Knee Brace Study

[Goofy Footer 539]

Do you wear knee braces? If so, which ones and why?

You can pick multiple answers for question 2.

Please Vote!

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A large epidemiological study was published in Feb 2011 which followed 2115 off-road motorcycle riders over the course of a year. These riders logged 39,611 cumulative riding hours and recorded the incidence of their injuries and frequency of brace use. Riders were grouped by Use or NonUse of prophylactic knee bracing.

57 of the 2115 riders (2.7%) sustained at least 1 knee injury during the year. 89 total knee injuries were reported (multiple injuries in one year for some riders). The most common injuries were the anterior cruciate ligament (ACL), menisci and medial collateral ligament (MCL).

Results of the study:

- There were statistically significantly more overall injuries in the nonbraced group vs braced group with 3.675 vs 1.587 injuries per 1000 riding hours (p<.001).

- The nonbraced riders had significantly higher ACL ruptures at 1.518 vs .701 per 1000 rider hours (p=.0275)

- The nonbraced riders had significantly higher MCL ruptures at .799 vs .111 per 1000 riders hours (p=.002)

- There were more ACL injuries than MCL injuries overall.

- There was a stronger difference in MCL injuries between braced and nonbraced riders than ACL injuries.

- Note that the results were survey based. There may be bias in the fact that participants had to voluntarily self-report for the year long survey and there may be innate differences in the personalities and/or riding styles of those who use braces vs. don't use braces.

- The study does have a large sample size of 2,115 riders and nearly 40,000 riding hours.

"The findings suggest that MCL and ACL injuries are likely reduced by the use of PKB (prophylactic knee bracing). The apparent beneficial effect of PKB use may be applicable to other sports and mechanics"

I have Attached the Study PDF

Knee Brace Study .pdf

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I read this study back in Feb but forgot about it until today. I tried to summarize the basic points above. I can explain the study more if desired (I "get to" analyze a lot of these studies in school). I'm actually quite happy this study got put together, its far far more interesting than most of what I read!

I really hope this sparks some discussion about Knee Braces and your riding habits!

[EDIT - The Poll has been fixed as of Dec 6 at 2:00pm and you can now Vote "No" to Question 2 if you don't wear knee braces. Thanks bikeslut]

[paulmbowers 236]

With any study like this, I first look at the source.

In this situation, it's the Sanders clinic. Mark Sanders "Dr Mark" is a frequent contributor on Thumpertalk and KTMtalk, and I believe I've seen him on ADVrider. He's well entrenched in the motocommunity, and I remember him discussing the effacacy of knee braces several years ago. Seems like a good guy. Specifically, he stated he was unable to form an opinion about braces, as studies had not been done.

Clearly they have now.

I have no objections to the findings, but this is such a wobbly subject, and the statisitical sample of injured riders wearing a brace is pretty small and subject to SO MANY variables. Had they created a lab machine that repeatedly injured knees in a controlled manner over a wide statistical base, I'd be more excited about it. As, doubtlessly, those who volunteered their knees for the project.

But. This is the first and best data we have surrounding this mystery of knee braces. Just as I don't wear a Leatt, it's not enough to move me to wearing braces.

That might be stupid.

Edit: I can't vote if I check "never" to option 1. Voting "never" eliminates any in option 2. This presents a moral and ethical dilemma with which I wrestled for the last hour or so. If I say "no" I don't use knee braces, the poll will not allow my vote. It requires an answer to option 2, all of which are questions based on the use of a knee brace. I could check "other" but that would not be fully honest, as it's not "other reasons I use a knee brace". I'd feel as if I'd corrupted the result. So, sadly, I cannot participate in the poll. My opinion will not contribute to the greater good, my high tide will not raise all boats. I will not matter.

[bikeslut 1]

Ditto

[Jim 0]

Although not covered in the study (at least the summary posted), I think a much greater number of people wear knee pads vice knee braces. Not that it matters much, as I don't' think a knee pad is going to prevent the injuries listed, but I"m sure they prevent a multitude of other, less severe injuries.

[PbdBlue 46]

The major concern that Dr. Mark has with knee braces is the potential increase in the fractures of the femur. His position is that the knee brace reinforces the knee area but transfers that load to the femur which in his opinion may result in a higher rate of fractures to the femur. Given the remote locations that dual sport riders find themselves on a regular basis a broken femur is a potentially life threatening injury particularly if the femoral artery is ruptured as a result of the injury. His viewpoint is that a knee is repairable. This is his opinion and I don't know if any studies have ever been done to support it but it is something to consider.

[dsfox 0]

I don't have time to read this whole study right now and will do that later....BUT:

YES, I wear knee braces: EVS with combined knee PADS and BRACES all in one piece....Love them...

they have full bending capability, are lightweight, but limit the sideways/twist of the knee that most often causes ligament damage...Very comfortable too.

REASON:

and of course this is my opinion only...to each his ownm, and I totally respect whatever riders like for themselves..

More protection is better,

KNEE injuries , ligament damage in general, takes a LONG TIME to heal.....

BONES generally take a SHORTER time to heal....(and bones dont' always sever an artery...I'd like to see the statistic of percentage of how often they do sever an artery)

(I have experience with both ligament and bone injuries, for myself and my kids who are avid soccer players)....

[TrophyHunter 15]

I have a set of knee braces that I don't wear. They just don't fit my legs or I'd try 'em. I bought them after my bike fell on my knee and I felt some bad lateral bending going on.

[paulmbowers 236]

Given the remote locations that dual sport riders find themselves on a regular basis a broken femur is a potentially life threatening injury particularly if the femoral artery is ruptured as a result of the injury.

Agreed, Randy- this is my nightmare, and not far out of the realm of possibility in motorcycle land.

Although currently I have enough trouble just getting out of the remote area under my bike's power.

[dirt dame 559]

[racerbill 0]

In 2002 on a remote trail in Idaho I dabbed in a turn as I have a million times. This time though my foot caught on a root and there was a tug with a lot of snapping sounds(to graphic ?). I tore my ACL, MCL, CCL and dislocated my knee. I was not wearing knee braces. Since then, after 2 surgeries and a year of rehab I now wear CTI braces 100% of the time. My orthopedic surgeon claimed that in testing the forces transmitted to a knee in test would still snap your ACL, this survey seems to dispute that. I can say that with a bit of Fear and Loathing I've raced and ridden again for the last 8 years with braces chanting my new mantra KEEP YOUR FEET ON THE PEGS.

[robertaccio 406]

I preferred the asterisk ones I had before but they got so beat up that the usual asterisk rebuild service said they were no longer servicable.

I now use Pod MX braces because a guy I know was selling them almost new for 50% of retail(I still like the Asterisk fit better).

I do have a frayed/stretched ACL in my left knee and have had it scoped and cleaned up (no rebuild). Also I have had both ankles scoped (ported and polished). The knee tear was from a beastly YZ490!! Plus years of Soccer wore out both knees and ankles.

All that said I wear knee braces more for impact protection than for hyper extension purposes, mine are adjusted in very loose wide degree settings. My right Pod currently has a lower section crack and separation from a embedded tree stump hit at last years Tecate Enduro, I still think that with a standard knee pad I would have really blasted my right shin to injury, it was a solid @25mph hit. The CF and fiberglass took the hit and cracked (it was super uncomfortable and scratched the crap out of my shin until the lunch break where I taped it all up). At home I reepoxied it and wrapped in with gorilla tape, it promptly cracked again, I will just leave it taped, it works fine like that.

Again in my case my knee "braces" are not used as braces but knee cages to block rearward and side inpacts to the lower legs from hard stuff like logs and rocks. They are very effective for this, they are like a roll cage for the mid-lower legs. thanks,R

(I wear my mouth piece,helmet,boots,elbow pads, etc for basically the same purpose)

[Uncle Champ 116]

I wonder if the study may be slightly skewed due to people that have knee trouble seem to be the one that wear braces. I have asked riders why they wear them and the most common answer I get is "I can't afford any more knee problems".

I agree more protection is better, but I don't wear a Leatt either.

Oh well old dogs and new tricks as they say.

Unc C.

[ADV Bum 205]

I wear the Asterisk knee braces. I like them for the knee cup and the cage affect as Robert mentioned. I feel safer with them as I had twisted my knee with just the knee-shinguards I used to wear. I also felt when wearing good boots I did not need the shinguard combo. I did get some new Asterisks off CL for cheap and that did help in the decision.

[Drabnor 0]

another vote for asterisk

[Goofy Footer 539]

With any study like this, I first look at the source.

In this situation, it's the Sanders clinic. Mark Sanders "Dr Mark" is a frequent contributor on Thumpertalk and KTMtalk, and I believe I've seen him on ADVrider. He's well entrenched in the motocommunity, and I remember him discussing the effacacy of knee braces several years ago. Seems like a good guy. Specifically, he stated he was unable to form an opinion about braces, as studies had not been done.

Clearly they have now.

I have no objections to the findings, but this is such a wobbly subject, and the statisitical sample of injured riders wearing a brace is pretty small and subject to SO MANY variables. Had they created a lab machine that repeatedly injured knees in a controlled manner over a wide statistical base, I'd be more excited about it. As, doubtlessly, those who volunteered their knees for the project.

But. This is the first and best data we have surrounding this mystery of knee braces. Just as I don't wear a Leatt, it's not enough to move me to wearing braces.

That might be stupid.

Paul, I appreciate your response especially considering you read through Dr Sanders full report. As noted in the report, while studies have been conducted in regards to the efficacy of knee protection in other sports such as football, little if any is known about their application in motorcycle riding. While the mechanics may be similar, the population and risk factors are different.

This study was conducted through an online survey, I believe largely Thumpertalk members. This may skew the results some as surely each online forum community has its own character. Consider that those participating in the study were more likely to be those with existing knee issues or those who wore braces already. The study does denote rider age, years of experience and type of riding but does not get into statistics beyond that.

While the number of injured riders is much smaller than the sample size (thankfully), he focuses on the injury incidence rate between the braced and nonbraced group. His original hypothesis was that there would be no difference in injury rates between the two groups. The study results suggest with confidence that there was indeed differences.

As you note, while there are many variables outside the realm of this study (such as aggressiveness of riding, type of pre-existing injury, bike used, physical shape of rider etc etc) this is the first study of its kind in the off road motorcycle world. Note that this study most likely took a over 2 years from development to publication and cost money. I've seen multi-million dollar grant studies which run years in length still have weak statistical findings. This study is the first and only (to my knowledge) of its kind in off-road motorcycling so for that I am thankful.

Edit: I can't vote if I check "never" to option 1. Voting "never" eliminates any in option 2. This presents a moral and ethical dilemma with which I wrestled for the last hour or so. If I say "no" I don't use knee braces, the poll will not allow my vote. It requires an answer to option 2, all of which are questions based on the use of a knee brace. I could check "other" but that would not be fully honest, as it's not "other reasons I use a knee brace". I'd feel as if I'd corrupted the result. So, sadly, I cannot participate in the poll. My opinion will not contribute to the greater good, my high tide will not raise all boats. I will not matter.

Ah, you have caught me at a loss. Shame on me, I did not pose my questions properly. I blame this on a misunderstanding of how the Poll works. I did not realize a voter had to select an option for Question 2. If I had known this, I would have undoubtedly put an option in #2 for "I Do Not Wear Knee Braces." Please take this as an apology for subjecting you and other voters to the moral and ethical conundrum faced in Voting No for Question 1 and not being able to vote in Question 2. Now too, I am facing a most proper dilemma, I fear the results of my study are now skewed and the statistical significance of my findings will come under scrutiny. I could go on and on but my error in properly formatting the Poll has put the true efficacy of my two question study in peril. Alas, well at least the good discussion shall carry on!

[Goofy Footer 539]

The major concern that Dr. Mark has with knee braces is the potential increase in the fractures of the femur. His position is that the knee brace reinforces the knee area but transfers that load to the femur which in his opinion may result in a higher rate of fractures to the femur. Given the remote locations that dual sport riders find themselves on a regular basis a broken femur is a potentially life threatening injury particularly if the femoral artery is ruptured as a result of the injury. His viewpoint is that a knee is repairable. This is his opinion and I don't know if any studies have ever been done to support it but it is something to consider.

Yes, this is my fear with knee braces as well. The boot more of less locks your ankle into place, placing the burden of injury on your knee, knee braces lock your knee and put the burden of injury on your femur (IMHO).

Interestingly, in response to Trey Canard's first broken femur just above where his knee brace clamped onto his thigh in July 2008, Dr Mark replied on a Thumpertalk thread saying "Now some more people may believe me. The top of the brace concentrates the force on the femur. That is where the break always occurs."

One could argue that the femur is the largest bone in the body and possibly less likely to break than the tearing of a knee ligament. Fat embolism from a broken femur would be catastrophic on the trail but so would a destroyed knee.

On a Possible Side Note

To help alleviate the incidence of knee (or other leg) injuries, I personally believe stretching is key. Luckily I am young enough to have a flexible body which absolutely has saved me from injuries.

I was once told not to stick your foot "out" so much to dab (sentiments confirmed by RacerBill as noted in a post to this thread).

I've been told that when you corner, instead of sticking your leg out to get leverage into the turn, stick it forward, so if it hits something, it gets pulled directly back (normal motion of the knee) instead of getting pulled or twisted sideways (painful tearing motion of knee).

Maybe More of This

As Opposed to This?

Thoughts? I'm sure some of the race guys have good advice they can send my way!

[bikeslut 1]

The major concern that Dr. Mark has with knee braces is the potential increase in the fractures of the femur. His position is that the knee brace reinforces the knee area but transfers that load to the femur which in his opinion may result in a higher rate of fractures to the femur. Given the remote locations that dual sport riders find themselves on a regular basis a broken femur is a potentially life threatening injury particularly if the femoral artery is ruptured as a result of the injury. His viewpoint is that a knee is repairable. This is his opinion and I don't know if any studies have ever been done to support it but it is something to consider.

Yes, this is my fear with knee braces as well. The boot more of less locks your ankle into place, placing the burden of injury on your knee, knee braces lock your knee and put the burden of injury on your femur (IMHO).

Interestingly, in response to Trey Canard's first broken femur just above where his knee brace clamped onto his thigh in July 2008, Dr Mark replied on a Thumpertalk thread saying "Now some more people may believe me. The top of the brace concentrates the force on the femur. That is where the break always occurs."

One could argue that the femur is the largest bone in the body and possibly less likely to break than the tearing of a knee ligament. Fat embolism from a broken femur would be catastrophic on the trail but so would a destroyed knee.

On a Possible Side Note

To help alleviate the incidence of knee (or other leg) injuries, I personally believe stretching is key. Luckily I am young enough to have a flexible body which absolutely has saved me from injuries.

I was once told not to stick your foot "out" so much to dab (sentiments confirmed by RacerBill as noted in a post to this thread).

I've been told that when you corner, instead of sticking your leg out to get leverage into the turn, stick it forward, so if it hits something, it gets pulled directly back (normal motion of the knee) instead of getting pulled or twisted sideways (painful tearing motion of knee).

Maybe More of This

As Opposed to This?

Thoughts? I'm sure some of the race guys have good advice they can send my way!

I use my foot to load the front end (worked better before running the trials tire up front)... I'll second Bill's thoughts that THE FOOT STAYS ON THE PEG (or it gets the hose)

I understand the "grounded" aspect of keeping a foot down, but SO little benefit in it

I have not injured a knee yet (knock on wood) riding bikes... dirt, street, bmx or mountain... OTHER than the broken kneecap from hitting the stem on a mountiain bike. The knee never healed, so I wear protection but not braces.

I also tend to fall correctly- If my bike is falling, I don't try to save it with my leg; I either throttle out or SEPARATE from the bike...

as for a broken femur- one of the few bones I haven't broken- I understand it's quite painful... my knee injuries have been with other sports (basketball and football); but I can see where they would prevent knee damage

like all protective gear... it's shades of gray- lobsterman or shorts and flip flops and everything in between

[bendobe 0]

I bought the $100 Thor knee braces and they have saved my knees quite a few times. The only real downsides is that they are hot and you need some sort of knee sock or the like under them (adding to the heat factor). Eventually I would like to get the Asterix braces but the $600 spend is down a bit on my bike list.

[Goofy Footer 539]

Some recent foot/ankle/leg injuries and subsequent discussion on "upgraded" riding boots/PPE led me to rethink the topic about Knee Braces.

I'm pumping this to see:

-- If anybody had some updates in regards to their use/non-use of braces

-- If anybody's opinion changed (Started/Stopped wearing braces)

-- To hear from some new members!

[REV5 0]

Mobius knee braces. I like the full coverage, mobility and comfort. The knee is a terrible design for the types of abuse we put them through. I like to protect them as much as possible. Because I do fall a lot. My femur is much stronger then my knee. The braces only protect the front half of the femur so the chances of the braces causing more damage is very unlikely. If it had hard protection on front and back of femur I would be concerned. Just like wrist gaurds when I skate vert. Always take out the back plate. Or you will for sure break your radius and ulna.

[350thumper 336]

I always wear a knee brace to protect an existing injury.

I ride knowing it could shatter at the first head on collision. Luckily for me I ride really slow now.

I suffer from degenerative joint disease so it will one day stop me from riding. But not today.

[Oracle 195]

Asterisk Cell braces for me. I've been wearing them for many years.