabilizers.
• Hinged Braces: These provide significant support with rigid bars on the sides and hinges that allow for controlled knee flexion and extension. They are used for ligamentous injuries (ACL, MCL, PCL), post-surgical recovery, or osteoarthritis.
• Unloader Braces: Specifically designed to shift stress away from a damaged part of the knee joint, often used for unicompartmental osteoarthritis. Their application is highly specific and often prescribed by a medical professional.

General Principles for Applying Any Knee Support

Before applying any type of knee support, consider these fundamental principles:

• Clean and Dry Skin: Ensure the skin around your knee is clean and dry to prevent irritation and ensure the support stays in place.
• Correct Sizing: A properly sized brace is paramount. Too tight, and it can restrict circulation or cause discomfort; too loose, and it won't provide adequate support. Always measure your thigh circumference (typically 4-6 inches above the kneecap) and calf circumference as per the manufacturer's guidelines.
• Proper Alignment: The support must be correctly positioned relative to your kneecap and the joint line. Misalignment can lead to chafing, discomfort, or ineffective support.
• Comfort vs. Support: While a brace should provide support, it should not cause pain, numbness, tingling, or significant restriction of movement beyond its intended design.
• Read Instructions: Always refer to the specific manufacturer's instructions that come with your knee support, as designs can vary.

Step-by-Step Guide: Applying Specific Knee Support Types

Here's how to apply the most common types of knee supports:

Sleeve/Compression Braces

1. Sit Down: Sit in a comfortable position with your leg extended or slightly bent.
2. Gather the Brace: Bunch up the sleeve brace, much like you would a sock, to make it easier to pull on.
3. Position Over Foot: Place your foot through the opening of the bunched-up sleeve.
4. Pull Up to Calf: Gently pull the sleeve up over your ankle and calf.
5. Center Over Knee: Continue pulling the sleeve up until it is centered over your kneecap. The top edge should be on your lower thigh, and the bottom edge on your upper calf.
6. Adjust for Comfort: Ensure the fabric is smooth, without wrinkles, and that the kneecap is comfortably centered within any designated patella opening (if present). It should feel snug but not constrictive.

Patellar Straps

1. Locate Patellar Tendon: Identify the patellar tendon, which runs from the bottom of your kneecap down to your shin bone (tibial tuberosity).
2. Position the Strap: Place the strap just below your kneecap, directly over the patellar tendon. The padded or contoured section of the strap should rest on this tendon.
3. Fasten Securely: Wrap the strap around the back of your knee and fasten it using the Velcro closure.
4. Adjust Tension: Adjust the tension until you feel firm, localized pressure on the tendon. It should be snug enough to provide support without causing discomfort or restricting blood flow. You should be able to comfortably bend your knee.

Hinged Braces

1. Open All Straps: Unfasten all the straps on the brace.
2. Position the Brace: Sit with your leg extended. Place the brace around your knee, ensuring the hinges on the sides align with the natural joint line of your knee (roughly level with the top of your kneecap). The kneecap should be centered within the patella opening.
3. Secure Bottom Straps: Begin by fastening the two straps closest to your calf, starting with the bottom strap, then the one just above the calf. Pull them snugly but not overly tight.
4. Secure Top Straps: Next, fasten the two straps closest to your thigh, starting with the one just above the knee, then the top-most strap.
5. Adjust for Fit: Flex and extend your knee a few times to allow the brace to settle. Re-tighten any straps as needed. The brace should feel secure and prevent excessive side-to-side or twisting motion, but still allow for the intended range of motion. The hinges should move smoothly with your knee.

Wrap-Around/Adjustable Braces

1. Open the Brace: Lay the brace flat with the inside facing up.
2. Position Under Knee: Sit with your leg slightly bent. Slide the brace under your knee, ensuring the patella opening (if present) is centered directly behind your kneecap.
3. Wrap and Fasten: Bring one side of the brace around the front of your knee, then overlap it with the other side. Secure the main Velcro closures.
4. Secure Additional Straps: Many wrap-around braces have additional straps (often above and below the kneecap). Fasten these straps, adjusting the tension to achieve the desired level of compression and support. Start with the lower straps, then the upper ones.
5. Check Alignment: Ensure the kneecap remains centered and the brace is not slipping during movement. Adjust the tension of the straps as necessary for comfort and stability.

Common Mistakes to Avoid

• Too Tight: Can restrict blood flow, cause numbness, tingling, skin irritation, or nerve compression.
• Too Loose: Provides inadequate support, may slip or bunch, and won't achieve its intended purpose.
• Incorrect Positioning: If the brace is not centered on the kneecap or the hinges are not aligned with the joint, it can cause discomfort, skin irritation, or fail to provide proper support.
• Wearing for Too Long: Unless advised by a healthcare professional, avoid wearing a brace for extended periods, especially overnight, as it can potentially weaken the muscles over time or cause skin issues.
• Ignoring Discomfort: A well-fitting brace should not cause pain. If you experience persistent discomfort, adjust the brace, or consult a professional.

When to Consult a Professional

While knee supports can be beneficial, they are not a substitute for professional medical advice. Consult a doctor, physical therapist, or kinesiologist if you:

• Experience new or worsening pain while wearing the brace.
• Develop numbness, tingling, or changes in skin color in your leg or foot.
• Are unsure which type of knee support is appropriate for your condition.
• Have a significant knee injury or persistent knee pain.
• Are considering a hinged or unloader brace, as these often require professional fitting and prescription.

Conclusion

Proper application of a knee support is as important as choosing the right one. By understanding the different types of braces, adhering to general fitting principles, and following specific application steps for your chosen support, you can optimize its effectiveness in managing pain, enhancing stability, and supporting your knee health. Always prioritize comfort and function, and don't hesitate to seek professional guidance when in doubt.