Most runners have experienced a dreaded bout of knee pain, whether it’s caused by overtraining or some other reason. And if you’re trying to resolve a knee problem, you’ve probably considered wearing a compression sleeve or brace on your knee.
'A brace generally applies pressure around different structures of the knee to try and help alleviate pain or provide support for the stability of the knee,' Lauren Borowski, M.D., sports medicine specialist at the Centre for Women’s Sports Health at NYU Langone, told Runner’s World.
But it can be hard to distinguish if your knee pain truly calls for the extra support. And there are so many different kinds of braces out there—what kind will meet your needs? We asked William Kelley, D.P.T, A.T.C., C.S.C.S., owner of Aries Physical Therapy, and Borowski for their tips on whether you should wear a brace, how to select the right one, and when your knee pain may signal a visit to the doctor.
Should you run with knee support?
At some point, your knee pain may start to interfere with your running or training schedule. So, when is it time to consider a brace?
'If there hasn’t been an acute injury and the pain gradually started, it might be worth trying a brace,' Borowski said.
And they can also be utilised before you’ve experienced an injury; you may see many professional athletes wearing knee braces for this reason.
'I think a knee brace is a great tool for high-level dynamic athletes to protect against injury,' Kelley said.
But they are best utilised under the guidance of professionals who can help pinpoint the root of your knee pain. For runners, a knee brace can be a solid temporary addition—along with physical therapy—to correct any underlying issues that led to the knee pain in the first place, Kelley explains.
What is the best knee brace for running?
Ultimately, you should consult a doctor before trying out any brace to ensure you’ve found the right brace for you.
'The recommendation of a professional such as a Doctor of Physical Therapy, orthopaedic doctor or sports medicine doctor are going to be your most trusted recommendations,' Kelley says. 'Amazon reviews may give you a good brand, but brace use really needs to be at the discretion of a professional.'
In general, knee braces can typically be categorised into three types.
Compression sleeve brace: A compression sleeve offers the lowest level of support. These are usually the first type that most runners seek out and are generally safe to slip on when you experience any kind of pain.
This type of brace is just a tight sleeve around the joint that limits the buildup of swelling and improves self-movement of the joint in space. And while this brace is the least cumbersome, it’s also the least supportive, Kelley explains.
'When it comes to brace recommendation, I am generally okay with the compression brace whenever a patient wants to start using it. If they perceive it to be helpful, there is no harm in wearing one,' Kelley says.
Patellar brace: The next level of support is the patellar brace. It helps guide the patella (knee cap) to track in a straighter pattern and to take pressure off the tendon.
'It is like the sleeve but with a thickened portion that acts on the kneecap. These are commonly used with patellofemoral pain and with patellar tendon issues,' Kelley said.
Additionally, 'If the front of the knee hurts on the centre part of the knee [the patellar tendon], you may want to try a patellar counterforce brace that applies some pressure directly to that tendon,' Borowski said.
Medial/lateral support brace: The top level of support is the medial/lateral support braces. These have strong, hinged portions that help prevent the knee from caving in and out.
'They are used to protect the ligaments of the knee, specifically the medial and lateral collateral ligaments, against sprains and tears,' Kelley said. 'They also protect the ACL by protecting against rotational forces as well. These are usually made of hard plastic, have straps, and are the bulkiest of the bunch.'
Additionally, for meniscus injuries, there is an 'off-loading' brace that takes pressure off of the medial or lateral meniscus after a meniscus injury, a surgery, or when arthritis is involved.
When should a runner not wear a knee brace?
Of course, a knee brace won’t be able to fix all knee ailments, and there are times you shouldn’t opt for one.
'If someone has an acute injury or trauma to the knee, like a fall or a twist of the knee, it is best to check in with a doctor and make sure nothing more serious is going on' Borowski said. 'If you notice persistent swelling, the inability to fully bend or straighten your knee, or if the pain worsens as you get further into the run and isn’t something that tends to go away as you warm up, it’s time to see a doctor.'
And, using a brace just for the sake of it is also not advised.
'Once brace use begins, the structures it is protecting just become further impaired, and the person becomes continually more reliant on the brace as time goes on,' says Kelley. 'Brace use just further magnifies deficits and can create deficits where none exist if a brace is used when not needed.'
Instead, working to gain the strength, mobility, and control needed to run safely without a brace should be your first steps before becoming reliant on external support.
The bottom line
Knee braces can be a great tool to keep you pain-free while running, but if you rely on them consistently, it may signal a deeper issue.
'I generally try to make them a temporary stopgap until pain-free function can be returned without the use of one, with the exception of the older runner with chronic pain that is trying to prolong time until surgical intervention is needed,' Kelley said. 'At that point, they can use the brace as long as it keeps them comfortable and running well. And of course, these are for the braces above the level of the compression sleeve. To reiterate, those are always fine to use.'
And if you find yourself consistently needing a knee brace to help with pain, consider going to a doctor or a physical therapist professional to find the root of the pain.
'Knee braces can be used long-term if it is helpful, but if the pain is lasting more than a few months, it is worth getting checked out to make sure nothing more serious is going on and that it is okay to continue running in the first place,' Borowski said.
Some people can run through knee pain, but for others, it may indicate that you should explore other cross training options.
'Utilise variance of training at the first sign of knee pain to attempt to cut it off early,' says Kelley. 'Changing up training to a block of low/no impact activities such as swimming and/or incorporating more strength training are just a couple ways that runners can make themselves a more well-rounded athlete, fill the cracks in their health and, more often than not, and become even better at running in the process due to this cross-training strategy.'
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