By: Jean Johnson for Knee1
Bracing has been around at least since the days of King Arthur when knights and warriors found that they could continue to walk on seriously injured limbs by encasing them in rigid, hinged armor. According to David Finch, D.O., although medieval armor has given way to “Velcro and polymers, the function remains essentially the same.”Bracing today can be used for preventing injury, re-injury, and accelerating the recovery process, as well as to stabilize the leg for walking.
Rehabilitation specialist, Molly Hoeflich, M.D., describes the recovery process involved with bracing. “An ankle-foot orthosis holds the foot up and is a relatively standard brace. Within arapy. We especially see this in cases of stroke where patients have weakness in the muscles that holbout a year, people often wean themselves off the brace, as they gain strength in thed the foot up,” Hoeflich said. “So the purpose of bracing is to help compensate for loss of muscle function.”
| Tips for successful use of lower extremity braces:
Keep your weight down to lessen pressure on joints
Work with orthotics specialists to get your brace fitted correctly – even though it may take repeated trips to the office
Listen to your physician about proper care and maintenance of the brace
Insist on getting clear instructions you can understand about the use of your brace
Sixty-two-year-old Mack Lowell of Parks, Arizona wears a form-fitting ankle-foot brace on his left leg, which was paralyzed following a stroke. “The brace is comfortable enough, I guess,” said Lowell who has no feeling on the left side of his body. “It helps me walk such as I can. Now that I’m home, I really rely on it to get around.”
The white polymer orthosis, fits in Lowell’s shoe and extends up to his mid-calf, serving to hold his foot in position. “It’s sort of a pain to put on, and someone has to help me. But without it, I probably would still be stuck in a nursing home.” Lowell shudders at the thought and smiles weakly at his inert leg cradled in its brace.
Factors that influence a patient’s candidacy for a lower extremity brace include prognosis, general health, weight, and age, with the elderly and children needing special consideration. Patients like Lowell who are lean and not too old, writes Finch, are good candidates for braces, since patient compliance is always a factor. Not only does the fit have to be perfect for the brace to be effective, but patients must also perceive the orthosis as being manageable if they are to wear the device long enough to get benefit. Not all braces are polymer molds, of course, and for those concerned about appearance or greater comfort, exploring options can pay off.
Elastic bandages or ankle sleeves are tried and true over-the-counter types of bracing that work for basic sprains or mild musculoskeletal conditions. There are also soft ankle braces that lace up, along with splint braces that prevent lateral motion and are easy to remove. Hinged ankle braces are another option that enables patients to roll down on the heel rather than hitting hard in a herky-jerky sort of fashion. Walking boots, on the other hand, offer comfortable stabilization for more severe ankle injuries, and have in many cases replaced the use of casts. Patients with lower extremity injuries confined to the foot and ankle have a wide array of options to choose from. Unfortunately, patients with knee problems don’t fare as well.
When it comes to bracing the knee, “if it’s a global muscle problem, you have to be pretty thoughtful,” says Hoeflich. “Knee braces are big, cumbersome and expensive. So if there’s any way you can try one out before you make a decision, we advise that.” “In the war against disability, the world of bracing offers an arsenal,” states Finch.
However, despite the advances in brace technology, health professionals are careful to point out that braces do not take the place of adequate physical therapy programs. Rather, they are considered a way to control mobility as patients work with therapists to regain strength and function of affected joints. Finch emphasizes the importance of starting physical therapy as soon as possible after an injury.