There are four categories of knee braces:

1. Knee sleeves (which are not technically braces)
2. Prophylactic knee braces
3. Functional knee braces
4. Postoperative or rehabilitation braces.

The most common of these items to athletes around the world are the knee sleeves. You are likely to run into someone wearing them at almost any gym. Let’s discuss what they are, what they do, and when to wear them.

What Are Knee Sleeves?

To clarify, knee sleeves are not the same thing as knee braces. A knee sleeve provides some support, but does not function in the same way a knee brace would. Knee braces are designed and used to protect a previous injury from further endangerment. Knee sleeves are designed to protect the knee from future injury or risk of damage. This protection is especially important for knees put under great daily pressure (running, jumping, weightlifting).

Knee sleeves also add a valuable compression element that increases blood flow and reduces pain, not only during but also after performance. The reason this compression aspect is so important is that a compressed knee encourages blood flow through the blood vessels of the knee. Here is how I would draw it up on a chalkboard: compression + blood flow = better recovery. Simply put, using a knee sleeve results in less pain and swelling during and after performance.

Knee sleeves are generally made from neoprene material and slide on over the knee. In simple terms, the idea behind the knee sleeve is to reduce pain. More specifically, the sleeve adds warmth, limits patella movement, and can increase proprioception (the capacity to feel the position of a joint in space as sensed by the central nervous system). In other words, the sleeve is more than a mechanical support mechanism for the joint, but is also used to improve proprioception.

There is a key difference to understand between knee braces and knee sleeves. The protective cushioning of the knee brace is meant to protect the anterior knee and patella, while the knee sleeve does not provide the same ligamentous support. Therefore, if you have an unstable knee and are using a knee sleeve to fix or stabilize the knee, it will not be enough. Visit your doctor or orthopedic surgeon and look into the matter further. In fact, there is a great chance the swelling caused by the sleeve might be aggravating to an unstable knee due to its restriction of lymphatic and venous return below the knee.

When to Use Knee Sleeves

Lifting force involving a decent amount of mass, i.e. you lifting progressively heavier, literally grinds the kneecap onto itself. This is often the cause of progressive tendonitis. An interesting statistic published by the Huffington Post indicates that nearly one in twenty Americans older than fifty have artificial knees. That’s more than four million people. So if that’s what happens to the average population, imagine the scenario for athletes and those who weightlift on a regular basis.

Knee sleeves do not need to be worn for all weightlifting exercises. If the knee is not involved as a primary lifting source, they are not necessary. They do however provide the support necessary for performing squats, the snatch, or the clean and jerk. Any time the knee is left weak or vulnerable, it is at great risk for damage, and usually long-term damage, unfortunately.

If you are fairly new to weightlifting, I wouldn’t spend the money on knee sleeves. Simply put, there isn’t enough pressure bearing down on your knees to require their use. But again, that is all relative to your age, athletic background, and more than anything else, form and technique. Poor training or technique can be disastrous in and of itself, so to help retrain the proper muscles might require a little “support.” Otherwise, after a year or so of lifting sleeves might be helpful, but only for the portion of your workout that involves the knees.

I do encourage the use of knee sleeves for all intermediate to advanced lifters as the support that they provide really does help hold the entire knee in place and thus prevents injury. Simply put, technique + proper equipment = proper strength and efficiency long-term.

References:

1. Hsu, JD., Michael, J., Fisk, J. “Atlas of Orthoses and Assistive Devices.” Philadelphia: Mosby. 3rd ed. pp.420–421.

2. AAOS Position Statement., “The use of knee braces.” American Academy of Orthopaedic Surgeons. Accessed 03/02/14.

3. Tanner, L., ” Knee Replacements Soar Among US Older Folk. Accessed 03/02/14.

Photos courtesy of RXBound.

The post The Advantages of Knee Sleeves: What They Are and When to Wear Them appeared first on Breaking Muscle.

As coaches, we have the opportunity on a daily basis to positively change the way someone moves. It is our responsibility to ensure quality movement prior to loading. I ask you this: raise your hand if you have allowed an athlete to load up a bar and move that weight with shit mechanics? Don’t be coy. All of you look silly, sitting at your computer or smartphone reading this article with your hand up in the air. What a disservice we have done to our athletes.

Meet Mr. RowHard

About a month ago, I was talking with a fellow coach about the reasons why most of our athletes have poor mechanics. A new member had started CrossFit and in his second week rowed 500m in 1:35. Impressive, right? The kid certainly is motivated to become better.

A few nights later, I watched the class do a modified Fight Gone Bad. Expecting greatness in all movements from Mr. RowHard, I was astonished at what I saw. Wall balls with a rounded back, butt wink, and weight in the toes. The medicine ball was completely owning this poor kid. With every box jump, his knees clapped together audibly over James Hetfield’s screams in Battery. This particular box does not do the sumo deadlift high pull (perhaps an idea for another article), so when he transitioned to power cleans, my eyes and brain were prepared for some stellar reverse globo-gym bicep curls (which is what I observed). Only when he got his ass on the erg did I start to see greatness. So why is it that he can row like a fiend, but moves poorly otherwise?

After Mr. RowHard picked himself off the ground, he noticed us two coaches discussing him and his performance. While we remarking about his poor squatting, he interrupted us and said, “Will you help me fix it?” Angels from heaven came down and began singing. This kid was wasted from one of the most demanding WODs in CrossFit, yet was dedicated enough to stay after class for two-on-one squat instruction. Hallelujah! Thirty minutes later, we were able to take a squat that looked like a dog taking a bathroom break in Saigon to a flat back, chest up, weight in the heels, knees pushing out thing of beauty.

I’m not going to bore you with squat instruction or progression. You’re all coaches or athletes in some capacity and should already know that information. What I will do is tell you what can happen to the knee if you don’t take that extra time with your people and help them to move with integrity.

The Sad Story of the Knees

The knee is the redheaded stepchild in a nasty divorce between the hip and the foot. It did nothing wrong, yet is the victim. If the muscles of the hip do not operate efficiently to control the femur, the knee suffers and will collapse medially. Medial collapse stresses the anterior cruciate ligament (ACL), medial collateral ligament (MCL), and medial meniscus. It places far more load through the medial aspect of the joint than what is favorable. It’s also the mechanism of injury to all of those structures, the Terrible Triad (super menacing!).

Furthermore, medial collapse and failure to engage the posterior chain (glutes and hamstrings) contributes to quad dominance with movement. When the hamstrings cannot counteract the quads, the tibia is given the opportunity to glide anterior on the femur, placing stress on the ACL and slamming into the articulation with the patella. Enter patellofemoral pain, AKA “I don’t know why your knee hurts but it does, so go do some PT and it will be fine.”

When all of these biomechanical nightmares are ignored, you’re looking head-on into early joint arthritis, pain, and eventually giving up the things you enjoy – like training to be better at life.

So, here are a few ideas of what to do:

1. Foam roll that shit.
2. Train your glute medius.
3. Stretch your calves.
4. Push out your knees.

Yes, it’s painful, and hard, and uncomfortable. So is life. What are your goals? Do you want to squat heavy shit or just sit on the toilet without pain? Do work. Get better. Quit beating up on your knee. It didn’t do anything wrong. Get your hip stronger, tell your foot to quit being lazy (see photos below) – and squat like you mean it.

Left: Active foot position; arch elevated by bringing great toe closer to the heel.

Right: Poor relaxed foot position. Arch is collapsing.

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