WEAR the F#@king Knee Brace!

[Nicomo Cosca]

(05-18-2022, 01:48 PM)Tony Wrote: He's comfortable without it and most likely more mobile
 Brady took his off too..

13 years later…

[Housh]

What i would be saying if i was coach Taylor. Most reinjiries happen because someone thought rehab was shorter than it is. A normal person would still probably need rehab on a torn MCL and ACL. Fact that Birrow tore both and finished the very next season is kind of a miracle

[TecmoBengals]

I speculate Burrow was just sharing his personal opinion about the brace based on the flow of the questioning. He seems to respect Zac and the organization so I'll also speculate he defers to whatever the professionals recommend.

[Sled21]

(05-18-2022, 06:39 PM)bfine32 Wrote: If Joe is relying on Team Doctors for what's best for his knee he's an idiot and I'm sure he is not.

I'm sure he has experts much above the Team Doctor's pay grade advising him. 

Ah, the old "The Bengals medical staff sucks" line of thinking. While I am quite sure Burrow is talking to the guy in LA who did his surgery, and to the trainers on the staff, the Bengals Doctors are not quacks either. There's a reason the team uses them. Of course, people can look at players who came back long after they were thought to be able, but there are just as many who come back ahead of schedule.

[grampahol]

(05-17-2022, 07:24 PM)Au165 Wrote: No offense but the multiple scientific studies are probably a better source on this than you “remember seeing” things. Some studies have actually suggested the braces could lead to more injuries in certain circumstances.

9 out of 10 dentists surveyed recommend letting Joe and the training staff decide instead of this board and to chew Trident sugarless gum for their patients who chew gum too..  Old commercials were a wonderful thing.. 

[Sled21]

(05-19-2022, 09:39 AM)grampahol Wrote: 9 out of 10 dentists surveyed recommend letting Joe and the training staff decide instead of this board and to chew Trident sugarless gum for their patients who chew gum too..  Old commercials were a wonderful thing.. 

Fun to look back...

[SladeX]

My only experience is a torn ACL, and i never wore a brace. The full recovery time was 12 months (in 2000), and i went back to martial arts at that time, finishing up 1st degree BB. I wasn’t playing professional football, but I wasn’t sitting around either. I still remember the first time I tried to spar, and my first competition. Not pretty… . Later on MMA became popular and I participated in that as well.

The fact that athletes come back in several months is amazing, and I assume the recovery protocol has changed for the better. It’s been about 18 months since the surgery. If it was fully successful, then at some point a brace is pointless, because the knee is repaired, and the muscles supporting it are at full strength. When the time is that he doesn’t wear one is between him and his doctors. The only reasons I can think of that would require him to wear a brace forever (on game day or otherwise) is if there is permanent, unrepairable damage, or an inherent problem with the knee.

[oncemoreuntothejimbreech]

(05-18-2022, 06:05 PM)jabor Wrote:

• I certainly appreciate your very reasonable viewpoint to look at the studies currently available , which clearly showed no consensus.  Just an FYI, I had googled and read the summaries of a few studies before I posted and sided with wearing a brace.
  

• In my mind, the benefit is not protecting the knee from the full weight of a 300 lb guy falling on it; I don't know if that's how most knee injuries occur. I am more interested in reducing stress at the limits of the knee, especially if it's been injured before.
  

• As for relying on team Drs... I'm absolutely fine with that. However, don't be that person (NOT "you" specifically) who bitches and questions the medical team's treatment and recovery strategy when an injury occurs/recurs because those damn Drs "obviously" let that player come back too soon
  

Yes, no consensus. As in no consensus bracing prevents ACL tears.  If they prevented ACL tears, then there would be a consensus.

To understand why there isn't a consensus you need to understand the mechanism of injury that causes an ACL tear. Then you can understand how the brace can stabilize the knee. And also, how the brace can't.

Mechanism of ACL Tear : Wheeless' Textbook of Orthopaedics (wheelessonline.com)

Quote: - ACL tears most often occur during football and basketball in younger patients, and occur most often from skiing injuries in older patients;
    - substantial anterior tibial shear forces that stress ACL are produced from quadriceps contraction, esp in 0-30 deg of extension;
    - typically, the ACL is torn in a noncontact deceleration situation that produces a valgus twisting injury;
            - this usually occurs when the athlete lands on the leg and quickly pivots in the opposite direction. (see pivot shift)
    - mechanisms reported as possibly able to disrupt ACL w/ minimal injury to other structures are:
            - extension or hyperextension
            - marked internal rotation of tibia on femur (may be most important);
            - pure deceleration
            - valgus position

The ACL prevents the tibia from sliding forward past the femur (translation) and stabilizes rotation. When an athlete changes direction suddenly they decelerate and plant their outside foot this creates shear forces in that tibial translation plane.  They are also going to rotate their upper body towards the new direction which causes shear forces in that rotational plane. The femur and tibia are going in two opposite directions in two different planes. Functional ACL bracing might help stabilize translation if it doesn't slip at all. But they do very little to stabilize rotation. If you can't prevent over rotation, you can't prevent an ACL tear. And 0-30 degrees of knee extension is normal range of motion.

Test it yourself. Go get yourself a cheap hinged knee brace and put it on correctly. Bend your knee slightly. Without putting weight on that leg try rotating your foot in and out. If you can rotate your foot, you can tear your ACL. Or just stand on the one leg which is braced. Turn you upper body left and right. If you can rotate your body that brace can't prevent a twisting injury to the knee.

[*Nate (formerly eliminate08)*]

(05-18-2022, 01:10 PM)oncemoreuntothejimbreech Wrote: Even placebos are clinically proven to be effective in a small percentage of patients.

Have You Ever Taken Obecalp? (webmd.com)

So far Burrow's knee brace has proven to have a placebo effect on at least three fans in this thread alone. It's making them feel better even though it isn't clinically proven to prevent injury.

Made me lol 

Nice one Breech.

[jabor]

(05-18-2022, 06:48 PM)Truck_1_0_1_ Wrote: Someone who is more knowledgeable about football and someone who is a licensed medical professional, have both refuted your statements with factual studies and deep dives.

Stop it.

Uh... no. Links to random medical websites =/= credible, objective, unbiased, clinical studies.

Your "proclamation" on validity gives me COVID "follow the (selected) science" mantra hives. 

There's obviously no "settled science" or some "medical professional consensus" argument based on links selected from Oncemoreuntothejimbreech's quick google search (or what you call a "deep dive"). But credit to him for trying to bring data to a discussion. 

If you actually look at the links shown in that post— and read the sources they reference (if they bother listing any)— you will see mixed conclusions on braces (benefits and negatives), comments that their results need more study, references to decades-old studies based on knee braces used in those times, or comments that quality data are limited.

More recent studies show:
— Varus-valgus knee stresses seemed to be reduced by braces. ACL protection is inconclusive. Knee pads or padding that helps absorb impact energy may be a beneficial option. (Do Prophylactic Knee Braces Protect the Knee Against Impacts or Tibial Moments? An In Vitro Multisensory Study - 2018: https://journals.sagepub.com/doi/10.1177/2325967118805399)
— Looked at 184 independent source records and found only 3 quality studies that they could consider in their systematic review related to ACL injury. Having such limited quality data reinforces the message that there is clinical uncertainty regarding prescribing functional knee braces when returning to sport. (Can a Knee Brace Prevent ACL Reinjury: A Systematic Review - 2021: https://www.mdpi.com/1660-4601/18/14/7611/htm)

Just to be clear:
— I'm not promoting that a brace should replace proper rehab or ongoing strength/conditioning.
— Knee brace effectiveness is inconclusive based on limited quality clinical data. It may very well help protect against some movement injuries (eg, varus-valgus knee stresses). Protection against ACL is inconclusive or not likely. 
— Maybe knee padding is a better answer than a brace (or nothing)
— Doctors clearly have different viewpoints, which is why you are ALWAYS told to get a second opinion. Even they realize that their expert opinion is not an absolute in most cases. 

[jabor]

(05-19-2022, 12:18 PM)oncemoreuntothejimbreech Wrote: Yes, no consensus. As in no consensus bracing prevents ACL tears.  If they prevented ACL tears, then there would be a consensus.

To understand why there isn't a consensus you need to understand the mechanism of injury that causes an ACL tear. Then you can understand how the brace can stabilize the knee. And also, how the brace can't.

Mechanism of ACL Tear : Wheeless' Textbook of Orthopaedics (wheelessonline.com)


The ACL prevents the tibia from sliding forward past the femur (translation) and stabilizes rotation. When an athlete changes direction suddenly they decelerate and plant their outside foot this creates shear forces in that tibial translation plane.  They are also going to rotate their upper body towards the new direction which causes shear forces in that rotational plane. The femur and tibia are going in two opposite directions in two different planes. Functional ACL bracing might help stabilize translation if it doesn't slip at all. But they do very little to stabilize rotation. If you can't prevent over rotation, you can't prevent an ACL tear. And 0-30 degrees of knee extension is normal range of motion.

Test it yourself. Go get yourself a cheap hinged knee brace and put it on correctly. Bend your knee slightly. Without putting weight on that leg try rotating your foot in and out. If you can rotate your foot, you can tear your ACL. Or just stand on the one leg which is braced. Turn you upper body left and right. If you can rotate your body that brace can't prevent a twisting injury to the knee.

When was using the word consensus, I meant that there are Drs who would favor wearing a brace and some that wouldn't. Is that not true?

Just a point of clarification. If you look at my OP, you will see I mentioned protecting the knee from injury... not just the ACL. All conversation seems to be ACL-related.

I never said knee braces prevent injury. Only that we have limited qualitative studies proving or disproving what benefit they may have. And without that information, I'd lean towards wearing one because there seems to be info at least leaning in the direction of protecting against some types of knee injuries. I've seen research that says padding may actually be a better option for impact injuries than a brace or wearing nothing. It will be interesting to see if tech ... or new strength/training regimens can come up with alternative ways to protect knees.

Bottom line, if a brace does protect against some injuries (even if not an ACL injury), isn't it worth wearing one? 

[oncemoreuntothejimbreech]

(05-19-2022, 04:16 PM)jabor Wrote: Uh... no. Links to random medical websites =/= credible, objective, unbiased, clinical studies.

Your "proclamation" on validity gives me COVID "follow the (selected) science" mantra hives. 

There's obviously no "settled science" or some "medical professional consensus" argument based on links selected from Oncemoreuntothejimbreech's quick google search (or what you call a "deep dive"). But credit to him for trying to bring data to a discussion. 

If you actually look at the links shown in that post— and read the sources they reference (if they bother listing any)— you will see mixed conclusions on braces (benefits and negatives), comments that their results need more study, references to decades-old studies based on knee braces used in those times, or comments that quality data are limited.

More recent studies show:
— Varus-valgus knee stresses seemed to be reduced by braces. ACL protection is inconclusive. Knee pads or padding that helps absorb impact energy may be a beneficial option. (Do Prophylactic Knee Braces Protect the Knee Against Impacts or Tibial Moments? An In Vitro Multisensory Study - 2018: https://journals.sagepub.com/doi/10.1177/2325967118805399)
— Looked at 184 independent source records and found only 3 quality studies that they could consider in their systematic review related to ACL injury. Having such limited quality data reinforces the message that there is clinical uncertainty regarding prescribing functional knee braces when returning to sport. (Can a Knee Brace Prevent ACL Reinjury: A Systematic Review - 2021: https://www.mdpi.com/1660-4601/18/14/7611/htm)

Just to be clear:
— I'm not promoting that a brace should replace proper rehab or ongoing strength/conditioning.
— Knee brace effectiveness is inconclusive based on limited quality clinical data. It may very well help protect against some movement injuries (eg, varus-valgus knee stresses). Protection against ACL is inconclusive or not likely. 
— Maybe knee padding is a better answer than a brace (or nothing)
— Doctors clearly have different viewpoints, which is why you are ALWAYS told to get a second opinion. Even they realize that their expert opinion is not an absolute in most cases. 

You have already been informed multiple times bracing can reduce MCL tears (valgus stress).

Isolated LCL tears (varus stress) are pretty rare. When LCL tears do occur they usually accompany other injuries. I have been told you’re more likely to break the fibula than tear the LCL due to varus stress. I would be interested in reading articles indicating bracing prevents these injuries.

As you just stated, bracing to prevent ACL injuries isn’t likely or inconclusive. Which means it isn’t supported by any data. So they are typically used during the rehab period while the knee is healing. Once healing and rehab is complete the athlete is typically weaned off the brace.

Out of the articles you cited which ones recommended functional bracing to prevent ACL re-injury after reconstruction?

[*bfine32*]

(05-19-2022, 09:39 AM)Sled21 Wrote: Ah, the old "The Bengals medical staff sucks" line of thinking. While I am quite sure Burrow is talking to the guy in LA who did his surgery, and to the trainers on the staff, the Bengals Doctors are not quacks either. There's a reason the team uses them. Of course, people can look at players who came back long after they were thought to be able, but there are just as many who come back ahead of schedule.

I did not call them quacks, I said he'd be an idiot to rely on our staff for what is BEST for his knee.

But you seem to know them better than I.

Who is the ACL/MCL recovery expert on the staff that JB should be listening to; as opposed to Dr. Neal ElAttrache?

[KillerGoose]

(05-19-2022, 05:24 PM)bfine32 Wrote: I did not call them quacks, I said he'd be an idiot to rely on our staff for what is BEST for his knee.

But you seem to know them better than I.

Who is the ACL/MCL recovery expert on the staff that JB should be listening to; as opposed to Dr. Neal ElAttrache?

There is Marc Golloway, Head Team Physician. He specializes in knee and shoulder surgeries. JB is likely utilizing both, as he did some rehab in LA and some rehab in Cincinnati. 

EDIT - Looking at it further, Cincinnati has three orthopedic surgeons on staff. Marc Golloway, Kevin Reilly, and Brian Grawe.

[*bfine32*]

(05-19-2022, 05:37 PM)KillerGoose Wrote: There is Marc Golloway, Head Team Physician. He specializes in knee and shoulder surgeries. JB is likely utilizing both, as he did some rehab in LA and some rehab in Cincinnati. 

EDIT - Looking at it further, Cincinnati has three orthopedic surgeons on staff. Marc Golloway, Kevin Reilly, and Brian Grawe.

I asked who should he listen to instead of DR ElAttrache for what is BEST for his knee. So is your answer Marc Golloway? 

Of course the Bengals have orthopedic surgeons on the staff, we're a sports team. 

[KillerGoose]

(05-19-2022, 06:38 PM)bfine32 Wrote: I asked who should he listen to instead of DR ElAttrache. So is your answer Marc Golloway? Of course the Bengals have orthopedic surgeons on the staff, we're a sports team. 

That would be the answer, yes. To be clear, I'm not arguing that he should listen to Marc instead of ElAttrache, just that these are the guys on staff so they are the answer by default. I have no idea on the reputation of these doctors. I tried to communicate this by saying he is likely using both staffs as he rehabbed in LA and Cincinnati. 

[wanga]

He’s just fluffing about how good it feels not to have it on all the time for training. I suspect it’ll be on again when the real stuff starts.

[*bfine32*]

(05-19-2022, 06:43 PM)KillerGoose Wrote: That would be the answer, yes. To be clear, I'm not arguing that he should listen to Marc instead of ElAttrache, just that these are the guys on staff so they are the answer by default. I have no idea on the reputation of these doctors. I tried to communicate this by saying he is likely using both staffs as he rehabbed in LA and Cincinnati. 

Makes you wonder why he just didn't have our folks do the surgery don't it? 

[ezekiel23]

(05-17-2022, 06:48 PM)jabor Wrote: That sounds nice, but I specifically remember a few times that defensive players fell on his knee while it was in an awkward position. It seems like such a common sense thing to wear.

I have to agree with you in that Burrow narrowly missed be seriously injured again on that knee he wore the brace on a few times at least.I’m an eyewitness to that.And honestly,had it not been for the brace,it could have been a catastrophic injury.But,as to whether he should wear the brace or not this coming season,I think he should just use his own judgment.That said,I would rather have a Joe Burrow that is possibly a step slower with the brace,than no Joe Burrow at all.

[basballguy]

So many people using thumbs in this thread lol