Do you wear a custom knee brace to combat knee ligament instability?

Custom Knee Braces and Rehab are the Best Non-Surgical Options to Fight Knee Instability

I've been wearing a custom, rigid, hinged knee brace due to an ACL injury, which resulted in severe stability problems in my left knee, for over 20 years. I have experienced a few chronic issues with these braces over the years, which I will discuss shortly, but all-in-all, customized knee braces are a true lifesaver for those wanting to maintain an active lifestyle while dealing with knee advanced problems. 

When knee ligaments are damaged the result can be severe knee instability and pain, not to mention all the other ways it can impact one’s daily routine and lifestyle. And the best, non-surgical option to combat knee instability is to get fitted and wear a custom knee brace. Most custom braces are rigid and have one or two hinges. Sometimes, the orthopedic technician fitting you for your brace will make a knee and leg cast and use the mold to have the custom-fitted knee brace made. Or they may simply take detailed measurements of the joint and leg as a reference for the custom knee brace manufacturer. 

Knee Injuries are a Pain in the Leg Joint

I’ve been wearing a custom knee brace since I was 15 years old to combat severe knee instability. My knee troubles stem from an injury during a high school basketball game. I was taking the last step for a layup when my left foot planted in some water that had been spilled on the court. My knee bent left and there was a loud but muffled popping sound. The pain was fairly intense and the swelling was immediate. By the time the game had ended and we drove back to our town, which was about an hour away, my knee seemed to be the size of my head. I could barely bend it due to the swelling.

I suffered a complete tear of my left ACL during that basketball game. The ACL (anterior cruciate ligament) is a commonly injured knee ligament, particularly in sports that involve jumping, planting & twisting, and changing direction. The ACL connects the thighbone to the shinbone and plays an integral part in knee stabilization. It was a devastating blow for a young person whose life revolved around sports. 

"Blow Outs" & Reconstructive Knee Operations 

My bones were still growing, so the orthopedic doctor suggested that I wait to have surgery, which I did. Unfortunately, during that time I was overly active and would continuously “blow out” my knee during volleyball and hockey games and while snowboarding.

During this waiting period, I ripped up a good amount of additional meniscus and cartilage which was removed during my first ACL reconstruction the following year, when I was 16. They used a patellar tendon graft for this reconstruction, but within six months I knew it hadn’t held. My knee was continuing to blow out at all too frequent intervals. In hindsight, I could have taken it a lot easier and probably held off even longer to have the ACL reconstruction — but teenagers are full energy, stubborn, and “invisible.” And as my mother would say, “hindsight is 20/20”.

I tried not to let my injury slow me down, but over the course of the next twenty-plus years, I had a number of knee operations. These included a few arthroscopic surgeries to remove more damaged meniscus and cartilage, as well as two more unsuccessful ACL reconstructions using a hamstring tendon graft from my left leg and then right leg. Most recently, my surgeon performed an opening wedge high tibial osteotomy, where my tibia plateau was cut in half and a wedge-shaped disc from my pelvic bone was inserted into it. This surgery is intended to realign the knee and allow the patient to carry more weight on the healthiest part of their knee.

Custom Fitted ACL Knee Braces Help you to Maintain an Active Lifestyle  

Throughout the course of all these knee surgeries, l have been able to maintain an active lifestyle, largely thanks to custom knee braces. My first three rigid, hinged knee braces were made in Richmond B.C. by Generation II Inc. (now Ossur). These braces were the Generation II Extreme Custom ACL knee braces, which featured a single hinge on the outside out the knee and a nice secure fit.

The next type of brace I tried was an Össur CTi Custom ACL brace, which has a double hinge design. Unfortunately, I couldn’t use my CTi brace for very long, as I had my high-tibial osteotomy surgery done shortly after having it made. The surgery changed the angle of my knee leg enough that the custom brace no longer had a custom fit and couldn't be used.

I now find myself sporting a DonJoy Defiance III custom ACL knee brace, which is a great choice for anyone with severe knee instability. It also has a double hinge design and fits like a glove. I am in the market for a new brace again next year and will most likely go with another Donjoy Defiance knee brace.

There is a number a great custom knee brace manufacturers including DonJoy Global, Breg Inc. and Össur. A good starting point is to talk to a local orthotics shop. They can help show you the different models and point you in the right direction.

Knee Brace Migration & Skin Trauma

The number one job of these fancy, carbon fibre, hinged accessories is to combat severe knee instability and, if fitted and made correctly, they do their job very well. That being said: they can be bulky, clumsy, restricting, and can take a while to get used to wearing.

But the two biggest problems that I have experienced with all the different custom knee braces that I've used over the years are:

1) The migration or slipping of the knee brace down the leg during activity or when worn over longer periods of time.
2) Skin trauma caused by pinching and rubbing from the knee brace straps. 

These chronic problems are two of the driving forces behind the creation of Bracelayer® Apparel Ltd. We wanted to create a functional compression pant that could be worn on its own to provide levels of knee support not found in traditional compression garments but could also be worn under custom knee braces to stop them from sliding down the leg, give some protection for knee brace strap irritation and trauma, and also also give some protection to the other knees.

Bracelayer Compression Gear: Making Bracing a Breeze 

Bracelayer® Knee Compression Pants help solve both of these issues by incorporating a thin layer of perforated neoprene around the knee, IT bands, and lower lumbar area.

This layer of perforated neoprene is thin enough to fit comfortably under custom knee braces, but is also strong enough to provide relief from from those straps pinching and digging into the athlete's skin. It also provides grip, even while sweating and during prolonged periods of sport, to keep the knee brace firmly in the place where it is designed to be.

And the best part about wearing our Bracelayer® Knee Sleeve Compression Pants under your custom knee brace is that you are giving your other knee a layer of support, stability, and protection that it deserves.