An unloader brace can provide extreme relief for people with unicompartmental knee osteoarthritis. But, what is an unloader knee brace, exactly? And can it help you too?
This type of brace is a knee support that relieves joint pressure. It can be a cost-effective way to ease pain, too. But it may not help everybody with knee osteoarthritis.
Below we discuss this and more. Here are the topics covered, tap on any of them to quickly jump into their sections:
How does a knee unloader brace work?
These braces are designed with a 3-point pressure mechanism. This shifts the pressure of the joint, decompressing one side of it. This ultimately helps take the load off the symptomatic side of your knee.
This can be a lifesaver if you're experiencing unicompartmental knee osteoarthritis or even meniscal issues.
But what is unicompartmental knee osteoarthritis?
This is a medical term to describe that knee osteoarthritis is present in one side of your joint.
See, the knee joint can be divided into two compartments. The one on the inner side is called the "medial" compartment, while the outer side is the "lateral" compartment. Degeneration can happen in one or both of them.
So, if the inner side of your knee has wear and tear but the outer side is ok, we'd call it "medial compartment knee osteoarthritis." This would be a type of unicompartmental knee OA.
In this type of knee OA, wearing an unloader knee brace could reduce the pressure on the medial compartment, reducing pain. (1)
Advantages of wearing an unloader knee brace
Some of the reasons why you should definitely wear an unloader brace include:
Cost-effectiveness
An unloader knee brace is usually a one-time purchase. You will save more money from it compared to months of pain medications that you may take daily just to move comfortably.
Could delay or prevent knee surgery
An unloader brace could help you move and function well in the short term, delaying the degeneration process. This often translates into delaying your need for surgery. (2)
This can be a big deal for those concerned about going under the knife and the costs associated with it.
Minimal to zero side effects
Skin discomfort is probably the most common side effect you may have when wearing a knee brace. This is a very minor issue compared to the severe side effects pain medications can cause.
Disadvantages of unloader knee braces
There are also a few drawbacks that you should be aware of with knee bracing, which are:
It won't reverse your knee joint condition
To be honest, no knee brace will. No treatment to date can reverse the degeneration process. But these garments can bring knee pain relief and make life easier.
This condition requires other medical treatments like physical therapy, weight loss, and exercise. Advanced cases may require a knee replacement to improve the symptoms.
Could take a while to get used to
Unloader knee braces are heavier than sleeves, for example. They're also harder to put on. This can make it difficult for some to wear it as often as they should to feel relief. (3)
Needs periodic cleaning and maintenance
As with any knee brace, unloaders require cleaning to prevent bad odours and skin irritation due to sweat. Doing this also extends the life of the garment.
How much do unloader knee braces cost?
An over-the-counter unloader knee brace can cost from a few bucks up to 200$. This will depend on the brand and materials. You can find them in medical supply stores or online.
And although convenient, you risk it may not fit well. This can cause skin problems, chafing, and even make no difference on your knee pain.
The safest option is going to an orthotist.
These are medical professionals who make knee braces for a living. Your doctor would refer you to one, especially if the shape of your knee doesn't fit well with most commercial braces.
An orthotist can mould a knee brace based on the exact specifications of your leg. Make sure you wear shorts or comfy clothes for your appointment.
The cost of a bespoke knee brace is definitely higher than a ready-made one. However, it'll fit better and is a good investment for something you'll use long-term.
How do I know whether an unloader knee brace will work for me?
You'll likely benefit from wearing one if:
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You have unicompartmental arthritis.
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You have a minor unilateral meniscal injury.
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You are compliant with wearing a brace for long periods.
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You can commit to taking care of ot and cleaning it regularly.
How can I make wearing an unloader brace more comfortable?
If you've decided to get your unloader knee brace follow these tips to make it as comfortable as possible:
Ease into it
Research suggests that to relieve knee pain, you should wear your brace daily for 6 hours at least. (4) But you can't start with that amount of time straight away, it'll be too uncomfortable and could even worsen your symptoms.
Instead, wear the brace daily for 1 hour during your first week. Increase it by another hour every week until you get used to wearing one for 6 hours.
Yes, it may take a while. But this gradual buildup will set you up for success.
Make sure it fits well
There are two ways to make sure this happens with unloader braces:
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Triple-check the sizing chart before buying.
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Once you have it on, slip two fingers underneath each strap. If you can't, it's too tight. If it's too easy to do, it's too loose.
Wear comfortable clothing
Wearing an unloader brace could easily become a sweaty experience for your leg. It's best to choose loose-fitting pants or shorts to improve breathability.
Also, this is one of the few knee braces that shouldn't be worn over pants. It won't shift the joint as it should, and it can easily slip down due to the fabric.
Other types of braces for knee joint pain
If you think that an unloader brace just isn't for you, don't worry. These next two braces could be just what you are looking for.
Knee compression sleeves
Compression sleeves are a great beginner and budget-friendly alternative to an unloader brace. They are made of compressive fabric that helps promote blood flow and knee function, all while reducing pain. (5)
They're also easier to put on than an unloader brace - you just slip it up on your knee and it's good to go!
But one tradeoff is that it won't shift the joint load, unlike an unloader brace. So if you're looking for a joint-hugging fit with minimal support, a knee sleeve is a good option.
Hinged knee braces
These braces have side stabilizers -hinges- that keep your knee stable. Some even have dials that limit how far you can curl your leg, which is very handy for those with pain when bending their knees.
But these don't shift the joint load either. They're a great alternative if you have knee instability from osteoarthritis, a ligament tear, or any other injury.
FAQs
How long should you wear an unloader brace?
You should wear an unloader brace daily for 6 hours at least to feel pain relief. (4)
Where can I obtain an unloader knee brace?
You can obtain an unloader knee brace online, in a medical supplies store, or from an orthotist.
What do unloader knee braces look like?
An unloader knee brace looks like a regular brace made of straps, hinges, and a padded pressure point on one side.
Conclusion: How does an unloader knee brace work?
An unloader knee brace works by shifting the weight from the painful side of your knee to bring pain relief.
It can be a good conservative option to hopefully delay or prevent surgery, provided you also do other treatments like physical therapy.
Resources
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Yan, Yuzhou et al. “Biomechanical Effect of Valgus Knee Braces on the Treatment of Medial Gonarthrosis: A Systematic Review.” Applied bionics and biomechanics vol. 2022 4194472. 29 May. 2022, doi: 10.1155/2022/4194472
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Lee, Paul Yf et al. “Unloading knee brace is a cost-effective method to bridge and delay surgery in unicompartmental knee arthritis.” BMJ open sport & exercise medicine vol. 2,1 e000195. 21 Feb. 2017, doi: 10.1136/bmjsem-2016-000195
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Squyer, Emily et al. “Unloader knee braces for osteoarthritis: do patients actually wear them?.” Clinical orthopaedics and related research vol. 471,6 (2013): 1982-91. doi: 10.1007/s11999-013-2814-0
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Mistry, Dylan A et al. “An Update on Unloading Knee Braces in the Treatment of Unicompartmental Knee Osteoarthritis from the Last 10 Years: A Literature Review.” Surgery journal (New York, N.Y.) vol. 4,3 e110-e118. 2 Jul. 2018, doi: 10.1055/s-0038-1661382
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Paluska, S A, and D B McKeag. “Knee braces: current evidence and clinical recommendations for their use.” American family physician vol. 61,2 (2000): 411-8, 423-4. https://pubmed.ncbi.nlm.nih.gov/10670507/