Braces: helping or hurting you?

I commonly get asked about whether or not to wear braces.  So here's my thinking behind it all and when to wear it and when not to wear it.

Braces are intended to lend support to structures that are weak or be used to aid in recovery.  So there are two situations in which you want to wear a brace as I just mentioned.  When someone has a recent injury, i.e. throws out their back, sprains their ankle, sprains their knee, has a car accident, a brace can help keep things more stable and help prevent the injured area from getting any worse. In this case, the brace is there to help increase stability to the injured area, decreasing the movement, and ultimately decreasing the amount of pain.

The second situation is when there is no stability any more because the ligaments are too loose to support it, or when the ligaments have actually completely torn, causing excessive degrees of motion to the joint.  In this case, the motion in the joint cannot be restrained by the ligaments any more and in normal activity, may result in a new acute injury, if not braced.  The brace is used to replace the ligaments, or passive structures of a joint.

Now the do's and don'ts according to my logic.......

As I mentioned in the first situation, after severe pain  or recent injury, braces can help reduce pain and help in returning to daily activities.  BUT, if a brace is worn too long, it can begin inhibiting involuntary muscle contraction from deeper stabilizing muscles which are meant to help support the area, resulting in greater weakness.  So for example, after having back surgery, a brace may be recommended so that there is greater support to allow for normal activities of daily living.  But after pain and inflammation have gone done and are tolerable, there should be effort made to reconnect to the stabilizer muscles to engage them in bracing your back.  In all honesty, who wants to have to wear a brace the rest of their life unless they really had to?!?!??

The second situation, where a ligament, let's say an ankle sprain, has repeatedly been sprained for a soccer player over several years and now there are just about no ligaments left.  An ankle brace may be appropriate to help the soccer player feel more stable during running as to prevent any additional injuries to their ankle.  In this case, exercise is still important to make the musculature as dynamic and reactive as possible, but it will probably not be enough, so a brace would be important to add an additional layer of support/stability.

I hope this helps clear up any confusion as to when and when not to wear a brace.

Again, this is just advice, and the best thing would be to ask your local physical therapist for specific instructions.  Take care and don't "brace" yourself too much!! =)

Dr. J Wong