How to choose the best knee brace︱Cross Training Adventure

[@crosstrainingadventure]

DO BRACES MAKE YOUR MUSCLES WEAKER? I know some riders like Ryan Hughes have been saying this. The problem is there is no science to back that position. In fact there's plenty of research that disproves this. Here is a summary of the research to date: enovis-medtech.eu/blog_eu/?p=1998 Here are the individual studies: Denton, J.M., Waldhelm, A., Hacke, J.D. and Gross, M.T. (2015). Clinician recommendations and perceptions of factors associated with ankle brace use. Sports health, 7(3), 267-269. Callaghan, M.J., Parkes, M.J. and Felson, D.T. (2016). The effect of knee braces on quadriceps strength and inhibition in subjects with patellofemoral osteoarthritis. journal of orthopaedic & sports physical therapy, 46(1), 19-25. Bodine, S.C. (2013). Disuse-induced muscle wasting. The international journal of biochemistry & cell biology, 45(10), 2200-2208. Kilroe, S.P., Fulford, J., Jackman, S.R., Van Loon, L.J. and Wall, B.T. (2019). Temporal muscle-specific disuse atrophy during one week of leg immobilization. Medicine and Science in Sports and Exercise. Matsuno, H., Kadowaki, K. M., & Tsuji, H. (1997). Generation II knee bracing for severe medial compartment osteoarthritis of the knee. Archives of physical medicine and rehabilitation, 78(7), 745-749. Girija, P., Eapen, C., Zulfeequer, & Kamath, S. (2010). Effect of knee support brace and lateral wedge in sole on isokinetic peak torque in osteoarthritis of the knee-a randomized clinical trial. Indian Journal of Physiotherapy and Occupational Therapy-An International Journal, 4, 25-28. Johnson, A. J., Starr, R., Kapadia, B. H., Bhave, A., & Mont, M. A. (2013). Gait and clinical improvements with a novel knee brace for knee OA. The journal of knee surgery, 26(3), 173-178. Hurley, S. T., Hatfield Murdock, G. L., Stanish, W. D., & Hubley-Kozey, C. L. (2012). Is there a dose response for valgus unloader brace usage on knee pain, function, and muscle strength?. Archives of physical medicine and rehabilitation, 93(3), 496-502. Larsen, B. L., Jacofsky, M. C., Brown, J. A., & Jacofsky, D. J. (2013). Valgus bracing affords short-term treatment solution across walking and sit-to-stand activities. The Journal of arthroplasty, 28(5), 792-797. Callaghan, M. J., Parkes, M. J., & Felson, D. T. (2016). The Effect of Knee Braces on Quadriceps Strength and Inhibition in Subjects With Patellofemoral Osteoarthritis. The Journal of orthopaedic and sports physical therapy, 46(1), 19-25. Callaghan, M. J., & Oldham, J. A. (2004). Quadriceps atrophy: to what extent does it exist in patellofemoral pain syndrome?. British journal of sports medicine, 38(3), 295-299. Salarie Sker, F., Anbarian, M., Yazdani, A. H., Hesari, P., & Babaei-Ghazani, A. (2017). Patellar bracing affects sEMG activity of leg and thigh muscles during stance phase in patellofemoral pain syndrome. Gait & posture, 58, 7-12. Kölle, T., Alt, W., & Wagner, D. (2020). Immediate effects of an elastic patellar brace on pain, neuromuscular activity and knee kinematics in subjects with patellofemoral pain. Archives of orthopaedic and trauma surgery, 140(7), 905-912. Németh, G., Lamontagne, M., Tho, K. S., & Eriksson, E. (1997). Electromyographic activity in expert downhill skiers using functional knee braces after anterior cruciate ligament injuries. The American journal of sports medicine, 25(5), 635-641. Ramsey, D. K., Wretenberg, P. F., Lamontagne, M., & Németh, G. (2003). Electromyographic and biomechanic analysis of anterior cruciate ligament deficiency and functional knee bracing. Clinical biomechanics (Bristol, Avon), 18(1), 28-34. 1

[@tonn333]

Isn't it like wearing crutches? My leg got visibility smaller and weaker after I had to use one. Our body constantly optimises itself. Use it or lose it.

[@PeterR0035]

FROM THE TEXT; these studies conclude that functional bracing does not cause muscle atrophy. In fact, they show that muscles are more active with functional bracing, and more active muscles mean less atrophy

[@tonn333]

@@PeterR0035 how are braced muscle with it's limited movement more active?

[@crosstrainingadventure]

Crutches prevent you using your leg muscles at all. Knee braces have zero impact on your leg muscles. They only time they come into play is when your leg is forced into an unnatural movement which will damage ligaments and tendons.

[@cooganbeggs4942]

Hughes is a muppet and the last person I’d be listening to on the subject. He’s been banging on about neck braces for years and has broken his neck 4 times! I can say with authority that no brace products can weaken your muscles in any way whatsoever

[@seanfrench1029]

Excellent review Barry. When I bought my 990 in 2011 plus riding gear, fortunately my medical insurance paid for most of the cost of my CTIs. I had them custom fitted and replaced again for free within 3 months after a tumble, without which I would have been using a walking frame today. About a year ago I had them reconditioned in USA (I'm from South Africa) to replace all the padding, straps and reviewing the hinges. I use them on 990, 690 and enduros on my 300. I've had several offs where they saved the day. Highly recommended but yes, they are pricey. No regrets. (PS. I use the cotton knee sleeves that I got with them or, long socks for knee braces)

[@crosstrainingadventure]

Good to hear Sean. They certainly last the distance. Mine just look so beaten up after years of use but still doing the job.

[@zemquoi]

So much great information in 7 minutes! I wore a custom brace (for skiing mostly) for 30 years after repair of one knee. Recently though I had to have a total replacement of both knees. I had great rehabilitation, but the look of horror on my Doctors face when I told him I wanted to continue riding and skiing with good braces, was followed with absolutely zero advice or help. So I took the task on myself and it is amazing how little good information there is out there about the subject. Lawyers, sigh. You have summarized everything that I HAVE been able to figure out. Currently I am saving the money to purchase off the shelf CTI braces because that is the brand of my old custom brace which lasted 40 years but no longer fits the new shinny knees. After watching this, I might just save a bit longer so I can afford custom fitting. Still, every ride these days is a dice roll until I get them. Thank you so much for the research!

[@bradsanders6954]

Ride bicycles! Luckily I like pedaling and its the #1 way to re-hab and strengthen knees.......I also found learning better techniques for dirt bike riding made more difference than any brace ever did. A huge difference. Nip it in the bud before you stick a leg out and bend the knee backwards like a chicken leg. Plan way ahead, pick better lines,............those who ride clumsy with no thought destroy bikes, they destroy their body over and over. I would get hurt worse trying to ride mellow, going slow leads to crashes for me.

[@crosstrainingadventure]

Glad you enjoyed the vid, there were a few weeks of work doing all the research for this one. It's amazing how well they last, mine look so battered now but are still working perfectly... just one or two new straps due to the velcro eventually weakening.

[@janniksims5740]

In Germany a lot of top riders without a brace sponsor use Orthema. They are a German company that started out doing medical braces and now they have Offroad riding specific braces. They are available in off the shelf, semi custom and fully custom models.

[@crosstrainingadventure]

Interesting! Here's the link if anyone wants to have a look. www.ortema-shop.com/en-us/motobike/protection-knee-leg

[@pjakszentis]

I rode Asteriks braces for years. They protected me well, but after long adventure travel hours it got more and more painful. I decided to try the Ortema semi-custom braces. So far they have worked, are easier to fit and more comfortable for me. In combination with sturdy boots the risk of knee injury has been effectively reduced by both. As you rightly said, buy the good ones that fit your legs.

[@crosstrainingadventure]

Is that the X-pert brace? Just wondering how is it semi-custom? If it's cheaper than the CTi customs it may be a good option for weirdly shaped legs!

[@pjakszentis]

@@crosstrainingadventure Semi-custom to the extend that the X-pert are offered in different sizes.

[@hogcranker]

A little over a year ago I had a tibial plateau fracture that has left me with limited extension of the knee- a quality brace is a must now, thanks for the info!

[@crosstrainingadventure]

Ouch. We were on a ride two years ago where a guy fell off almost at a standstill and had the same fracture. It was a week long ride and he didn't even have basic knee guards or pads in his riding pants.

[@Wintersdark]

Leatt braces for this guy. I'm near 50, and smacking my knee on a rock would lay me up for months. Mine are fully plastic, but are very sturdy and extend well above the knee and down to near my ankle. They're cheaper ones, iirc they where about $200cdn, but I'm not offroad enough to justify the huge spend of better ones. Theyve survived a few good crashes, and are certainly marked up but still work great; I'm DEFINITELY glad i had them on.

[@davidpoffenbarger3686]

Well timed Barry. My knee braces are several (many!) years old and need to be replaced. Thanks for all your great work making vids enjoyable while still being informative!

[@crosstrainingadventure]

Cheers, David! With this kind of vid I'm trying to get heaps of info in and avoid the waffling. I barely watch any KZbin vids for info as they usually take so long to say anything!

[@johnussher6990]

Another thing to consider is how wide your hips are and the width of your bike at the knees when standing with correct toes in posture. I am small though. 163cm so narrow hips. I used Mobius braces when on my narrow dirt bikes with no issue. They were un-rideable on my Kato 890. Went with Leatt C frame to keep the knees in. Many thousands of Klm not crash tested yet. Hopefully the single hing will hold up when needed.

[@Dagnatic]

Perfectly timed vid Barry. Just coming back from an ACL/MCL/meniscus reco. Great info.

[@crosstrainingadventure]

Glad it was helpful!

[@DirtyDovi]

Awesome info and episode as always Bro! I had to grab something for riding on/off road bikes as well as a few electronic unicycles.. They had to be full featured but still sort of 'basic', they had to be really light weight, etc. And I found the perfect setup: Acerbis Impact EVO Knee/Shin Guards [I didn't need anything crazy but was surprisingly impressed w/ what they show] 👍

[@PeterR0035]

Thank you! ❤❤❤

[@crosstrainingadventure]

Any time!

[@DonkeyDongDoug]

never used them, but wouldn't mind having a set.. My right knee is already a little borked from a High School wrestling match with Anthony "Rumble" Johnson. So preventing any future injury wouldn't be a bad idea.

[@russpaton8877]

Surprised to hear the Mobious lumped in as cheap and no good. Mobious is one of the only ones approved for medical in North America and is worn by a very large number of Rally riders. I have been using my X8's for 5 years now and love them. I have ore existing ACL damage and kneencap damage from downhill skiing accident 35 years ago.

[@russpaton8877]

So used to my x8's now that evenbafyer riding all day I am not rushing to take them off. Never find them loosing off over the day except the lowest strap that is inside my boot cuff. I have monster large knee/calves to the point many boots cuffs will not close around my calves.

[@crosstrainingadventure]

I must admit there may have been changes in recent years that I'm not aware of, Russ. They still look like the ones I tested years ago.

[@russpaton8877]

@@crosstrainingadventure what's your favorite Barry

[@crosstrainingadventure]

As per the vid, no real favourite, Russ. The fit is the really crucial thing and there are some tips in the vid. My main suggestion is just avoid the cheap ones if possible and make sure the fit suits your legs.

[@JoshStreetDesign]

I've tried them all, Mobius are by far the best.

[@noControl556]

I went with high-quality mx-style pads for Adventure riding. I wear Pods for dirt bike (enduro) while comfortable for a few hours, a bit much for multi-day rides, I didn't find the pads that came with my adventure pants to fit snug enough plus I like to have some padding on the inside of my knee as grip the bike really tight with my knees. Also I don't dab my foot nearly as much on the big ADV bike, or need to hop off and push the bike over stuff like on the enduro, so not as concerned about twisting my knee, just need something in case I dump the bike over on some rocks.

[@crosstrainingadventure]

On a very relaxed ride I sometimes just rely on the pads built into my adv pants. But I don't really trust them. It would be so easy for movement of the pants in a crash to leave the knee exposed to a full impact as the pad moved. 😢

[@ZeLogicnator5k]

Great topic! Thankfully I haven't had many below the waist injuries, just nuked my shoulders too much. I've been using the Mobius X8's for the past 6 years and have been happy with them. I ride faster single and hare scramble tracks, not a lot of enduro. I think they kept me from blitzing my knees a number of times and they are comfortable enough for me to wear for 5+ hours. They do chafe if I don't use corn starch (gold bond) due to lack of ventilation. Will I buy them again? I'll probably buy the CTI's or equivalent ortho brace next. The rest of the time I wear Leatt hybrid 3df. But those will be getting replace, straps are too stretched out. Comfort, imo, is underrated by some. If guards, braces, or really anything are not comfortable, like the fit is off or they chafe too much or too quickly, there is a higher likelihood you either: - won't wear them (which makes the purchase pointless) or - won't ride as long/much (which is a bummer). - But if you ignore protection, you will wear them all the time and the protection will be inadequate. It's a balance.

[@Laur1eharry]

Great video!

[@crosstrainingadventure]

Thanks!

[@josephthornton8560]

huge legs. i bought what i could. leatte 5.5 mx boots and leatt dual axis knee gaurds. they dont really fit right and they do hurt a little. i'm poor. i cant afford another setup for a while. i'll have to use em best i can for now.

[@nomad_lad]

I've got a vein issue on one of my legs which means I can't strap anything tightly around the leg or it restricts blood flow and causes pain and swelling... I think this means knee braces and most pads are out for me... I think the best I can hope for is pads held in place by compression trousers or adv bike trousers which generally don't keep the pads in place 🙄 I welcome any suggestions 🙏

[@janisvinters8797]

Asterisk not bad... P.s. Some knee braces need pants that are wider in knee area to fit and usage of pants are comfortable..

[@doctormaddix2143]

4:56 damn that DR is sick! even has the cyclops rally light! can i find any pictures of the bike for some inspiration? :)

[@crosstrainingadventure]

I don't think he's posted any. But if you google 'dr650 cyclops headlight' for images you get heaps of very modified bushpigs!

[@s7ok3d54]

As a fatty thats ridden most my life (poorly) I had a few close calls in crashes and foot catches that left me limping for a few weeks , so i decided to shell out the dosh on some mobius braces as they fit my thunderous legs , After using them for around 2 years i retired them and forked over the dosh for a set of asterisk carbon cell 1s ( really liked the pod but didnt fit at all) and as soon as i slipped them on the feel and fit was 100x better for my legs , After a few more big hits , leg catches at pace and some severe bruising left on the contact points of the braces im convinced they have to be working ?

[@bradsanders6954]

I agree on the Pods. They are as flimsy as it gets. The Mobius are full enclosure hot and sweaty. Sweat can make the brace slide down on hard hits. I cringe now just thinking of twisting a knee on a dirt bike. Cant do it anymore. Many ex racers are crippled for life, pro or amateur. My left knee is full Ti.

[@ZeLogicnator5k]

I've been running the X8's for a number a years and personally they have worked great for me. But they definitely have little to no ventilation. I tried the fit of the pods and the astericks and just didn't jive with them. But my buddy loves his astericks. They're like gloves

[@blacky8498]

I always wear braces, broke my leg when I was young and dumb. Safety first

[@sorin.n]

Do they allow blood to flow normally if you keep the straps tight? Do yhey slide down during normal use? Are the boots kerping them from sliding down on the leg? So many questions... 😅

[@bradsanders6954]

Kinda depends on your legs, skinny legs just wont let many knee braces get a grip on them, sweat and impacts can make the brace slide down and that sucks. Big calves let a brace grab on to a leg...........in hot weather some braces with no vents absolutely suck, torture. Hours with these cages strapped to your legs riding tight singletrack...........I effing hated it eventually. And still destroyed a knee wearing a 1200.oo brace on each leg. The tighter the strap the bigger of a divot left on your leg and Ive still have the velcro rip loose on a hard hit. Obviously Ive worn knee braces a lot.

[@sorin.n]

@@bradsanders6954 Tkank you!

[@crosstrainingadventure]

All good questions! The vid looked at ways to ensure a good fit. And if you can't, you might need to go for custom braces. I tend to tighten mine a lot but never restricted blood flow. Not sure if anyone has ever reported that happening?

[@sorin.n]

@@crosstrainingadventure ❤️

[@crosstrainingadventure]

Actually one viewer has just commented saying he has physical issues with his leg veins and can't have any compression from things like brace straps.

[@SWATT101]

Already have an right knee, ACL issue... another reason I don't (can't)ride aggressively at 64 lol

[@crosstrainingadventure]

Must admit in my 60s I'm tending to slow and enjoy the views more!

[@adamdyment9732]

Please refer to Australian dollars as dollar-bucks or dollary-doos

[@crosstrainingadventure]

My bad, Adam! Bonza advice, cobber. I will delete and redo about 340 vids to comply with international standards. 😊

[@adamdyment9732]

@@crosstrainingadventure i dont know what any of that means, but i like it.

[@SenorTucano]

Wouldn’t ride without mine

[@bikesandstuffwithjoe2215]

I got asterisk but l can't say I would buy them again. $1000 Aus. Comfortable but poor build quality. Side hinge broke at about 10 hours. All inner linings peeled off quick. Kneecap cover design cheaply made. The kneecap cover looks as if it were an afterthought.

[@crosstrainingadventure]

Damn. I wonder if they've swapped over to cheaper manufacturing in China as many brands have done in recent years? Even CTi moved their factory from the US to Mexico but hopefully it won't lead to a drop in quality.

[@leeroykelly781]

Is there a video topic that you guys want to revisit at some point?

[@crosstrainingadventure]

You bet.

[@MattPerry]

I bought one of these, i crashed, if i had mx boots and these i would not be hurt.

[@bradsanders6954]

Dont count on it, it depends on the angle of the twist and the suddenness of the hit, amongst other things. Guys destroy their knees with the best boots and knee braces on tight as can be..........nothing, is a guarantee and isnt claimed to be.

[@crosstrainingadventure]

Yeah I'd say it reduces your chances a lot but you never get 100% protection. I've broken four bones in my foot when the DR650 slammed down on the side of expensive mx boots and crushed them. And you can still wreck your knee despited braces. The braces only reduce your chances to varying degrees depending on the type of hit.

[@MattPerry]

@@bradsanders6954 nop, othe case thst i ssid i was wearing sneakers...

[@MattPerry]

@@crosstrainingadventure for sure. But i was wearing running shoes, so it hurt a lot.

[@JoshStreetDesign]

I got $3,800 custom DonJoy Defiance Pros this summer after a full knee construction, and I'm sorry to say they are HOT GARBAGE. Literally provide no bracing support, they're very uncomfortable, provide no impact protection, even with the mx guards attached, and they're heavy and bulky. I've tried so many others as well but in my opinion nothing beats the Mobius X8s. They check every box.

[@tahoehiker]

Real men ride in shorts and sandals!

[@brianmartindale2221]

Don't forget the tank top, see-through if following recent trends

[@leeroykelly781]

And no helmet! Only 10-plys wear helmets! It’s common sense!

[@crosstrainingadventure]

True! And it's related to engine size. I've noticed the bigger the sports bike the less clothing is needed.

[@samarthdhomkar5724]

Make a video on the new Himalayan 452.

[@crosstrainingadventure]

No.

[@samarthdhomkar5724]

@@crosstrainingadventure why not?

[@hung8969]

Wonder how long it will take before this sport learns bracing = making everything weaker. You’re relying on a brace to support you. You shouldn’t be riding. Every single joint you brace you weaken everything around it. Take them off and go to the gym.

[@crosstrainingadventure]

I know some riders like Ryan Hughes have been saying this. The problem is there is no science to back that position. In fact there's plenty of research that disproves this. Here is a summary of the research to date: enovis-medtech.eu/blog_eu/?p=1998 Here are the individual studies: Denton, J.M., Waldhelm, A., Hacke, J.D. and Gross, M.T. (2015). Clinician recommendations and perceptions of factors associated with ankle brace use. Sports health, 7(3), 267-269. Callaghan, M.J., Parkes, M.J. and Felson, D.T. (2016). The effect of knee braces on quadriceps strength and inhibition in subjects with patellofemoral osteoarthritis. journal of orthopaedic & sports physical therapy, 46(1), 19-25. Bodine, S.C. (2013). Disuse-induced muscle wasting. The international journal of biochemistry & cell biology, 45(10), 2200-2208. Kilroe, S.P., Fulford, J., Jackman, S.R., Van Loon, L.J. and Wall, B.T. (2019). Temporal muscle-specific disuse atrophy during one week of leg immobilization. Medicine and Science in Sports and Exercise. Matsuno, H., Kadowaki, K. M., & Tsuji, H. (1997). Generation II knee bracing for severe medial compartment osteoarthritis of the knee. Archives of physical medicine and rehabilitation, 78(7), 745-749. Girija, P., Eapen, C., Zulfeequer, & Kamath, S. (2010). Effect of knee support brace and lateral wedge in sole on isokinetic peak torque in osteoarthritis of the knee-a randomized clinical trial. Indian Journal of Physiotherapy and Occupational Therapy-An International Journal, 4, 25-28. Johnson, A. J., Starr, R., Kapadia, B. H., Bhave, A., & Mont, M. A. (2013). Gait and clinical improvements with a novel knee brace for knee OA. The journal of knee surgery, 26(3), 173-178. Hurley, S. T., Hatfield Murdock, G. L., Stanish, W. D., & Hubley-Kozey, C. L. (2012). Is there a dose response for valgus unloader brace usage on knee pain, function, and muscle strength?. Archives of physical medicine and rehabilitation, 93(3), 496-502. Larsen, B. L., Jacofsky, M. C., Brown, J. A., & Jacofsky, D. J. (2013). Valgus bracing affords short-term treatment solution across walking and sit-to-stand activities. The Journal of arthroplasty, 28(5), 792-797. Callaghan, M. J., Parkes, M. J., & Felson, D. T. (2016). The Effect of Knee Braces on Quadriceps Strength and Inhibition in Subjects With Patellofemoral Osteoarthritis. The Journal of orthopaedic and sports physical therapy, 46(1), 19-25. Callaghan, M. J., & Oldham, J. A. (2004). Quadriceps atrophy: to what extent does it exist in patellofemoral pain syndrome?. British journal of sports medicine, 38(3), 295-299. Salarie Sker, F., Anbarian, M., Yazdani, A. H., Hesari, P., & Babaei-Ghazani, A. (2017). Patellar bracing affects sEMG activity of leg and thigh muscles during stance phase in patellofemoral pain syndrome. Gait & posture, 58, 7-12. Kölle, T., Alt, W., & Wagner, D. (2020). Immediate effects of an elastic patellar brace on pain, neuromuscular activity and knee kinematics in subjects with patellofemoral pain. Archives of orthopaedic and trauma surgery, 140(7), 905-912. Németh, G., Lamontagne, M., Tho, K. S., & Eriksson, E. (1997). Electromyographic activity in expert downhill skiers using functional knee braces after anterior cruciate ligament injuries. The American journal of sports medicine, 25(5), 635-641. Ramsey, D. K., Wretenberg, P. F., Lamontagne, M., & Németh, G. (2003). Electromyographic and biomechanic analysis of anterior cruciate ligament deficiency and functional knee bracing. Clinical biomechanics (Bristol, Avon), 18(1), 28-34.

[@tonn333]

​@@crosstrainingadventurewhen I had to use a crutch, my leg got way smaller and weaker. I would imagine the same applies here. Use it or lose it. I still wear my braces.

[@crosstrainingadventure]

Crutches prevent you using your leg muscles at all. Knee braces have zero impact on your leg muscles. They only time they come into play is when your leg is forced into an unnatural movement which will damage ligaments and tendons.

[@tonn333]

@@crosstrainingadventure what about your tendons and ligaments, are they encouraged to get stronger by using "crutches" such as braces? Probably not, right?

[@crosstrainingadventure]

As per previous comment. The braces only start to work once your leg goes to an unnatural angle. There is a lot of research from extremely qualified experienced health and sports professionals that disproves these kind of myths. Here is a summary: enovis-medtech.eu/blog_eu/?p=1998