Knee Brace Use by Athletes

The knee is the most frequently injured joint during athletic events, and the medial collateral ligament is one of the most frequently injured ligamentous structures of the knee. The medial collateral ligament is a prime stabilizer of the medial side of the knee. The most frequent cause of injury to this ligament is a blow from the lateral side of the knee or thigh with or without a rotatory force, which causes a valgus stress. In the growing child, similar forces to the lateral side of the knee may result in a femonal fracture due to displacement of the distal epiphysis. It has become a goal of sports medicine enthusiasts to decrease the number of knee injuries and, specifically, the medial knee injury. The most readily apparent method to protect the knee is to provide additional external support. The lateral unidirectional articulated knee brace, strapped to the thigh and the calf, was developed in an attempt to reduce knee injuries. These lateral knee-stabilizing braces, the so-called "prophylactic knee braces," have become widely used by football players at all levels of skill. A number of early reports provided mixed conclusions as to the value of these braces.1 Two recent comprehensive studies both concluded that so-called preventive braces are not preventive and may, in fact, be harmful.2,3 Based on current evidence, the American Academy of Pediatrics recommends that lateral unidirectional knee braces not be considered standard equipment for football players because of lack of efficacy and the potential of actually causing harm.