Knee Braces????

Last Thursday I had a complete ACL reconstruction, they took a piece of hamstring to reconstruct it. I know I will not ride for 6 months but when I do get back on the bike, I must have a pair of knee braces (as I was not wearing any when the injury happened). I was just looking for some suggestions about a particular brand or even model of kneebrace. Thanks. :thumbsup:

You are probably not going to like this, but below is taken from the October, 2005 review article in the American Journal of Sports Medicine.

Functional Braces

The effect of a functional brace on the knee and ACL graft is determined by the brace attachment technique, brace design parameters, the brace-limb attachment interface, and the loading environment to which the braced knee is exposed. Our review revealed 2 RCTs that studied the effect of functional bracing on healing after ACL reconstruction with a BPTB graft.

McDevitt and associates75 presented a prospective RCT comparing rehabilitation using functional bracing for 1 year to rehabilitation without bracing after ACL reconstruction with a BPTB graft. The patients were randomized by random numbers or a coin toss. Both groups of 50 patients were treated for the first 3 weeks after surgery with a rehabilitation brace locked in extension. The brace was removed 2 to 3 times per day for range of motion activities. In the functional brace group, the knee was mobilized gradually from 3 to 6 weeks with the rehabilitation brace used intermittently. Then, the patient was fitted for a functional brace at 6 weeks and was allowed full range of motion. The brace was worn full-time for the following 6 months and thereafter during all rigorous activities until 1 year after surgery. In the nonbraced group, bracing was discontinued after 3 weeks. Other details of the rehabilitation protocol were not provided. Ninety-five percent of the patients were followed up for a minimum of 2 years (mean, 29 months). At the time of final follow-up, no differences were revealed between the groups in terms of AP knee laxity, 1-legged hop distance, IKDC and Lysholm scores, range of motion, and isokinetic strength. Two braced subjects and 3 nonbraced subjects sustained reinjuries to their ACL graft. The authors concluded that there were no significant differences between the braced and nonbraced treatment groups.

In a prospective RCT, Risberg et al93 compared rehabilitation with functional bracing to rehabilitation without bracing after ACL reconstruction with BPTB grafts in 60 patients. The number of surgeons was not provided; the patients were randomized into braced and nonbraced groups by an unspecified method. The braced group was protected by a rehabilitation brace for 2 weeks, and a functional brace was used nearly full-time for the following 10 weeks. Thereafter, the functional brace was used as needed for sports. The nonbraced group had no brace at any time postoperatively. Otherwise, both groups followed the same postoperative rehabilitation protocol, which was described in detail. Ninety-three percent of the patients were followed up for 2 years. The authors found no evidence that bracing had an effect on knee joint laxity, range of motion, strength, functional knee tests, patient satisfaction, or pain at final follow-up. No evidence that bracing reduced the risk of new injury was observed.

The 2 studies reviewed in this section do not identify a compelling reason to use functional braces after ACL reconstruction.

I just purchased Asterisk braces, way to go with my torn ACL.. :thumbsup:


Toolboy, did you tear your ACL when you were wearing the asterisk?

I had the same operation about 4 years ago. ( I was 44 years old) I waited about 1 year before I rode again. I bought the Asterisk and they do work. I have felt my knee twist but the brace holds it in place. I NEVER ride without them, I look at them as a helmet for my knees. What ever you do DON'T come back to soon.

Good Luck

Dr. Mark:

You may be interested in reading the following article "Response of Eight Knee Orthoses to Valgus, Varus and Axial Rotation Loads" which is an example of one of many new studies being done to test the efficacy of knee braces.

The jury is still out, but as in this and other arcticles in recent months, where new testing methods have been developed to properly measure the forces placed on the knee joint, there is growing support for the use of knee braces in a rehabilitative or preventative role.

Here is the link:


Was that study done in 1990?


Yes, sorry I reread my post and it was stated incorrectly - this article relates one of the first attempts to develop a standard for measuring the forces placed on the physical frame -ie. knee joints. In recent months there have been additional studies and methods used that confirm the results of this initial attempt.

I got this information from our company research guy when I was considering knee braces for my son. Our Dr. Piper works with ASTM to develop standards for sports head gear and helmets, and keeps current with other types of testing for protective devices to see if any new methods could apply to his work. He gave me a pile of articles, most beyond my comprehension, except for the summaries, which in many studies showed there could be benefits to wearing knee braces of the proper type. CTI and Donjoy were the most mentioned brands and no one in the tests made available to me had tested the Asterisks or other braces specifically developed for MC riding.


I would be be very interested in an independantly financed clinical, rather than laboratory study, performed in the recent past. Sixteen year old lab study, may not be what we are all looking for.

Since I am only 17 years old, some of the information I look at does not apply to me. I will listen to what my doctor says as far as getting back on the bike :thumbsup: Thanks Stinger, i will be investing in some before I ride!

Dr Mark:

I will ask for the articles again on Monday and will send you any current info or links. FYI, I had called both CTI and their sister company Asterisk and asked for any studies they may have conducted on their products or for any comparisons to competing brands, but they said they did not have anything for publication. Most likely they do not want to make any claims or imply something that could lead to liability issues.


Not a doc, but just a lowly mechanical engineer that has the pleasure of owning a CTI2, thank you Cigna, and a pair of Asterik's - bought out of pocket via a HCSA. I had a 90% tear of the ACL and tore the meniscus in 4 places playing basketball.

IMO, neither the CTI2 nor the Asterik's would have prevented my injury - it was purely rotational. The way the braces attach to the knee/leg does not prevent all rotation. They help but by no means do they prevent all rotation.


Dr Mark:

Per our earlier email, below are a few additional articles describing the potential benefit or lack of benefit from wearing a knee brace. The many articles made available were divided on the ability of braces to actually prevent injury to a healthy knee or prevent additional injury to a previously injured knee.

The three of the four referenced below were chosen as representative of at least some positive conclusions and the one for its discussion of greater frequency of ACL injury to women, which has a description of the most common occurrence of ACL injury which may be of interest to MC riders:

Journal of Sports Rehabilitation, 6, 97-110, 1997 – Knees of Female Athletes 1)“the ACL is most vulnerable when the knee is pointing inwards and the foot is pointing outwards with the torso falling forwards” (which reinforces the practice of keeping the ball of your foot on the foot pegs when not shifting or using the rear brake so your foot is not ripped off the peg) 2) To prevent injuries one should be strong in the quads, hamstrings, hip abductors and hip external rotators, abdominals and obliques.

The Sports Performance Journal, 12/02/2005– 1) Prophylatic knee braces may provide limited protection against injuries to the medial collateral ligament in football players. 2) Studies have not consistently demonstrated similar protection by these braces for other knee ligaments, menisci, or articular cartilage. 3) Off the shelf prophylactic knee braces can provide at least 20% to 30% greater resistance to a lateral blow to the knee of sufficient magnitude to cause medial joint damage – one trial has shown a statistically significant reduction in these injuries with brace use.

The Physician and Sports Medicine, Oct 99 – Laboratory studies using surrogate models have shown that most functional knee braces limit some tibial rotation and anterior knee translation. However moderate laboratory effects rapidly disappear during typical use. Patients have differing degrees and types of instability so brace wear and performance may depend largely on the user.

American Journal of Sports Medicine, Vol 28, 2000 – For the purpose of evaluation, the patients had a special transducer implanted in their ACL at the time of surgery which is a very accurate method for testing ligament strain. When using the DonJoy Legend brace anterior shear loads up to 130 N were significantly reduced. The brace did not reduce strain values when the knee was subjected to external torques or varus-valgus movements. The data indicates that a functional knee brace can protect the ACL during anterior-posterior shear loading in the non-weightbearing and weightbearing knee and during internal torques in the non-weightbearing knee.

American Journal of Sports Medicine, 31:99-105 (2003) – Study was to consider the effectiveness of bracing during transition phase between weighted and non-weighted knees. Conclusion was that bracing a knee with a chronic ACL tear was effective in both conditions, but not effective in reducing the abnormal anterior translations produced by the change between these postures. (when shifting from weighted to non weighted or back, there was no protective effect)

American Journal of Sports Medicine, 33:602-611 (2005) – 1) Surrogate knee studies have indicated that off the shelf braces provide 20% to 30% greater resistance to a lateral blow when the knee is in full extension. Custom functional braces doubled the protective effects and proved effective with the knee in some flexion. 2) Concluded from the studies of football players (West Point and the Big Ten Conference) that although the issue is not closed, preventive knee braces appear to offer some protection to the MCL from a contact injury involving a valgus blow, but there may be negative effects on performance level, leg cramping and fatigue symptoms.

Overall the articles can be as discouraging as they are encouraging to a MC rider in the sense that one cannot prevent all knee injuries due to the nature of MC riding with the many different situations that can present themselves in the form of whoops, ruts, mud, rocks, and trees, while turning, jumping or crashing! But that being said, based on the studies, braces designed for our sport could protect the knees from internal damage in certain situations, and in addition, provide crash protection from things that we may fall on or run into.

Most of the comments on this site about knee braces say they are uncomfortable or awkward only when you first ride with them, and after that you don’t even notice you have them on, if so, it may be a good thing to wear them.


Thanks. When its all said and done, there is not very much science behind it all to direct us one way or another.

Riders need to know that before they ante up bucuu bucks for something that may or may not help.

I wear a neoprene sleeve over my knee and shin protectors that have a clam shell that protects the knee cap from penetrating injuries.

Hey Dr. Mark, I know there are so many different opinions on knee braces but if a person was to get a set between the asterisk and evs which would you reccommend and why. I was leaning towards the asterisk but the crumple zones on the evs have me seriously reconsidering. I'm just concerned that if there is no give in the asterisk braces that something else will need to give, any thoughts??

I really don't have an opinion. I probably wouldn't buy either. However if I had a to make a choice I would opt for the one that was more comfortable. Since I believe there is little science behind it all, I would also be more amenable to the least expensive of the two products.

i wass thinking about getting knee braces for my knee after i messed it up,but after hearing bad thing about them i got the evs pastrana knee guards.

I have been running for about 25 years now. I have done many marathons, halfs, etc. I have always had a little twitch in my knee and would feel it a little more when I got dont riding motocross. I just started wearing EVS knee braces and noticed that I dont feel the pain when I get home like I used to. Take it for what its worth, but I think they are worth it in prevention......Preventitive Maint. is always better then corrective.

I tore my ACL with Asterisk knee braces on but I doubt any knee brace would have prevented it, but the reason I wear knee braces is because they offer more protection then standard knee cups.

Before I committed to using knee braces I fell and landed on my knee and the knee pad removed all the skin from my knee and did not tear my pants.

Thats not a big deal but the asterisk braces are attached to your leg so you can't get an abrasion.

I have heard of people that think knee braces are responsible for broken femurs or tib fibs.

You can make an argument for anything but I just feel better riding with them on, at this point I am just trying to ride for a long as I can so if it is 1% better I will do it.

I have been running for about 25 years now. I have done many marathons, halfs, etc. I have always had a little twitch in my knee and would feel it a little more when I got dont riding motocross. I just started wearing EVS knee braces and noticed that I dont feel the pain when I get home like I used to. Take it for what its worth, but I think they are worth it in prevention......Preventitive Maint. is always better then corrective.

What you are exeperiancing is not knee protection, rather unloading of damaged cartilage. Knee braces can be effective in pain relief from OA or articulating surface damage, do not, however, confuse that with protection.


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