To brace or not to brace—that is the question.
Painful joints and muscles feel better when they’re supported or offloaded. To feel better, you may divert force and effort away from the painful area by distributing it elsewhere.
Let’s use a painful knee as an example. If your knee hurts, you may:
- Sit or lay down to take load off the area
- Start to limp, placing more weight on the opposite leg
- Enjoy walking in water more than land because the buoyancy offloads your knee
Most people turn to bracing, which can be quite helpful in supporting your body while you go about your business. Bracing isn’t a long-term solution because it can change how your body responds to your environment, but it can be a good short-term solution when used correctly.
Here’s when bracing is a good idea… and when it’s not.
What Does Bracing Do?
A brace is used to protect a body part from excessive force, sometimes from a specific direction, to protect the area and limit pain. You can find braces for almost any body region like your knee, back, elbow, wrist, and neck.
There are different types of braces, each with a different purpose.
Soft vs Rigid Braces
Soft braces, often interchangeably named compression sleeves, are commonly used around joints to squeeze the area and claim to supplement muscular support.
Rigid braces restrict movement, almost like a cast. They’re often used to limit joint motion so soft tissues, like muscles and ligaments, are protected while the joint heals.
Hinged Braces
Hinged braces have the option to restrict or allow movement up to a certain point. Many hinged braces have frames on either side of the limb to help further stabilize the joint.
These braces are common after knee surgeries to limit how much the joint bends during certain stages of healing. For example, a surgeon may lock your hinged brace in a fully straight position right after your operation. But several weeks later, the surgeon may unlock the hinge to introduce movement again.
Counterforce Straps
Counterforce straps help offload a muscle’s painful tendon. They’re most commonly used under the kneecap to divert force away from the patellar tendon, or at the elbow to offload the muscles involved in a tennis elbow tendon injury.
When is Bracing an Injury Helpful?
Braces are helpful if your goal is to protect your body when it is already vulnerable. Some examples where bracing is indicated can include:
- Protecting a newly injured ankle
- Reinforcing a knee after an ACL operation
- Offloading a muscle while it’s involved in an activity that would otherwise be painful
By protecting your body with a brace, you’re keeping soft tissues safe from reinjury. However, bracing to completely limit movement shouldn’t be the main goal unless you have a fracture or you’ve been directed to completely immobilize a muscle or joint by your doctor.
Bracing an injury is most successful when you gradually introduce non-painful movement and activation. Even though your body has an injury, you can still engage in exercises, stretches, and light activity as tolerated. In fact, this can help speed up recovery by improving blood flow, keeping muscles strong, and preventing stiffness. The brace’s role is to make sure your body feels safe and secure while you stay moving.
If you’re unsure how much movement you can tolerate, seek professional help by visiting a physical therapist.
When Is Bracing an Injury Not Helpful?
Bracing is not helpful when you’re using it to complete potentially painful activities without preparing the body for long-term success. This means that the brace is supplementing muscular and structural support around a body region while your body is actually capable of developing this support itself.
Although braces are meant to supplement muscular and structural support, it shouldn’t play that role forever. Your goal should be to wean off the brace as you rehabilitate, not to depend on it as you perform activities that seem difficult because of your injury.
When you use a brace long-term, you’re influencing how your body responds to your environment.
For example, if you wear a postural support brace at your desk job to keep you upright, you’re relying on that external support to achieve good posture. Meanwhile, the muscles that should be supporting good posture become weak because they aren’t being used. Next time you work an eight-hour shift at your desk job without your postural support brace, it will be more difficult to hold upright posture, and you might exacerbate your problem resulting in upper back or neck pain.
Another classic example is a back brace, which supplements the trunk strength needed to bend and lift. Patients often ask about back braces to manage back pain, but the solution should be the opposite. Instead of using an external support to offload your back, it’s better to learn how to use muscles as internal support, just as our body is intended to function. Then you can progress, building the strength and confidence you need to run, jump, lift, and surf independently.
Remember that braces can’t get stronger to support the activities you love, but muscles can.
To Brace or Not to Brace?
You should use a brace if you’ve been instructed by your doctor to immobilize the injured area, or if you need a temporary solution to offload a painful muscle or joint.
You should not use a brace as the primary solution for a new or recurring problem. Instead, your goal should be to wean off your brace as you become stronger, more mobile, and less painful.
If you’ve tried short- or long-term bracing but your injury still lingers, seek professional help. Physical therapists at JACO Rehab know how to help you!
Reach out if you’d like an evaluation with one of our skilled therapists. JACO Rehab has four locations on Oahu: Honolulu, Miliani, Waikele, and Kapolei.
Don’t wait and see if your injury gets better. Stop living with limitations and talk to a physical therapist!
Written by Nicole Hernandez, DPT