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Knee Brace After an ACL Injury: Do I Need It?

Navigating an ACL tear can be a challenging journey, especially if you don’t have the answers to questions you may have. In this blog post, we will explore the considerations surrounding ACL tears and a common question we get asked: are knee braces essential after an ACL injury or surgery.

Understanding ACL Injuries:

     The anterior cruciate ligament (ACL) is a vital component of the knee joint, in which its main purpose is to provide stability of the knee joint, or tibiofemoral joint. The ACL provides stability by limiting hyperextension, or the shin moving excessively forward on the thigh bone.

     Furthermore, it limits the amount of rotation, especially internal rotation or the knee collapsing in, that happens at the knee. In basketball, these movements at the knee occur the most during cutting, jumping, landing, deceleration and sudden directional changes.  Therefore, if your muscles and ligaments aren’t able to do their job during these movements, the ACL could tear.

     When torn, individuals face a crucial decision – whether to opt for surgery or pursue non-surgical rehabilitation. See the video below:

The Role of Knee Braces in Non-Surgical Recovery:

     For those of you who chose a non-surgical approach after an ACL tear, the question arises: Is a brace necessary? A brace can offer valuable stability to the knee, especially if you experience episodes of the knee “giving out.” This feeling of instability becomes a key factor in deciding whether a brace is beneficial.

     The brace functions as a protective measure, preventing unwanted rotation or hyperextension movements in the absence of the ACL. Essentially, the brace acts like your “ACL” by external stability. As you develop your strength and function over time, you should be able to wean away from utilizing a brace.

     Furthermore, if you possess or develop strong quadriceps, proper muscle co-contractions, and do not experience feelings of instability, a brace or surgery may not be required. If this is the case, in research you are often referred to as “coper.”

The Role of Knee Braces in Non-Surgical Recovery:

     Following ACL surgery, the discussion around braces becomes more nuanced. During the initial post-surgery days or weeks, a brace is often required by the surgeon to provide stability and protect the knee. At this stage, the primary goal is to protect the surgical site especially during this vulnerable period of inflammation and general weakness.

     As the swelling decreases, your range of motion improves, and your strength progresses, the intent is to wean away from the brace as quickly and as safely as possible. By weaning from the brace (under supervision of a physical therapist or surgeon), you allow your muscles to body work the way they need to for you to rehab appropriately and faster than relying on the brace.

     However, a debate exists within the medical community regarding the long-term use of braces after ACL surgery. Some surgeons opt not to prescribe functional braces after the initial recovery, encouraging patients to activate their quadriceps and engage in a more dynamic recovery process.

The Role of Knee Braces in Late-Stage Recovery:

     As you progress through rehabilitation, the decision to wear a brace becomes more individualized. For example, if you are aiming to return to sport between the 9 and 12-month mark, you may need to use a brace for added stability and confidence as you gradually progress through sport-specific activities. However, rushing the recovery process is not recommended.

     The emphasis is placed on a comprehensive rehabilitation timeline that prioritizes strength, stability, and confidence in the injured knee. The use of braces for those attempting to return to sports earlier than the recommended 12-month mark is discouraged, as it may compromise true readiness and overall performance.

Conclusion:

     In the complex landscape of ACL tears, the decision to wear a brace depends on numerous factors. These include your feeling of instability or knee “giving way”, the choice between surgical and non-surgical approaches, and the stage of recovery. This guide aims to empower individuals to make informed decisions regarding the use of braces after ACL injuries.

The Basketball Doctors - Gabriel Ignacio Physical Therapist

Dr. Gabriel Ignacio PT, DPT, OCS, TPI

The Basketball Doctors - Marco Lopez Physical Therapist

Dr. Marco Lopez PT, DPT, CSCS

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The Basketball Doctors assume no responsibility or liability for any injury, loss, or damage incurred as a result of any use or reliance upon the information and material contained within or downloaded from its website. The Basketball Doctors are unable to provide any warranty concerning the accuracy or completeness of any information contained herein. The information provided in the videos are by no means complete or exhaustive, and, therefore, does not apply to all conditions, disorders, and health-related issues. The information is not intended to be physical therapy, medicaladvice, or treatment. Any reference to or mention of any particular diagnoses or dysfunctions is intended for informational purposes only and not an attempt to diagnose your particular problems.
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