Bracing may be utilized for various reasons. The "unloader brace" could be utilized for tibiofemoral problems occurring only on one side of the joint. The "unloader brace" unloads the affected side of the joint putting increased force on the opposite side of the knee. A patellofemoral tracking brace may offer improved comfort for patients with subluxation or dislocation of the patella. A compression sleeve may be recommended for patients with chronic swelling. Bracing is often utilized to improve patient's comfort; however, it typically does not fix the problem.
Scientific studies of knee arthritis progression have shown that the higher the load on the joint, the more joint deterioration occurs. Weight gain can cause increased knee pain and lower activity levels resulting in more weight gain. To break this cycle, it is often necessary to combine some form of knee pain control and work with your doctor or physical therapist to develop a pain free exercise program. Initially, this may be aerobic exercise using the upper body only, yet most patients are able to perform some level of lower body aerobic exercise such as low resistance cycling or swimming.
The knee is subjected to very high loads, not only with work and sports, but even activities of daily living such as climbing stairs and squatting. Muscles participate in distributing these loads by smoothly gliding the knee through is normal path of motion and acting as "shock absorbers" to dampen sudden high loads. This applies to muscles directly around the knee as well as the core muscles of the pelvis, abdomin, and back. Without adequate strength, the loads placed on the knee cannot be sufficiently dissipated and may result in knee pain. As the exercises to strengthen these muscles may not be intuitive, it is often useful to seek advice from your doctor or therapist about a comprehensive core-to-floor physical therapy program.
Transcutaneous Electrical Nerve Stimulation (TENS)
Pulsed low level electrical current (that is not even felt during treatment) has been shown in clinical studies to reduce pain and improve function in patients who would otherwise be knee replacement candidates. This device is FDA-approved for the treatment of pain associated with osteoarthritis of the knee.