From the Guidelines
For patellofemoral pain, a patellofemoral brace with a lateral hinge and adjustable patellar buttress is the best option, as it provides the necessary support and stability to the patella, reducing pain and improving function, as recommended by the most recent and highest quality study 1. When selecting a brace, consider the individual's activity level and preferences, as a more active person may require a brace with additional features such as adjustable straps and a more secure fit.
- Key features to look for in a patellofemoral brace include:
- A lateral hinge to provide stability and support to the patella
- An adjustable patellar buttress to allow for customization of the fit
- A comfortable and breathable design to reduce irritation and discomfort
- Adjustable straps to ensure a secure and snug fit It is essential to follow proper fitting and application guidelines to ensure the brace is effective in reducing pain and improving function, as outlined in the study 1.
- Proper fitting involves:
- Measuring the circumference of the affected leg to determine the correct brace size
- Positioning the buttress support comfortably and adjusting as needed
- Securing the counterbalancing strap with moderate tension
- Periodically inspecting the brace for migration, strap loosening, or material fatigue In addition to bracing, a comprehensive treatment approach should include physical therapy to strengthen the quadriceps and hip muscles, stretching tight structures, and modifying activities that aggravate symptoms, as recommended by the best practice guide 1.
- This approach should prioritize education and supportive interventions, adjusted to reflect the individual's needs and preferences.
From the Research
Patellofemoral Pain and Bracing
- Patellofemoral pain is a common condition characterized by knee pain in the anterior and retropatellar region of the knee joint 2.
- Abnormal patellofemoral joint motion is a possible cause of patellofemoral pain, and patellar braces are thought to alleviate pain by restoring normal joint kinematics 3.
Effectiveness of Bracing for Patellofemoral Pain
- A study using real-time MRI found that a patellar-stabilizing brace reduced lateral translation of the patella and lateral tilt, whereas a patellar sleeve only reduced lateral translation 3.
- However, a systematic review of clinical trials found very low-quality evidence that knee orthoses (including knee braces and sleeves) did not reduce knee pain or improve knee function in the short term (under three months) in adults with patellofemoral pain syndrome who were also undergoing an exercise program 2.
- Another study found that the use of patellofemoral, knee, or lumbar mobilizations in isolation, or electrophysical agents, is not recommended for patellofemoral pain, and there is uncertainty regarding the use of patellar taping/bracing 4.
Clinical Practice Guidelines for Patellofemoral Pain Management
- A systematic review of clinical practice guidelines for physical therapist management of patellofemoral pain found that higher-quality guidelines recommended exercise therapy, foot orthoses, patellar taping, patient education, and combined interventions, but did not recommend the use of manual therapy (in isolation), dry needling, or patellar bracing 5.
- The review also found that recommendations from higher-quality clinical practice guidelines may conflict with routine physical therapist management of patellofemoral pain 5.
Types of Braces for Patellofemoral Pain
- Different types of knee orthoses, including knee braces, sleeves, and straps, are available for treating patellofemoral pain, but there is limited evidence on their effectiveness 6, 2.
- A study found that a knee brace reduced lateral displacement of the patella more than a knee sleeve, but there is uncertainty regarding the use of patellar taping/bracing for patellofemoral pain 3, 4.