Noninjured Football Players Prefer Prophylactic Knee Braces to Functional Braces
Noninjured Football Players Prefer Prophylactic Knee Braces to Functional Braces
abstract & Commentary
Synopsis: Noninjured athletes prefer prophylactic knee braces to functional braces for running and agility. Additionally, some prophylactic braces do not affect speed as much as agility.
Source: Greene D, et al. Effects of protective knee bracing on speed and agility. Am J Sports Med 2000;28(4):453-460.
The purpose of this study was to examine the effects of functional and prophylactic knee bracing on speed and agility of junior college football players. Thirty uninjured football players of various positions (6 lineman, 5 linebackers/tight ends, and 19 skill players) participated and were used as internal controls when tested with and without the brace. Players were included if they were uninjured, demonstrated no instability on exam, and were on the active roster. The braces used were the off-the-shelf brands for the Air Armor Knee and Thigh Protection System, Breg Tradition, Don Joy Legend, Mc David Knee Guard, and OMNI-AKS 101W. A certified Orthotist/Prosthetist fit all braces.
The athletes were tested with the braces on both legs and without braces in a 40-yard dash and with agility drills. USA Track and Field representatives recorded times. Brace migration was measured by recording movement away from a mark placed on the leg before the testing. Surveys regarding brace satisfaction and performance were recorded immediately after the trials.
Thirty players were enrolled and 17 completed both trials. Athletes were lost from the study because they sustained an injury, quit the team, or became academically ineligible. When the athletes were wearing the Air Armor or Omni braces, they showed no difference from control in the 40-yard dash speed and were significantly faster than when wearing the other braces in the agility testing. The athletes wearing the Air Armor, recorded significantly less migration than all other braces in the superior/inferior direction. The subjective testing revealed that the athletes wearing the Armor Knee, McDavid, and OMNI all rated superior to the others in the 40-yard dash. In the agility drills, those wearing the Air Armor and OMNI rated better. The athletes chose the AIR Armor and the Mcdavid for the overall best brace and chose the Breg for the most protection.
Comment by James R. Slauterbeck, MD
This is an interesting study. Some conclusions can be made but many questions remain. An athlete with a normal knee prefers a prophylactic brace to a functional brace for running and agility. Additionally, some prophylactic braces do not affect speed as much as agility.
The methods and process of analysis are good. However, in my opinion a study design flaw is present. Normal healthy athletes were used and both functional and prophylactic braces were compared. I wish they had tested similar braces because it is not fair to compare a functional double upright-hinged brace (Breg and DonJoy) to the other single-hinged prophylactic knee braces. The braces have entirely different functions. Functional knee braces are made to provide stability in the post-injured knee. Prophylactic braces are typically worn by the uninjured athlete and function to prevent injury. Certain design characteristics between the types of braces will provide a different feel to the athletes. Studying ACL reconstructed or deficient athletes in functional braces or studying healthy athletes in prophylactic braces could advance this research.
This study nicely addresses the issue of protection enhancement vs. performance inhibition in uninjured athletes. Many athletes will wear braces during practice but not games in order to keep the edge in quickness and speed while sacrificing any perceived protection from the brace. The athletes in this study chose the Air Armor or the McDavid for the overall best brace despite 50% of the athletes rating the Breg brace best for protection. Uninjured athletes clearly choose a brace that gives the ability to run and cut over stability. It is important to recognize that these athletes were not injured but were testing both functional and prophylactic braces. Therefore, it would be in error to apply this study to post-ACL-reconstructed athletes who may desire the increased stability at the sacrifice of agility.
Despite a few limitations, this article provides good information to coaches, trainers, and physicians who believe in prophylactic knee bracing for uninjured athletes. Of course, this study did not attempt to determine the effectiveness of these braces at preventing injury. But if you are of the opinion that knee bracing prevents injury, then you should look for a brace that is well fit, does not slip, and does not impede function.
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