What types of braces are available?
Two examples of a dynamic braces are a range limiting brace, with stops to prevent a joint from moving through full range (often prescribed post surgery to protect a graft), or dynamic range braces designed to improve range, often post-cast or post-immobilization. There are also many braces used for sleep such as carpal tunnel braces, plantar fasciitis splints, or finger immobilizers.
Functional and Athletic Braces
Lets start with a few ground rules:
1: Bracing is not a replacement for rehab. If you need a brace you also need some sort of treatment. Your treatment could consist of a 10 minute exercise routine you complete at home every day, or it could include regular visits to your Athletic Therapist. Never just strap on your brace and assume your injury woes are over!
2. Braces are specific to injured structures. Not all braces are created equally, in the same way that not all ankle sprains are the same! Please consult with your Athletic Therapist to ensure that you are purchasing the correct type of brace for your injury, and more importantly, that it fits well and you are using it correctly.
3. Braces do not make you invincible! Even with a brace, you are still at risk for re-injury or aggravation. Please see #1 -- this will help you avoid re-injury as you return to sport! The rule of thumb with braces is that they will not prevent an injury, as they do not alter the external forces being applied, but they MAY reduce the grade of your injury (i.e. a micro-tear instead of a partial thickness tear of a ligament).
Categories of Braces
A custom brace is made according to specifications sent to the manufacturer. These specs include your specific injury type, and what sort of restriction and support you require, your measurements for a perfect fit, and sometimes your sport limitations (i.e. needs to fit above a ski boot). These are the most supportive braces, and also the most expensive. The two most common custom braces are Knee osteoarthritis unloader braces, and Knee Ligament braces (i.e. ACL Braces). They are usually made of a light composite material with fabric and Velcro straps.
Pros: Fits very well, provides the highest level of support, and usually comes with a very comprehensive manufacturer warranty
Cons: Very expensive, and is usually covered by insurance only under specific circumstances (surgical cases), takes up to a week to order and manufacture
A customizable brace is one that has components that can be altered by the therapist who is providing it to you. It may have stays that can be form fitted to your injured joint, strapping that can be altered to fit, or thermoplastic sheets that are heated and molded to fit your needs.
Pros: May fit better then an off-the-shelf brace, and is less expensive then a custom brace
Cons: Difficult to find, not as common as other types of bracing, and has a margin of error depending on practitioner applying the modifications
An off-the-shelf brace is the most common, and is one that you can buy yourself at many retail locations, or order through your Athletic Therapist. There are many different sizes and types of braces manufactured for each type of injury.
Pros: Cost effective, and easily replaceable. Very applicable in cases where brace will only be worm for a short amount of time. Lots of options to choose from.
Cons: May not apply adequate amount of support for certain injuries. Can often be used incorrectly.
Types of off-the-shelf functional braces
Sleeves and compression wear
Compression is an important part of recovery, performance and pain reduction. There are many different options that can provide compression to large body parts (compression shorts, calf or knee sleeves) or to specific areas (golfers elbow compression band).
Common applications of compression wear include:
-Muscle strains (pulls) or contusions (bruises)
-Chronic inflammation (golfers or tennis elbow, patellar tendinitis)
-Chronic or acute swelling (meniscus irritation or PFPS)
-Improved proprioception post injury
-Pain reduction / improved recovery post exercise
Range reducing braces
These are braces that have some sort of rigid strapping, or metal/plastic stays. They are used to reduce certain rages of certain joints. Unlike the non-functional braces, theses braces will not reduce range so much that you are unable to complete your activities. If you require that much support, you likely are not ready to return to sport!
Common range reducing braces include:
-Ankle braces following an inversion or eversion sprain
-J-Brace for the patella to reduce PFPS or subluxation
-MCL or LCL knee braces
-Hyper-extension reduction for knee or elbow
-Wrist flexion or extension braces
.... AND SO MUCH MORE!
Uses of Braces
A brace also can wear out after use, or even 'wear-in' to a certain athlete. This means that a brace shouldn't be shared among individuals, or given to someone else when you're dong with it. It should also be frequently inspected to make sure it's not time to replace it! If you are wondering if your brace is still working for your joint, bring it in for a checkup!
Braces also should rarely be used to prevent injury from occurring. Many parents will purchase ankle braces for their children who play sport to prevent them from rolling their ankles on uneven terrain. This is actually a very dangerous practice in most situations as it allow the muscles surrounding the joint to become weaker and actually increase the risk of injury, even if the athlete is wearing the brace! If you would like added protection please consult with your Athletic Therapist to see what else can be done to prevent injury, including correct footwear, proper warm-up and cool down techniques, and of course preventative exercises! Sometimes preventative bracing is indicated, but please consult with your AT before making this decision.