You’ve probably seen them. If you haven’t been sentenced to wearing one, you may know someone who has. Or you’ve seen someone walking around in one at school or at the store. I’m talking about the knee immobilizer. This is the ugly blue or green foam thing that they strap around your knee in the emergency room after a knee injury. It has metal uprights that run along the sides of your knee that are supposed to give you support and prevent your knee from moving in any direction. The whole thing runs from your mid thigh to your mid calf. You usually get this with a complimentary pair of crutches.
When I talk about this, it’s important to understand that I’m only referring to acute knee injuries you might present to the emergency room for. This does not include post operative care. If your surgeon has you in a brace that immobilizes your knee, there’s a damn good reason for it and you should follow doctor’s orders. But, rest assured, it won’t be the ugly thing I’m discussing here. It will be a different brace meant to immobilize your knee for a period of time, but can be unlocked to allow movement when appropriate.
The emergency room staff sends you home with this thing with no other instructions but to follow up with your doctor. Sometimes you’ll just go see your primary care provider (PCP) and sometimes they’ll be good enough to hook you up with an appointment with an orthopedist or sports medicine physician. Either way, you’ll inevitably wait a few days to see them, all the while being stuck in the really awesome looking and fashionable knee immobilizer.
As you may have noticed by the title of this article, I hate these things, and it’s not just because they’re ugly and uncomfortable. I have a few additional reasons that I’ll outline below and I’m sure I’m not the only one who hates them.
People Wear Them Too Long
When you leave the emergency room wearing one of these things, it’s assumed that you’ll just wear it until someone tells you not to. Unfortunately, by the time you see your PCP, get a referral to physical therapy, schedule your appointment, and actually come in for your first visit a few weeks has usually passed. No one told you to take it off and you‘re still wearing the stupid thing.
In my opinion there is no need to wear one of these things for more than a couple days. At that point there is always something more appropriate for you to wear on your knee if it’s needed. Many times it’s not even needed at all. But if you do need something, it might be a hinged brace to give you some protection, but still allow you to move your knee.
This is why I think it’s best to get in to see a doctor that specializes in sports medicine as soon as possible because they will usually take you out of the thing and give you something more appropriate for your injury. If no one tells you to ditch the immobilizer before you make it to physical therapy, usually I’m the one telling you. The down side to that is now you’ve been wearing it for so long that other bad things have started to happen.
They Cause Muscle Weakness
There have been studies that show it matters if you’re male or female when you wear one of these. Females have been shown to lose significant amounts of quadriceps strength after wearing one of these for just a few days, where males could afford to wear them longer before significant strength is lost. I’m not sure if this is due to hormones, but I’m guessing it has something to do with it.
Nonetheless, if you’ve been wearing one of these for three weeks and not using your knee at all, you are going to be very weak. Which means getting back to your sport is going to be a little harder and will definitely take longer. Your quad has basically been on a three week vacation lying on a beach somewhere doing nothing. Imagine what you would feel like if you just laid in bed for three weeks and then tried to get up. That’s how your quad feels after this.
They Kill Chondrocytes
I know. What the heck is a chondrocyte? That is the medical term for a cartilage cell. Basically, in order for your joint to be healthy, it needs to move. Immobilizing the joint actually starts to kill off your cartilage cells. This can, of course, can lead to more injury as you start to do more activity. The longer your knee is immobilized, the more likely this is to be a problem. Therefore, it’s best to get out of the knee immobilizer and into something more appropriate as soon as practical after an injury. Then you don’t have to worry about this at all.
It Causes A Stiff Knee
After a knee injury, you may already have swelling and pain that are going to limit the range of motion that you have or are willing to put yourself through. After a few days of down time, the pain and swelling usually start to subside and you may feel good enough to start moving your knee. If you’re stuck in a knee immobilizer, you can’t.
The longer you’re in the immobilizer, the more difficult it will be to get your range of motion back. This is because you’re muscles are going to start to get tight and shorten due to inactivity. If you’re not moving through their full potential range of motion, they get tighter. In this case, tighter is not a good thing. Wearing a knee immobilizer too long can add a week or more to your rehab process just to try and recover your motion. Most athletes are not looking for a longer recovery period.
So, now you know why I hate knee immobilizers. There is definitely a place for them, though. It’s good that the emergency room has something for you when you need it, but I would urge you to ask how long you have to wear it for and see a sports medicine provider as soon as you can. Most people don’t even think to ask if they can take it off as they start to feel better. So, if you’re unfortunate enough to injure your knee, remember to ask some questions and try to prevent some of these other things from becoming a problem.