Does Wearing A Brace Help Prevent Injury
Jessica Hegg reviews the evidence to support the use of braces to help prevent injury.
In 2014, in what came to a surprise to many in the American football world, a requirement from on high came down that the offensive and defensive linemen of the Dallas Cowboys football team were all going to have to wear knee braces. In hopes of preventing future injury, the football players (some begrudgingly) strapped on the knee braces at an early season practice and the rest is history. Other teams, including the New England Patriots, have followed suit, with even more widespread use amongst college divisions
A 2017 New York Times article has turned the lense on this trend, refueling the hotly debated topic amongst athletes, physical laborers and the medical community . . . do braces truly help prevent injury?
From foot and ankle braces, to knee, back, wrist, and hand braces, the options of physical aids for our bodies is seemingly endless. What is it exactly that braces do? Depending on the type, i.e. a flexible sleeve brace for your knee versus a hard spica splint for your thumb, braces serve a handful of purposes:
Braces are widely used post-injury to aid recovery and provide pain relief. Take longtime surveyor, Jerry Winfield, for example. He spent decades manipulating surveying instruments, like a level gun, with his wrist and fingers, and upon retirement found himself experiencing a nagging pain in his palm and fingers. What was happening? His doctor told him carpal tunnel syndrome was causing inflammation that put pressure on the median nerve running from his arm to his hand, leading to pain, which Jerry shared even woke him up in the night. The solution? A hand brace that immobilized the hand and prevented movement and pressure while he slept. Relief was swift and significant.
This type of post-injury experience with braces is common, but when it comes to preventing injury, the effectiveness of braces can be a much more wishy-washy subject. Let us take a look at the top 3 types of braces and what we know:
Specifically looking at back braces, which are most popular amongst physical laborers where heavy lifting is a daily requirement (like warehouse workers and airport baggage handlers), the Center for Disease Control reported the findings of multiple studies analyzed by the National Institute for Occupational Safety and Health (NIOSH) in 1996. They could not specifically link the use of back braces with preventing back injury (the leading cause of workman’s compensation claims) claiming insufficient scientific evidence to support or refute the assertion on which many back braces are sold.
Seemingly outdated, the 1996 report has been followed up with a few studies, including a 2015 report which also found low correlation between back braces (or back belts) and injury prevention. Experts conclude instead that low back pain and low back injuries are best prevented by implementing ergonomics programs that educate workers about proper lifting techniques and that redesign workplace settings to make lifting less hazardous.
Inconsistent evidence across various scientific studies involving prophylactic bracing of the knee both support and refute the claims that knee braces prevent injury. Knee braces are worn largely by athletes either recovering from an injury or surgery, or in efforts to proactively stop an injury from happening.
The knee cap is surrounded by crucial cartilage, tendons, and ligaments, like the anterior cruciate ligament (ACL), which can be strained or torn with overuse, hyperextension, and severe impact. A 2016 study which looked at changes in lower limb muscle function with prophylactic knee bracing suggested that “prophylactic knee bracing may help to provide stability to the knee joint by increasing the active stiffness of the hamstrings and vasti muscles later in the landing phase rather than by altering the timing of muscle forces.”
A previous 2010 study, however, which focused specifically on football players and injuries to the medial collateral ligament (MCL) found that preventative knee bracing did not consistently reduce MCL injuries. Most knee brace studies aimed at answering the question “do knee braces prevent injury?” go back and forth and claim that further evidence and study is required to make a sound scientific recommendation.
Ankle braces which secure the ankle to stabilize it and prevent it from rolling over are often recommended to athletes who have experienced ankle injuries before and who are re-engaging in athletic activity. Similar to back and knee braces, hard scientific backing to the claim that ankle braces can fend off injury is sparse.
A 2016 literature review which examined evidence from 10 different studies on the correlation between ankle bracing and lower-extremity landing biomechanics found that ankle braces could alter movement in a way that actually predisposes an athlete to injury. A similar meta-analysis completed that same year, however, did in fact show positive results from ideal prophylactic ankle braces which specifically limited excessive joint motion during ankle inversion while still allowing normal range of motion.
Hand braces, shoulder braces, and wrist supports (or splints) are more commonly used to immobilize hand, shoulder and wrist joints to limit movement, relieve pain, and prevent exaggerating an existing injury or condition like carpal tunnel, arthritis, or a wrist sprain.
What about elbows? Lateral epicondylosis, or tennis elbow, is affecting more than just tennis players. Also known as “mouse elbow” from its result of prolonged computer use.
A 2009 study found that orthotic management which involved wearing orthoses including an elbow strap or an elbow wrap aided grip strength both immediately and significantly for tennis elbow sufferers. The elbow orthotic use also diminished feelings of pain when gripping.
Weight Lifting Braces
If you are weight lifting circuit has grown to more and more weight, longer reps, and harder regimens, you might be considering wearing a brace to aid your performance and help prevent injury. Weight lifting braces range from the commonly scene waist belts to braces for your knees, elbows, wrists, and hands.
What exactly do weight lifting braces do? A waist belt, for example, helps support the core muscles and give your abs a wall to push against when lifting, adding leverage to your form. Like other research around bracing, studies examining the efficacy of weight lifting belts varies and seems a bit outdated, like this 1991 study from the British Journal of Sports Medicine that found wearing a belt during weight lifting had potential benefits including stabilizing the trunk and making for safer lifting.
Wrist and elbow braces (and strengthening wraps) help stabilize and support these more vulnerable joints and also provide a non-slip gripping surface to aid safer lifting. Elbow wraps specifically provide pain-free lifting support for someone with sore or overused arms. Wearing wrist straps through your entire workout or lifting routine is unnecessary, but the more compromising lifts like shrugs and and stiff-legged deadlifts may help you.
Knee wraps and knee sleeves may also be worn by some athletes during weight lifting circuits, especially when performing squats. The knee joint absorbs a lot of the shock with heavy weight lifting, and wraps and sleeves can provide compression and support to aid your training sessions.
As far as preventative measures go, the efficacy of the top braces including back, ankle, knee, and elbow - is roughly up in the air, though the benefits from weight lifting belts, braces, and wraps seem more widely experienced. Keep in mind, scientific analysis requires a strict and irrefutable foundation of evidence, and if not enough studies have been completed to provide said evidence, a final conclusion simply can't be made.
Experts have also found an interesting phenomenon if you will that sometimes braces generate an over-confidence and athletes end up committing to more physical exertion and joint stress than if they weren't wearing one. You may have noticed in weight lifting that a belt or brace enhances the efficiency and strength of your performance, so quickly escalating to more weight and more reps seems that much more feasible (even if your muscles aren't quite ready for that).
Another issue experts hone in on with bracing is how well wraps, straps, and braces are applied when completing physical activity or lifting weights. Proper bracing technique is critical when playing sports and lifting weights, as misplaced or loose braces, wraps, and tape can actually make you more susceptible to injury and be detrimental to your overall performance.
Injury prevention can also be a result of regular exercise, stretching, maintaining a healthy weight, and catching and treating potential conditions (like tendonitis) before they make your muscles and connective tissues more susceptible to strain and rupture. If you are still wondering if a prophylactic brace is a good idea for you to prevent injury when you work, lift weights, or play sports, talk to your doctor or sports medicine specialist about what they recommend based on their vast and in-person experience.
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About the Author
Jessica Hegg is the content manager at ViveHealth.com. Interested in all things related to living a healthy lifestyle she works to share valuable information aimed at overcoming obstacles and improving the quality of life for others.
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