BRACE WARS - Not !!
On Bob's ACL KneeBoard, there used to be spirited debates over the use or non-use of braces. Mostly everyone had an Immobilizer from day one out of the hospital but thats when the debates started - what happens from that
point ?
Many were told to take off the Immobilizer after a few days and begin walking on their own. While others not only wore the Immobilizer for a longer period of time but were then given another brace with a hinge and told to wear that one for 2-3 additional months. Then after a reconstruction, there are many that do not need to wear a brace from then on. While some OS recommend those released get fitted for a custopm sports brace and wear it for perhaps a year after the reconstruction. So.............there is no universal philosophy on the wearing of the braces. there are factors that influence the use of them - not everyone has the same deficiencies nor the same OS. We all come in different shapes, sizes, ages and abilities. Anyway, "Braces are not just for teeth !".
These are the categories (my opinion only) in which individuals may be prescribed the use of a brace: The braces are primarily the Immobilizer, Recovery Brace & Custom Sports Brace.
#1 Pre-Surgery Functional Brace - Hinged Brace
#2 Immediate Post-Surgery Period Rehabilitative Brace - Immobilizer
#3 Recovery Period Rehabilitative Brace - Hinged Brace
#4 Post- Reconstr & Sports Release Functional Brace - Custom Sports Brace
#5 Partial ACL & Sports Release Functional Brace - Custom Sports Brace
Immobilizer Brace:
This brace does not allow any flexing and basically protects the leg from impacts or strains that it is not ready to handle during the aerly rehab period. It consists primarily of a cotton fabric with wire support rods longitudinally embedded into the matl. Velcro closures hold the brace close to the leg. Many wear this brace right after the operation and from 1-4 weeks post-op when walking. It is taken off for flex exercises.
Hinged Recovery Brace:
The hinged recovery brace is sometimes used pre-surgery (so could the Immobilizer) and also post-surgery. It is not used by all individuals since OS differ on the benfits of prolonged brace use versus going cold turkey and allowing perhaps more freedom for the muscles to develop more rapidly. Howver, if flex exercises and muscle strength exercises are done according to PT/OS guidance and one gives it all they got, a brace should not be a hindrance to an on-schedule release for sports. Some individuals, though, use a brace as sort of a crutch. They rely on it for it's support. The recovery brace can be both a rehab and a functional brace. It can be locked at zero degrees extension to assist those in maintaining their extension when they are not actively doing flex exercises. It can also be unlocked or locked at various max degrees based on PT/OS guidance. Mt recovery brace in the photos is a Donjoy recovery brace. One photo is a closeup of the adjustable hinged mechanism. The brace is not custom designed. It comes in a couple of different sizes and the technician can bend the metal logitudinal support arms to fit the contour of the individual's leg. Sort of a brute force custom fit ! LOL It has velcro closures for tightneing the brace to the leg. My brace could be worn under business pants. The brace may be utilized not at all or even up to 3 mos post-op or longer ! Hint - The pads that fit under the velcro closures could be taken off and washed ! Also, the metal hinge can squeak after many weeks of wearing the brace - It's not your knee ! Wd-40 or other lubricant on the brace hinge will solve that problem.
Custom Sports Brace:
Woweee, zowee look at those colors !! You pay the bucks, you get to pick out the colors. I had a Donjoy Model 2000 custom sports brace back in 1990 for my partial 50% ACL tear. My OS had determined that my remaining ACL was still tight enough to offer some functionality but that a brace was need to provide addl functionality. Remember, sports braces are good for protection against side impacts, moving side to side and are also good for preventing hyperextension. But they are not so good for protecting the knee against twisting movements. Only a fully functional ACL will do that !!
The custom sports brace is made primarily to provide functionality for those with ACL partial tears as well as those that have just been released for all sports following an ACL reconstruction and they have an OS that feels that added protection is warranted (based on OS conservatism, nature of sports activities and/or early release dates). I had a Donjoy Model 2000. I believe the current model now is a Donjoy Defiance. Basically, my unit was custom made. A mfrs representative met me at my OS's office and took manyy measurements off of my leg (after my leg was at full strength and muscle tone). Then the factory machine spits out a brace. I think it took a few weeks until i received it. The brace served me well for 8 great knee years. As you can see from the photos, it also closes up with velcro closures. It consists of fibreglas/plastic material reinforced with metal inside it. Some use it with a rubber sleeve as is shown in one of the photos. However, i never used it with the sleeve.
