Do Knee Braces Work? and the Science Behind Knee Braces.

evssports dirt bike knee braces

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Summary

#1 Regardless of your type of dirt bike riding, knee braces should be a serious consideration as part of your essential dirt bike kit.

#2 Studies show that although they do not completely eliminate knee injuries, they go a long way to minimizing and preventing them from happening.

#3 The true name for a knee brace is a ‘prophylactic knee brace’, meaning that they are a preventative measure and so they should be used to before knee injuries occur, not after.

#4 Knee braces are expensive because huge amounts of research, testing and medical certification are invested into them to make them as safe and as comfortable as possible.

#5 In comparison, knee braces are actually very cheap when you compare them to the enormous costs of knee surgery and rehabilitation.

Introduction

When I talk to other dirt bike riders in my travels, I find that there is a lot of speculation around knee braces.

Some riders swear by them while others think that knee pads are adequate and braces are overkill and a just a bit of a rip-off.

There are heaps of knee braces that are available these days and they are marketed to the public just like any other piece of dirt bike gear.

The difference though is that the science, engineering and medical research that goes into the design and construction of quality knee braces (and neck braces) far outweigh any other piece of protective gear, even helmets.

Darian Hickey wearing Asterisk knee braces

Why is this? Well because the knee is a really complex system and it can be injured in many different ways from forces coming from all different directions.

The design and construction of a knee brace needs to take these issues into consideration so it can properly protect the knees from these range of injuries.

The reason why I wrote this blog post was to give readers a better understanding of how and why knee braces are built and why they work.

Hopefully with this understanding you will get a better appreciation for knee braces and will be able to make a better informed decision when it comes time to buy a set.

The research in this blog is derived from the work of Dr Leatt and his team of engineers and medical specialists.

Dr Leatt is the founder of Leatt industries, whose many years of passion and hard work has advanced the technology of knee and neck braces to the modern standards that we see today.

The specific examples of design goals in this article are based from Dr Leatt’s whitepaper; “Research and Development Efforts towards the Production of the Leatt ® C-Frame Carbon Knee Brace”

Why Knee Braces?

Knee injuries are really common among dirt bike riders.

In 2011, the American Journal of Sports Medicine performed a study of knee injuries associated with dirt bike riding.

Bryan Bachman wearing Mobius knee braces

The study found that knee injuries made up 9% of all injuries that occurred in AMA sanctioned motocross and supercross events.

Out of those knee injuries, 43% were ACL injuries, 20% were meniscus injuries and 15% MCL injuries.

These injuries would typically occur from using the leg as balance when cornering or from landing a jump with the knee fully extended, otherwise known as hyper-extension.

In the wider sports arena, it is reported that 90,000! ACL reconstructions are performed every year in the USA alone.

These types of knee injuries are very painful, are extremely expensive to treat and take a long time to heal.

Some knee injuries do not completely heal which can cause lifelong problems.

Sometimes these knee injuries can even end a rider’s career for life (even recreationally), as the knee is no longer able to withstand the forces exerted on it from dirt bike riding.

With this in mind, a dirt bike rider then should do everything in their power to protect their knees from injury, and the best type of protection available on the market are certified knee braces.

 A Preventative Measure.

The official medical term for a knee brace is a ‘prophylactic knee brace’.

The term ‘prophylactic’ is Greek in origin and is defined as ‘an advanced guard’ to ward off disease or injury (Yes, just like a condom!).

Therefore, knee braces are designed to prevent injury to your knees in the first instance.

The Pablo Quintanilla wearing custom made CTI knee braces

Unfortunately I know a lot of riders who buy knee braces only after they have busted their kneecaps or torn their ACL.

There is nothing wrong with doing this of course because they will support your injury..

But the most important point here is that as a preventative measure, they are primarily designed to be worn while your knees are healthy to minimize injuries in the first place.

Why are they so Expensive?

There is a reason why knee braces can be the most expensive piece of dirt bike gear out of your whole kit.

Knee braces are more than just protective gear, they can be classed as a medical device.

Because of this they need to be put through extremely rigorous testing procedures.

Adriana Hinestrosa wearing EVS knee braces

 

They have to meet strict medical standards in order to be sold to the public as a device that will protect your knees.

Additionally, some knee braces have received CE certification from the European Union for either impact protection or as a medical device.

Aside from that, the research, simulation, testing and design of knee braces is an intense process!

The Leatt lab alone employs 6 different testing rigs and even a crash test dummy to simulate real life impacts on their knee and neck braces.

They also employ two bio-mechanical engineers in the testing and design process to optimize the safety and comfort of their equipment.

As another example, the maker of the X8 knee brace, Mobius spent 7 years in research with pro rider Ryan Vilipoto to get enough data and feedback to create their knee brace.

Taylor wearing Mobius X8 knee braces

Also, construction of a good pair of knee braces is not cheap.

They contain a lot of different materials such as carbon fiber, fiberglass, different types of plastics, rubber, foam, exotic metals and aluminium all woven together in a complex design of function, protection and comfort.

All that being said, they are a really cheap investment compared to knee reconstruction surgery which will cost you tens of thousands of dollars!

 So what is CE Certification?

Since the European Union (EU) was formed in the 1980s, the EU Government needed to find a way to trade local and imported products across its 28 countries without any trade restrictions.

The problem was that the EU was made up of both wealthy and poor countries which was a real problem for quality control!

They needed a way to standardize the quality and safety of all goods traded in the EU so poorer countries wouldn’t be restricted and miss out on the action.

They came up the CE certification, which means that manufacturers needed to meet a standardized level of health, safety and environmental standards called ‘directives’.

When a product has the CE mark stamped on it, it means that it meets the  health, safety and environmental standards set by the European Union and the product can be sold in the EU locally and imported.

Knee braces can be certified under two CE categories, as a medical device and as protective gear.

The Jason Mainquist Wearing Asterisk Junior knee braces

Some knee brace makers are certified under both categories while others are certified for 1, and some are not certified at all.

To see which knee braces are certified as a medical device, click here to see a table that outlines these details.

Now considering that the EU is a 17 trillion! dollar market (as of 2017) it is definitely a good idea for knee brace makers to get that CE mark stamped on their product.

CE certification also offers the consumer piece of mind that they are receiving a product with high safety standards.

But just because a brand of knee braces isn’t CE certified, that doesn’t necessarily mean that the product is inferior, it just means that they cannot sell their product into the EU.

Unless the knee braces are a no-name brand and are super cheap rubbish, all the mainstream brands are of the highest quality and surpass the CE standards. To see a list of the leading brands of knee braces, click here.

The Mechanics of the Knee

Another reason why knee braces are expensive is that they need to be designed to protect your knees from a whole bunch of different hyper-extensions from many different angles.

The knee is really complex joint and has 6 different ‘directions of freedom’.

knee braces knee movement
Photo courtesy of Kneestability.weebly.com

When the knee is under severe load or when it is in a crash, the knee can hyper-extend in any of these directions, causing different types of injuries to occur.

The most common injuries that occur from knee injuries according to the Kennedy knee injury classification system are anterior crucial ligament (ACL) (40%), Lateral Collateral Ligament (LCL), posterior cruciate ligament (PCL) and medial collateral ligament (MCL) tears.

kennedy knee injury classification system
Photo courtesy of Indian Journal of Orthopaedics

 Therefore, it is crucial for a knee brace manufacturer to study these injuries carefully and design them to protect the knees from these main types of hyper-extensions from occurring.

So what are they Designed to do?

Specifically, knee braces are designed to achieve a number of really important tasks.

a. To mimic normal knee movement without restricting any leg movement.

b. To protect your legs and knees from rocks and other flying debris.

c. To decrease the number and the severity of knee injuries in any direction without compromising the integrity of other leg bones.

d. To have ‘fracture points’ in the brace that break away under extreme force to prevent injuries to the femur and shin bones (leatt).

e. To decrease and prevent dangerous ranges of motion in the knees while maintaining rider usability.

f. To transfer impacts into the knee brace instead of through the knees as well as redistributing those forces into less vulnerable parts of the legs such as the thigh and the calf muscles.

g. To be used with all types of motocross riding boots.

h. To make sure that the knee brace can be used by all different types of people without compromising on comfort and safety.

i. To have a degree of natural knee contact with the bike so the rider still maintains proper control and feel of the bike.

j. To protect the patella’s from injury using knee protectors that don’t slip under load and general leg movement.

 So do Knee Braces Work?

Major studies [1,2,3] into the use of knee braces on live (and dead) humans all point to the conclusion that knee braces are effective in reducing knee injuries and act as a good preventative and protective measure from the most common types of knee injuries.

The evidence is also clear however, that they do not completely eliminate knee injuries.

Because of this, riders need to be aware that competitive (and recreational) riding with knee braces is still a high risk sport and injuries to the knees cannot be ruled out.

 

Happy riding!

Title image courtesy of EVS Sports

references

[1] Chew K.T.L., Lew H.L., Date E, Fredericson M: Current evidence and clinical applications of therapeutic knee braces. Am J Phys Med Rehabil 2007;86: 678–686.

[2]  Sanders M.S., Cates R.A. , Baker M.D., Barber-Westin S.D. , Gladin W.M., Levy M.S. Knee Injuries and the Use of Prophylactic Knee Bracing in Off-road Motorcycling: Results of a Large-Scale Epidemiological Study. American Journal of Sports Medicine, July 2011; 39:1395-1400.

[3] Meyer S.J., Brown T.D., Jimenez B.S., Brand R.A. Benchtop mechanical performance of prophylactic knee braces under dynamic valgus loading: a cadaver study. The Iowa Orthopedic Journal. 1989; 9:92-97.

Dr Leatt C: Research and Development Efforts towards the Production of the Leatt ® C-Frame Carbon Knee Brace.

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