It's story time boys and girls.

Around a week ago my ortho friend told me about a patient of his: 16 year old boy who came into his office with a fractured femur from playing basketball. This boy fractured his leg after having knee to knee contact with another boy of approximate weight and height. What made this more interesting was it was his patient who was actually running at the other kid who was stationary and it was his patient who also came in with all the momentum and force; he was the one who caused this accident. Without letting my ortho friend finish I cut him off and asked "What kind of horrible pathology does this kid have? What's he got rickets or something? (insert sarcasm here)". My ortho friend laughed, told me no, and finished the story.

I guess a few weeks ago the same kid slightly "twicked" his knee. He also came to my friend's office to have him check it out. My ortho friend evaluated it, told him it looked okay, not even really a sprain/strain, to ice it, and it would be fine. Well, in all the wisdom that his father and coach could muster up together, they decided to go out and buy this kid the best knee brace possible so "he couldn't injure it more".

This is the kind of brace they got him and told him to wear.


So this kid is running around in a game with the most solid brace known to man for a "twicked" knee, no real sprain/strain, and hits another kid knee to knee, leg to leg at full force while running towards the basket. Since this kid was wearing such a solid brace, and that the knee was supported, something had to give. Instead of the knee, it was his femur (the thickest freakin bone there is!). It snapped it 2, sold clean break, and now this kid had to undergo major surgery- screws, rods, etc. When my ortho friend asked his father why he was wearing the brace the father looked at him with a puzzled expression and responded back "because I wanted to make sure his knee stayed safe". Good job dad. Good job.

Ankle Braces. Knee Braces. Hip Braces. Back Braces. Shoulder Braces. Elbow Braces. Wrist Braces. Finger Braces. A brace for almost every joint of the body. Braces were designed to help support that joint, taking off stresses from the ligaments, tendons, capsules, joint itself, and so on and so on. Meant to be used after surgery or even major sprain/strains, the brace is a common tool used in all sports by numerous athletes.

So what's the point here? Athletes, especially young athletes and our future stars, are utilizing them wrong. They were never designed to be used PERMANTELY or for any bump, bruise, or "owie" that occurs. And yes, it does make a difference if you should wear an ace bandage, utilize taping, light brace, or the heavy duty monster that I posted a pic of above.

"A ligament is a short band of tough fibrous dense regular connective tissue composed mainly of long, stringy collagen fibres. Ligaments connect bones to other bones to form a joint. (They do not connect muscles to bones; that is the function of tendons.) Some ligaments limit the mobility of articulations, or prevent certain movements altogether." wikipedia.

Ligaments are elastic, and while under tension, they lengthen. They are designed to stretch and protect the joint from dislocation or worse. A sprain is when the ligaments are compromised (read here for the varying Grades of sprains:

Now, let's pretend that you suffered from a second degree knee sprain of your ACL. You rest for awhile, and are now ready to practice and play in a future game. You decide to go and wear a knee brace so your knee is more stable and less pressure is taken off of your knee and damaged ligaments. Great. No problem here......yet! At the beginning and immediately after an injury, when returning to practice and a game it's not a bad idea to wear a brace. Problem is that athletes never ween themselves off of the brace. The only way a ligament and a tendon get strengthened is if you place that ligament or tendon under pressure and tension (just like a muscle!). Most people understand that for muscles to grow they need to be placed under resistance. It's no different with ligaments and tendons. By constantly utlizing a brace and wearing a brace the ligaments and tendons and even the joint never get stressed and rehabbed to it's full potential. Even the muscles around that joint never reach maximum potential with a brace on. If ALWAYS wearing a brace, (which the point of the brace is to take pressure OFF of the ligaments and joints (aid them in their functions), during practice and even during your training the joint, ligaments, tendons and muscles will never increase in strength and thickness properly.

Athletes who need to get on the field or court as fast as possible, even after surgery, should begin their rehabiliation utilizing a brace. Even during the strengthening stages. However, they have to eventually ween themselves off of them (which most athletes are NOT doing). They have to get to a stage in their rehabilitation were they are exercising that joint, and the ligaments and tendons, without any aids or help so it strengthens maximally (is that a word?). This will NEVER occur if rehabing while wearing a brace. Yes, during the initial stages of practice you might need to wear a brace. YES in games you should wear a brace. But eventually again, you need to ween yourself off of these things. Imagine a kid who twicked his MCL in his knee. He's a basketball player. MCL stabilizes the inside of the knee and is stressed when the knee goes inwards and foot outwards. He needs that ligament to be strong for cutting. He he always exercises, drills, practices, and plays with a brace that ligament will always remain weak. He goes outside and does something for fun, with no brace.... he's predisposed himself to injury!

Braces are being over utilized in professional and amateur sports today. With prolonged use they actually WEAKEN that joint and the surrounding ligaments and tendons since you never put 100% pressure and tension on that joint (which is the job of the brace). Surgeries are a different case. Unrepaired MCLs or ACLs or any other ligament is another case. This isn't set in stone.

So if you wear a brace all day long, during exercising, during practice, during games, while you sleep, etc, etc, think about what you are doing. Get rid of that "crutch" and start strengthening that joint properly.

Consult a doctor (who knows what the hell he is talking about) and make the right choices.

Just trying to educate.



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