Sports Medicine

, Volume 28, Issue 2, pp 77–81 | Cite as

The Effects of Functional Knee Bracing on Muscle Function and Performance

  • Jorma Styf
Current Opinion


When applied, knee braces compress the soft tissues of the thigh and leg. External compression may abnormally elevate intramuscular pressure beneath the straps of the knee brace, decrease local muscle blood flow and muscular oxygenation, and induce premature muscle fatigue. Functional knee braces may give valuable support to athleteswith unstable knees. Theymay also be a valuable rehabilitative tool in patients following surgery for knee joint instability. However, prophylactic and functional knee braces do not improve performance and may even inhibit performance in asymptomatic athletes. Athletes and coaches should be aware of the serious adverse effects of knee bracing.


Muscle Blood Flow Anterior Tibial Translation External Compression Intramuscular Pressure Functional Knee 
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  1. 1.
    Sitler M, Ryan J, Hopkinson W, et al. The efficacy of a prophylactic knee brace to reduce knee injuries in football. Am J Sports Med 1990; 18: 310–5PubMedCrossRefGoogle Scholar
  2. 2.
    Jackson RW. An evaluation of knee injuries in a professional football team: risk factors, type of injuries, and the value of prophylactic knee bracing. Clin J Sports Med 1991; 1: 1–7CrossRefGoogle Scholar
  3. 3.
    Rovere GD, Haupt HA, Yates CS. Prophylactic knee bracing in college football. Am J Sports Med 1987; 15: 111–6PubMedCrossRefGoogle Scholar
  4. 4.
    Teitz CC, Hermanson BK, Kronmal RA, et al. Evaluation of the use of braces to prevent injury to the knee in collegiate football players. J Bone Joint Surg 1987; 69: 2–9PubMedGoogle Scholar
  5. 5.
    Wojtys EM, Loubert PV, Samson SY, et al. Use of a knee-brace for control of tibial translation and rotation: a comparison, in cadavera, of available models. J Bone Joint Surg 1990; 72: 1323–9PubMedGoogle Scholar
  6. 6.
    Styf JR. The influence of external compression onmuscle blood flow during exercise. Am J Sports Med 1990; 18: 92–5PubMedCrossRefGoogle Scholar
  7. 7.
    Styf J, Nakhostine M, Gershuni DH. Functional knee braces increase intramuscular pressures in the anterior compartment of the leg. Am J Sports Med 1992; 20: 46–9PubMedCrossRefGoogle Scholar
  8. 8.
    Styf JR, Körner LM. Microcapillary infusion technique for measurement of intramuscular pressure during exercise. Clin Orthop 1986; 207: 253–62PubMedGoogle Scholar
  9. 9.
    Styf J, Korner L, Suurkula M. Intramuscular pressure and muscle blood flow during exercise in chronic compartment syndrome. J Bone Joint Surg Br 1987; 69: 301–5PubMedGoogle Scholar
  10. 10.
    Lundin O, Styf JR. Intramuscular pressure in the leg and thigh related to tensile strap force during knee brace wear: an experimental study in man. Am J Sports Med 1998; 26: 567–70PubMedGoogle Scholar
  11. 11.
    Sejersted OM, Hargens AR, Kardel KR, et al. Intramuscular fluid pressure during isometric contraction of human skeletal muscle. J Appl Physiol 1984; 56: 287–95PubMedGoogle Scholar
  12. 12.
    Styf J, Ballard R, Aratow M, et al. Intramuscular pressure and torque during isometric, concentric and eccentric muscular activity. Scand J Med Sci Sports 1995; 5: 291–6PubMedCrossRefGoogle Scholar
  13. 13.
    Sforzo GA, Chen NM, Gold CA, et al. The effect of prophylactic knee bracing on performance. Med Sci Sports Exerc 1989; 21: 254–7PubMedGoogle Scholar
  14. 14.
    Styf JR, Lundin O, Gershuni DH. Effects of a functional knee brace on leg muscle function. Am J Sports Med 1994; 22: 830–4PubMedCrossRefGoogle Scholar
  15. 15.
    Beynnon BD, Renström PA. The effect of bracing and taping in sports. Ann Chir Gynaecol 1991; 80: 230–8PubMedGoogle Scholar
  16. 16.
    Beynnon BD, Johnson RJ, Fleming BC, et al. The effect of functional knee bracing on the anterior cruciate ligament in the weightbearing and nonweightbearing knee. Am J Sports Med 1997; 25: 353–9PubMedCrossRefGoogle Scholar
  17. 17.
    Kurosawa H, Walker PS, Abe S, et al. Geometry and motion of the knee for implant and orthotic design. J Biomech 1985; 18: 487–99PubMedCrossRefGoogle Scholar
  18. 18.
    Rovick JS, Walker PS. Design of an off-the-shelf knee orthosis using averaging techniques. Proc Rehab Eng Soc North Am 1986; 107: 107Google Scholar
  19. 19.
    Regalbuto MA, Rovick JS, Walker PS. The forces in a knee brace as a function of hinge design and placement. Am J Sports Med 1989; 17: 535–43PubMedCrossRefGoogle Scholar
  20. 20.
    Folkow B, Gaskell P, Waaler BA. Blood flow through limb muscles during heavy rhythmic exercise. Acta Physiol Scand 1970; 80: 61–72PubMedCrossRefGoogle Scholar
  21. 21.
    Ashton H. Effect of inflatable plastic splints on blood flow. Br Med J 1966; 2: 1427–30PubMedCrossRefGoogle Scholar
  22. 22.
    Matsen FA, King RV, Krugmire Jr RB, et al. Physiological effects of increased tissue pressure. Int Orthop 1979; 3: 237–44PubMedCrossRefGoogle Scholar
  23. 23.
    Ogata K, Whiteside LA. Effects of external compression on blood flow to muscle and skin. Clin Orthop 1982; 168: 105–7PubMedGoogle Scholar
  24. 24.
    Eiken O, Bjurstedt H. Dynamic exercise in man as influenced by experimental restriction of blood flow in the workingmuscles. Acta Physiol Scand 1987; 131: 339–45PubMedCrossRefGoogle Scholar
  25. 25.
    Jerosch J, Castro WH, Hoffstetter I, et al. Secondary effects of knee braces on the intracompartmental pressure in the anterior tibial compartment. Acta Orthop Belg 1995; 61: 37–42PubMedGoogle Scholar
  26. 26.
    Zetterlund AE, Serfass RC, Hunter RE. The effect of wearing the complete Lenox Hill derotation brace on energy expenditure during horizontal treadmill running at 161 meters per minute. Am J Sports Med 1986; 14: 73–6PubMedCrossRefGoogle Scholar
  27. 27.
    Highgenboten CL, Jackson A, Meske N, et al. The effects of knee brace wear on perceptual andmetabolic variables during horizontal treadmill running. Am J Sports Med 1991; 19: 639–43PubMedCrossRefGoogle Scholar
  28. 28.
    Houston ME, Goemans PH. Leg muscle performance of athletes with and without knee support braces. Arch Phys Med Rehab 1982; 63: 431–2Google Scholar
  29. 29.
    Wojtys EM, Kothari SU, Huston LJ. Anterior cruciate ligament functional brace use in sports. Am J Sports Med 1996; 24: 539–46PubMedCrossRefGoogle Scholar
  30. 30.
    Aratow M, Ballard RE, Crenshaw AG, et al. Intramuscular pressure and electromyography as indices of force during isokinetic exercise. J Appl Physiol 1993; 74: 2634–40PubMedGoogle Scholar
  31. 31.
    Osternig LR, Robertson RN. Effects of prophylactic knee bracing on lower extremity joint position and muscle activation during running. Am J Sports Med 1993; 21: 733–7PubMedCrossRefGoogle Scholar
  32. 32.
    Paulos LE, France EP, Rosenberg TD, et al. The biomechanics of lateral knee bracing. Part I: response of the valgus restraints to loading. Am J Sports Med 1987; 15: 419–29PubMedCrossRefGoogle Scholar
  33. 33.
    Pope MH, Johnson RJ, Brown DW, et al. The role of the musculature in injuries to the medial collateral ligament. J Bone Joint Surg 1979; 61: 398–402PubMedGoogle Scholar
  34. 34.
    Erickson AR, Yasuda K, Beynnon B, et al. An in vitro dynamic evaluation of prophylactic knee braces during lateral impact loading. Am J Sports Med 1993; 21: 26–35PubMedCrossRefGoogle Scholar
  35. 35.
    Schootman M, Mechelen W. Efficacy of preventive knee braces in football: epidemiological assessment. Clin J Sports Med 1993; 3: 166–73CrossRefGoogle Scholar

Copyright information

© Adis International Limited 1999

Authors and Affiliations

  • Jorma Styf
    • 1
  1. 1.University of Göteborg, Sahlgrenska HospitalGöteborgSweden

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