On Wearing Supports for Knee Pain

I enjoy the Ask Well column at the New York Times website. It’s well-written and does a nice job of summarizing important research/studies and doesn’t blindly follow the fad of the day. I was intrigued when the idea of knee supports came up for discussion.

My completely unresearched position is that knee supports could make sense. After all, one challenge for a patient is unloading the joint. Wouldn’t a good support do just that?

So I was curious about what this (rather short) column found.

First, the most common, cheaper supports, the elastic sleeves that you tug over your aching joints, probably don’t provide meaningful mechanical support. Which means they don’t work? Not necessarily.

Neoprene sleeves are thought to help by aiding proprioception, according to   Dr. Robert A. Gallo, an associate professor of orthopedic sports medicine. Proprioception is the body’s sense of where it’s positioned in space (interestingly, this ability appears to decay among knee pain sufferers).

We are told:

In theory, improved proprioception around the knee joint could augment knee stability by improving your balance.

Of course there’s another reason why they might work: the placebo effect. The placebo effect can be very powerful. I think it’s behind a lot of glucosamine’s perceived benefits, for example. I’m very skeptical of the glucosamine story, after the supplement did absolutely nothing for me and my research uncovered no reasons why it should have.

But back to knee supports: So let’s say neoprene doesn’t mechanically unload the joint (which isn’t surprising, if you think about it -- that a small piece of synthetic rubber could significantly alter the alignment or movement of a joint that regularly handles loads of your body’s weight plus; it would be kind of like expecting a reed of straw to hold up a brick). What then would help?

What could be useful, Ask Well says, are bulkier braces that really do unload the joint. These are more complex (and expensive) and sort of make you look like a cyborg. These braces have been shown in studies to help people with knee arthritis.

Me, I never used a brace/support. I did try patellar taping. Once that seemed to work really well. And on other occasions it didn’t work at all.

Oh well. Maybe that was the placebo effect too.