Bracing: when it is helpful and when it isn’t

A very common question we get asked at Grassroots Healthcare is “Do I need to wear a brace to help with my injury?” Well this is very much a ‘depends’ sort of answer. It depends on the injury, where along the injury process you are and your personal circumstances.

Let’s first outline the advantages of wearing a brace and give some examples of when youmight need to wear one.

Braces are items we place on a body part, usually over and around a joint, to provide extra stability to that area. They come in different forms but are generally quite flexible and elastic to ensure they move with the body, whilst being strong enough to protect the joint simultaneously. Some braces are quite movable whilst others can lock a joint in a particular position.

When is it helpful?

The advantages of bracing include:

• Providing stability to an injured body part to aid with treatment, rehabilitation and return to sport or work scenarios

• Allowing faster healing by limiting movement at an injured body part

• Reducing pain by de-loading injured structures

• Can be easily put on and removed for any given situation

• Are widely available and affordable

A common injury where you may need to use a brace is in the early stages of a moderate to severe medial collateral ligament (MCL) sprain of the knee. Imagine your knee has been forced inward whilst your foot is planted on the ground. If the force is great enough, the ligament stretches, tears and the stability of the knee is compromised. In this case, a brace is helpful to stop the knee from falling inwards again, which would interrupt the healing of the ligament. As healing progresses, the brace can be used less frequently or removed altogether to allow for more movement and activity. Other examples where a brace may be required include:

• Wrist and ankle sprains

• Tennis or golfer’s elbow

• Knee cruciate ligament sprains

• Pelvic instability (these are particularly helpful during pregnancy)

• For stabilisation and re-training of scoliosis cases (i.e. abnormal spinal curves)

When isn’t it helpful?

One of the most common negative effects of bracing that we see is over-reliance. When someone has injured their ankle playing netball, part of the rehab process to get them back on the court quickly may be to wear a brace to provide them with the confidence to play to their full potential without fear of re-injury. This is all well and good as long as they wean off using the brace as rehab progresses. Many people end up wearing the brace as a safety net for 6 months, a year, or even longer because they are scared of re-injury. If you rely on a brace for support, it means the body part that was injured won’t have the necessary forces placed through it to ensure a full recovery to a pre-injury state. This could affect many factors including muscle strength, ligament stability and the body’s ability to know where the joint is in space (a.k.a ‘proprioception’). In order to return to that state, it's necessary to move and exercise completely unaided.

Other disadvantages include:

• Failure to achieve full joint range of motion post-injury

• Possible muscle wasting

• Increased loads placed on other body parts, which can risk another injury elsewhere

Our best advice to you is to never see a brace as a replacement for good movement and rehab. Always follow the advice of your practitioner as to when you should and shouldn’t wear a brace. If you have any doubts or questions, please call us on5543 4254 to discuss.

References

1. Chen, L. et al. 2008. Medial collateral ligament injuries of the knee: current treatment concepts. Current reviews in musculoskeletal medicine. 1 (2). 108-113. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2684213/

2. Brukner, P. et al. 2017. Clinical Sports Medicine. 5th ed. Australia: McGraw Hill Education