Bracing

The Collingwood Sport Medicine and Rehabilitation Centre carries a full line of off-the-shelf braces. We also have available the services of a skilled bracing technician who does all of our custom braces. The following is information that may be of help to you.

There are many types of braces available to treat a wide variety of injuries and conditions. They range from simple off-the-shelf sleeves to custom-made braces with graphite shells and high-tech hinges. Simply put, braces have 2 major functions: they protect and decrease pain from an acute injury and they facilitate return to activity after an injury has stabilized.

Braces work in 2 ways They provide direct mechanical support to protect, and prevent further injury to, ligaments and tendons. They enhance the body’s proprioceptive system, which in turn helps protect a joint from further damage. Proprioception gives our brain constant feedback about what is happening to our limbs and joints. When a joint is injured, proprioception is impaired leaving the joint more vulnerable to re-injury. Some experts feel this is the most beneficial function of bracing.

There are 4 main types of braces: Post-injury braces: Used immediately after an injury; decrease swelling and pain around a joint by providing compression and joint stabilization; promote ligament healing. Return to sport braces: Protect the joint once the athlete returns to play, by providing restriction of movement and improvement of proprioception. Post-operative braces: Used for postoperative care mainly after knee surgery; put the joint at rest and help protect it; allow appropriate but limited motion. Two types: a straight immobilizer, which prevents all motion, and a hinged brace that allows range of motion. Prophylactic braces: Used to prevent injuries for certain sports such as football. There is some evidence that functional braces can assist in protecting against injury in low-load, low-velocity, low-torque activities. For the high-velocity, higher-load, higher-torque activities such as jumping, pivoting, or cutting, or in certain contact situations, no brace can prevent an injury. Use of prophylactic braces is controversial.

Braces can be of benefit in the following areas: Upper extremity: Shoulder: Slings and pads can provide light support and can improve proprioception. For recurring shoulder dislocations harnesses keep the shoulder from getting into a position of risk. Tennis and golfer’s elbow: Treated by a strap worn around the upper forearm. Wrist sprains or tendinitis: Treated with a simple strap brace, or with a rigid wrist splint that leaves the thumb and fingers free. Thumb tendinitis: Immobilized by a thumb splint. Finger sprains: “Jammed fingers” or fingers with minor fracture can be protected with moldable aluminum splints. Lower Extremity: Knee: Medial collateral ligament sprains: Off-the-shelf soft shell braces with good side hinges can protect the ligament. ACL tears: Usually require custom-made braces with graphite shells and high-tech hinges. Kneecap (patella) pain ("runner's knee"): A pullover knee sleeve with various types of cutouts can support or stabilize the patella; may have a half-circle buttress lateral or below the kneecap. Patellar tendinitis (“jumper’s knee”): Good relief can be obtained by using a single strap with a foam or air pocket pad applied over the tendon. Patellar dislocation or subluxation: A patellar stabilizing brace that has a cutout sleeve and heavier side buttressing can help prevent the kneecap from popping out of place. Ankle: Ankle Sprains: Most ankle injuries are inversion sprains (the foot rolls in injuring the outside of the ankle); braces range from simple off-the-shelf models that provide light support to custom hinged models that help control significant ankle instability. Achilles tendon pain: Bracing with an air support pad can help in some cases. Foot: Plantar fasciitis: a splint worn at night; keeps the ankle bent to 90 degrees.

Brace Purchasing Tips: Look for a supplier who has a good choice of braces and is knowledgeable in the fitting process. Make sure the brace is comfortable. Look for a brace that's appropriate for both rehabilitation and returning to play. Consider the type of sport and the appropriate regulations: for example braces which have “hard parts” are not allowed in certain contact sports. If a brace is no longer providing good support, take it back for re-assessment; it may need adjustment or repair. Custom molded braces should be fitted by an expert. Don’t rely only on a brace alone: an injured joint needs rehabilitation to increase strength and endurance. You may have an insurance plan that covers the cost of braces. To qualify you will likely need a prescription from a doctor.