Knee Braces Are The Best Friends That A Bad—or Good—knee Ever Had

When Notre Dame offensive tackle Mike Shiner went down with a knee injury during a 1982 preseason football practice, nobody thought it possible that he would return to the Irish in only four weeks, sound and ready to play. His quick return is credited, in part, to a brace he was wearing at the time of the injury, called the McDavid Knee Guard. The McDavid is one of the two knee braces most widely used in athletics today. The other is the Anderson Knee Stabler, which is similar in design and favored by many NFL teams.

"The young man would have been finished playing football," says coach Gerry Faust, "but the knee brace saved him. He had an injury, but he would have destroyed the knee if he hadn't had the knee brace on." Irish athletic trainer John Whitmer agrees. "Without the brace, Shiner's injury would have been much more traumatic," he says. "We did arthroscopic surgery [a technique used to "see" inside the knee] on him and found partial tears in his ligaments. We attribute his lesser injury to the brace."

The brace was developed in the late 1960s by Dr. Robert McDavid, a former college football coach at New Mexico Military Institute who is now professor of exercise physiology at Indiana State. His invention is gaining wide acceptance among the nation's college athletic trainers and football coaches. Notre Dame, Oregon, Tulane, Louisiana State, Tennessee and West Virginia are among the many teams using the brace to help prevent knee injuries.

At Notre Dame the brace is mandatory in practice for offensive and defensive linemen, linebackers and tight ends. Faust requires the linemen to wear it during games.

At Oregon, much the same applies. "We use it on various people at different positions," head trainer Dean Adams says. "It's mandatory on contact days in practice and one-third of our people voluntarily use it in the games.

"We've cut down on knee injuries. There have been some slight strains on ligaments, and a player may be out from a day to a couple of weeks, but we've had only one significant injury. Some players say that when they're hit from the outside and feel the knee start to go, the brace takes over and the leg straightens out. They became believers. The brace held the knee intact."

That, of course, is the basic purpose of the brace. "We want to prevent injury to a healthy knee and help avoid reinjury to a damaged knee," McDavid says. "So far, we've been highly successful."

According to McDavid, damage to the knee accounts for 21% of all sports injuries. The reason is simple: The knee isn't designed to move from side to side. There are four major ligaments in the knee—two on the outside and two on the inside of the joint. All are susceptible to damage, but most knee injuries involve the medial collateral, an outside ligament, and the anterior cruciate, an inside ligament. (The lateral collateral is the other outside ligament; the other inside ligament is the posterior cruciate.) The medial and lateral collaterals, located vertically along each side of the knee, prevent it from moving from side to side. They serve as braces for the knee. An athlete hit hard from the outside may suffer damage to the medial collateral. When this happens, the knee becomes unstable. Ligaments, made up of many fibers, can be partially or completely torn. Reconstructive surgery is sometimes necessary and often not completely successful.

The sleeve-type McDavid Brace is pulled over or wrapped around the knee and is secured by double Velcro strips both above and below the knee. Tape can also be applied to add more support. A splint made of Lexan, a virtually indestructible polycarbonate, is sewn inside. The splint is hinged at the knee joint and runs along the outside of the leg, forming a bridge between the upper and lower leg. In a sense, the brace acts as a second medial collateral ligament.

"We've sold more than 13,000 units so far," McDavid says "and only a half dozen or so have been returned to us. And the only injuries of any consequence have been to the player at Notre Dame and one at Oregon. We're confident that it works." Many teams using the brace are keeping records on its effectiveness, although a true scientific study hasn't yet been made. As Notre Dame's Whitmer points out, "It's too early to tell. We've been using it for three years, but it could take five to eight years to get the statistical data we need."