Knee Protection? Compression? Braces?
- Thread starter SteveI
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Injured Again
Hall of Fame
Steve, I've posted some videos recently of me playing with two, level 1, neoprene knee braces. The problems cropped up during our shutdown, where the lack of access to resistance training machines led to muscle, strength, and neuromuscular coordination loss. Of course, I was pretty rested so when I was able to first get back on the court, it felt good to run around. Until it didn't.
What has always worked for me is to do a lot of resistance training involving my legs, plus multi-plane flexibility stretching in my legs and knees. I'm a real believer in leg extensions and hamstring curls, and at least twice a day I'll work my knees through the full range of motion in bending and under sideways motion. Then I tried to keep my knees warm using the braces any time I played or even walked the dog.
It took a few weeks but I'm now I'm painfree again. Good luck to you!
What has always worked for me is to do a lot of resistance training involving my legs, plus multi-plane flexibility stretching in my legs and knees. I'm a real believer in leg extensions and hamstring curls, and at least twice a day I'll work my knees through the full range of motion in bending and under sideways motion. Then I tried to keep my knees warm using the braces any time I played or even walked the dog.
It took a few weeks but I'm now I'm painfree again. Good luck to you!
tlm
G.O.A.T.
If you are talking about leg extensions on a machine I’ve heard those can be bad for the knees. I agree the stretching is good, and when I was having knee pain I wasn’t working my legs other than playing tennis.
Now I do squats and calf raises and deadlifts for the hamstrings and so far no more knee pain. The stronger the muscles are the better support for the joints.
Injured Again
Hall of Fame
Efficacy of doing leg extensions seems to be widely argued. My sister-in-law is a physical therapist and says they are hard on the knees and to not do them. I've had a few sports-medicine physical therapists who advised **to** do them. Their reasoning is that with my history of knee arthritis and pain, and my exercise history which usually strengthens the muscles on the outside of my thigh (I think they're called the vastus lateralis), that I need to also strengthen that pear shaped muscle on the inside of the thigh above the knee (vastus medialis?). It was said that will help my kneecap track better when I bend my knee. Whatever, it works fantastically well for me. There were many times in my middle to late 40's when I had severe enough knee pain to prevent freely moving on a tennis court. Now, outside of injury, that is never the case.
My son snapped a picture of me a few weeks ago after we first got back into the gym. I work hard to try and keep my legs in shape, but as we've talked about in this thread, sometimes I'm not sure it's worth it for all of the bad things that it can bring.
My wife has also experienced knee pain, starting a few years ago when we were prepping to hike the Inca trail. In her case, doing leg extensions aggravated her knee issues but she did eventually solve all of her knee issues by rigorously and regularly stretching her IT band.
We have a couple of doctors here, and I think @yossarian is a physical therapist? Maybe they can offer some input?
jhick
Hall of Fame
I have had some success with foam rollers, investing in high quality tennis shoes and orthotics, and losing weight always helps put less stress on the knees. I started having knee issues about 6-7 years ago after helping my niece move out of her dorm (3rd floor and had to come down stairs...no elevator). Knee braces (compression) helped a bit initially with stability but I didn't want them to be a long term solution. I don't play with braces anymore. My knees usually ache a bit after playing, but not during and I ice them after playing. I have more of an issue with achilles tendonitis now on my right leg. Try to stretch and ice...gets a little sore after playing and the next morning. Getting old stinks.
yossarian
Professional
Efficacy of doing leg extensions seems to be widely argued. My sister-in-law is a physical therapist and says they are hard on the knees and to not do them. I've had a few sports-medicine physical therapists who advised **to** do them. Their reasoning is that with my history of knee arthritis and pain, and my exercise history which usually strengthens the muscles on the outside of my thigh (I think they're called the vastus lateralis), that I need to also strengthen that pear shaped muscle on the inside of the thigh above the knee (vastus medialis?). It was said that will help my kneecap track better when I bend my knee. Whatever, it works fantastically well for me. There were many times in my middle to late 40's when I had severe enough knee pain to prevent freely moving on a tennis court. Now, outside of injury, that is never the case.
My son snapped a picture of me a few weeks ago after we first got back into the gym. I work hard to try and keep my legs in shape, but as we've talked about in this thread, sometimes I'm not sure it's worth it for all of the bad things that it can bring.
My wife has also experienced knee pain, starting a few years ago when we were prepping to hike the Inca trail. In her case, doing leg extensions aggravated her knee issues but she did eventually solve all of her knee issues by rigorously and regularly stretching her IT band.
We have a couple of doctors here, and I think @yossarian is a physical therapist? Maybe they can offer some input?
Rogue Flip is the PT. I’ll be one in approximately one year
Not an inherently bad exercise, just not entirely functional. At heavy weights they do put a lot of stress on the knee, but if you can’t tolerate things like squatting due to arthritic changes and you feel like leg extensions work for you then there’s no need to stop
Injured Again
Hall of Fame
I can tolerate doing weight room squats but if I squat all the way down so my butt is just off the ground, that is hard on my knees. The physical therapists have really recommended leg extensions as a way of helping my kneecap track better as I bend my leg. I remember looking at an anatomical diagram when it was first recommended to me and thinking the medialis doesn't work in that way but the extensions definitely help develop the medialis and my knee pain goes away when I do extensions religiously.
yossarian
Professional
whatever works for you. I don’t believe you can preferentially strengthen the VMO over the rest of the quad. Knee tracking can just be due to the structure of your knee, but taping, joint mobilization, and stretching of the lateral retinaculum may also help
tlm
G.O.A.T.
Why can’t you use a leg press machine instead of extensions? One of my buddies injured his knee doing extensions and when I’ve tried them I could feel the strain in the knee.
Do you need to do full squats? I would think you could do partials and still work the leg muscles pretty thoroughly.
Injured Again
Hall of Fame
Re-reading that bit that you quoted, I really wasn't clear in a number of ways.
First, when I was talking about squatting all the way down so my butt is just off the ground, that is with no weights - just squatting down like I'm going to play catcher. These old knees can't handle bending that sharply without discomfort. I only do squats to 90 degrees or just a little more. I'm primarily doing them on a leg press machine - we have a full line of Nautilus equipment. I'll freeweight squat every so often just to make sure I can still activate all of those balancing muscles but I'm only doing 135 pounds.
Since I was a hardcore cyclist and runner for a couple of decades, and did work in the gym as well, I was told I overdeveloped the outer quad muscles (vastus lateralis) and needed to develop the inner quad (vastus medialis) via leg extensions, all to help my kneecap stay more centered as I bent my leg. The leg extensions worked wonders for me.
Anyhow, I played tennis today, and hit an open stance topspin backhand where I had to take a large lunge with my left leg to land and stop in one motion. Right on contact with the ground, I felt a burning sensation on the inside of my kneecap and now it has started to bleed through.
Admittedly this was a fairly hard stop but I would guess I only used about 70% of my maximum strength to stop. So nothing I wouldn't feel comfortable doing all the time. And if I can't be confident doing this level of a move without injury, it's almost like I should give up tennis. Right now, this feels like a two-week injury. Getting old sucks....
tlm
G.O.A.T.
Re-reading that bit that you quoted, I really wasn't clear in a number of ways.
First, when I was talking about squatting all the way down so my butt is just off the ground, that is with no weights - just squatting down like I'm going to play catcher. These old knees can't handle bending that sharply without discomfort. I only do squats to 90 degrees or just a little more. I'm primarily doing them on a leg press machine - we have a full line of Nautilus equipment. I'll freeweight squat every so often just to make sure I can still activate all of those balancing muscles but I'm only doing 135 pounds.
Since I was a hardcore cyclist and runner for a couple of decades, and did work in the gym as well, I was told I overdeveloped the outer quad muscles (vastus lateralis) and needed to develop the inner quad (vastus medialis) via leg extensions, all to help my kneecap stay more centered as I bent my leg. The leg extensions worked wonders for me.
Anyhow, I played tennis today, and hit an open stance topspin backhand where I had to take a large lunge with my left leg to land and stop in one motion. Right on contact with the ground, I felt a burning sensation on the inside of my kneecap and now it has started to bleed through.
Admittedly this was a fairly hard stop but I would guess I only used about 70% of my maximum strength to stop. So nothing I wouldn't feel comfortable doing all the time. And if I can't be confident doing this level of a move without injury, it's almost like I should give up tennis. Right now, this feels like a two-week injury. Getting old sucks....
Okay I see what you meant I don’t like to squat down into catcher position either. I do squats the same way around 90 degrees and 130 lbs done very strict. Like you mentioned that is a good way of keeping the stabilizer muscles active.
That sucks that you are having a lot of injury problems, I guess it shows how rough this game can be. I have a few of my hitting partners that are out with injuries right now.
Efficacy of doing leg extensions seems to be widely argued. My sister-in-law is a physical therapist and says they are hard on the knees and to not do them. I've had a few sports-medicine physical therapists who advised **to** do them. Their reasoning is that with my history of knee arthritis and pain, and my exercise history which usually strengthens the muscles on the outside of my thigh (I think they're called the vastus lateralis), that I need to also strengthen that pear shaped muscle on the inside of the thigh above the knee (vastus medialis?). It was said that will help my kneecap track better when I bend my knee. Whatever, it works fantastically well for me. There were many times in my middle to late 40's when I had severe enough knee pain to prevent freely moving on a tennis court. Now, outside of injury, that is never the case.
My son snapped a picture of me a few weeks ago after we first got back into the gym. I work hard to try and keep my legs in shape, but as we've talked about in this thread, sometimes I'm not sure it's worth it for all of the bad things that it can bring.
My wife has also experienced knee pain, starting a few years ago when we were prepping to hike the Inca trail. In her case, doing leg extensions aggravated her knee issues but she did eventually solve all of her knee issues by rigorously and regularly stretching her IT band.
We have a couple of doctors here, and I think @yossarian is a physical therapist? Maybe they can offer some input?
Most people will argue against knee extensions as it does put a lot of force on the joint itself especially in the terminal extension range (0-30degrees). The question that no one knows is at what point is that force not good for the knee anymore? The body and its components love stimulus, but everyone's body responds differently to it. So for example 100 pounds leg extensions might be fine and healthy for you, but for the 85 year old osteoporosis patient that might be no bueno.
Second thing is people argue that because it's an open chain exercise (foot not on the ground), that it's not a functional exercise. But during the midswing portion of your gait pattern prior to heel strike, that's open chain and obviously walking is very functional. Kicking a soccer ball also comes to mind, but I digress, we're tennis players.
So my take mirrors Yossarian that if it's working for you and it's not causing you any pains, go ahead. My only concern would be if you're only doing that and the hamstring curls for lower extremity resistance exercises. If that was the case, then I'd say you're missing out on a lot of other stuff which would be beneficial to knee health.
You mentioned squats and I love squats and deadlifts. I do both, mostly unilateral. And I do a lot of lunge variations. All very functional in regards to tennis.
I also do specific glut medius work both open and closed chained. You'd be surprised at how weak/lack of endurance a lot of weightlifters are in that region even when they tell me they squat/deadlift. Super important for knee health.
So me personally, as much as I like the feel of knee extensions, I will do other squat/deadlift/lunges/hip thrusts, etc...and every once in a while if I have access to them, leg extensions. If I had to build my own gym and had space restrictions, that machine would not make the list.
My other thing I'm curious about in your case is how much flexiiblity/elasticity work are you doing? Bc strength is really only one component of a balanced body IMO, endurance and flexibility are the other two. I believe that injury occurs when you've exceeded the tissues' elastic potential, and strength while it plays an important part of that equation is only one part of it. I treat a lot of really strong people for injuries and I'm not telling them "well it's because you only squat 300 pounds, that's why you got hurt". And especially in the population in your age, most are lacking full range of motion in their lower extremities. And the texture of their tissues are like rocks.....Neither are ideal.
yossarian
Professional
had a former bodybuilder with knee pain come in the other day who said he’s “very strong.” And he was. 5/5 on all MMT and I pushed as hard as I could
had him do a single leg stance/squat and boom — hip drop. clamshells kicked his ass
I would love to do something like a running stork on the wall with a physio ball but he also has pretty severe arthritic changes so we’re avoiding closed chain for now
Unfortunately, if you haven't found a brace that helped with whatever you're looking for in the past, I doubt you'll find one in the present. If you're not doing so already, a strength & conditioning & flexibility program for your lower extremities should help. It won't be an easy fix in terms of time and you'll have to put in the work, but in the long run, that's probably the best solution I could suggest.
Good luck.
socallefty
G.O.A.T.
If you are just a few months removed from knee surgery, I would use a hinged brace that is somewhat heavy duty. I used a hinged brace from Athledict after my surgery a couple of years ago. If you just have sore knees and want to keep them warm with some light support, compression braces are good enough and they affect your movement less when you are playing singles. I like nylon fabric compression sleeves as they also allow sweat to dry fast rather than the more restrictive neoprene ones (which probably offer more support) as the neoprene feels hot during warm weather.
Injured Again
Hall of Fame
Most people will argue against knee extensions as it does put a lot of force on the joint itself especially in the terminal extension range (0-30degrees). The question that no one knows is at what point is that force not good for the knee anymore? The body and its components love stimulus, but everyone's body responds differently to it. So for example 100 pounds leg extensions might be fine and healthy for you, but for the 85 year old osteoporosis patient that might be no bueno.
Second thing is people argue that because it's an open chain exercise (foot not on the ground), that it's not a functional exercise. But during the midswing portion of your gait pattern prior to heel strike, that's open chain and obviously walking is very functional. Kicking a soccer ball also comes to mind, but I digress, we're tennis players.
So my take mirrors Yossarian that if it's working for you and it's not causing you any pains, go ahead. My only concern would be if you're only doing that and the hamstring curls for lower extremity resistance exercises. If that was the case, then I'd say you're missing out on a lot of other stuff which would be beneficial to knee health.
You mentioned squats and I love squats and deadlifts. I do both, mostly unilateral. And I do a lot of lunge variations. All very functional in regards to tennis.
I also do specific glut medius work both open and closed chained. You'd be surprised at how weak/lack of endurance a lot of weightlifters are in that region even when they tell me they squat/deadlift. Super important for knee health.
So me personally, as much as I like the feel of knee extensions, I will do other squat/deadlift/lunges/hip thrusts, etc...and every once in a while if I have access to them, leg extensions. If I had to build my own gym and had space restrictions, that machine would not make the list.
My other thing I'm curious about in your case is how much flexiiblity/elasticity work are you doing? Bc strength is really only one component of a balanced body IMO, endurance and flexibility are the other two. I believe that injury occurs when you've exceeded the tissues' elastic potential, and strength while it plays an important part of that equation is only one part of it. I treat a lot of really strong people for injuries and I'm not telling them "well it's because you only squat 300 pounds, that's why you got hurt". And especially in the population in your age, most are lacking full range of motion in their lower extremities. And the texture of their tissues are like rocks.....Neither are ideal.
Thanks so much for your detailed reply!
The leg extensions are not the primary exercise I do, and it doesn't seem to take many repetitions overall for my knees to feel better. It also doesn't take long for a lack of repetitions to make my knees feel like they gradually become less comfortable repeating the movements necessary for tennis agility.
I will typically try to get into the gym before playing tennis and will do one set of 15 squats and calf raises on the nautilus, one set of 10-12 leg extensions, one set of 15 bilateral hamstring curls, one set of ten unilateral hamstring curls, one set of one legged lunges, and then some stretching followed by dynamic movement.
I totally understand what you say about stretching. Unfortunately for me, I sem to have certain planes of motion where I am lacking in flexibility. I've been working on those but it is hard to gain range of motion and suppleness of tissues is probably not going to be achieveable at my age.
Your insights are very appreciated.
i had meniscus surgery on my left knee in 2013. Around 2016 i started hitting the gym regularly, and doing a lot of leg exercises in my rotation, squats, leg extensions, hamstring curls, calf work, and specialized exercises for my left knee from my physical therapists. My knee seemed very stable (not getting worse, maybe improving a bit). I quit going to the gym in March of 2020 due to covid, and my knee got worse and worse. I started walking about 68 minutes a day instead of going to the gym, and occasionally worked out at home with almost no weights. Knee is terrible. I just got my first vaccine shot last week, and plan on starting the gym again after my 2nd shot, to hopefully strengthen the muscles around my knees and loosen up the ligaments and tendons so that my knee starts feeling "stable" again.
yossarian
Professional
what
ChaelAZ
G.O.A.T.
I've tried using braces, compression sleeves, etc for knees and never found anything that a) stays in place, and/or b) doesn't restrict movement too much. I do use arm compression at times and do like that for warming up and play.
SteveI
Legend
This is my experience to a tee. I was hoping there was something out there that I was not aware of. My best bet is to wear compression NIKE gear over the entire leg.. Like the NBA players wear. I also use a stationary bike for 10 mins to warm up before I head to the courts or walk.. etc.
SteveI
Legend
fuzz nation
G.O.A.T.
I've never used braces or sleeves on my knees, but I'm fortunate to have remained relatively healthy in that department.
I can honestly say that the biggest difference-maker in terms of promoting happy knees for me has been riding my bicycle - moderate rides of 45-60 mins at least twice a week. If I'm keeping after my riding, no question that I have more overall endurance and my knees feel GREAT.
I had been neglecting my riding through the course of last summer with a very busy tennis work schedule. Everybody wanted to get out on the courts in a relatively low-risk setting, so I was at it every day in some capacity for about three solid months. I didn't make time for my bike and sure enough, when the kids at a clinic were doing some sprints near the end of the summer, I joined in and popped something in the back of a knee just a tiny bit. All's well now after a quiet winter, but I'm not going to make that mistake again. My legs need the bike.
SteveI
Legend
I use the bike all the time to do non impact cardio and just warming up my old knees. I have to be careful with my iffy back that I sit upright while biking. So many issues to work around.. thanks for the insights.
I swear by these:
www.bauerfeind.com
I wear them on both knees for 3 years now and would not step on the court without them. It's a well made product and provides great support. Just make sure you get the size right as it needs to be tight-fitted and does not stretch much even with machine washing.
Complimenting that with spin classes 3 times a week then you are off to a very good start.
GenuTrain Knee Brace | Bauerfeind
GenuTrain® knee brace, knee support, athlete compression support, arthritis, tendinitis, muscle pain, reduce swelling, joint problems
www.bauerfeind.com
Complimenting that with spin classes 3 times a week then you are off to a very good start.
I guess I should’ve said loosen up my knee, keep it flexible.
shoesandko
Rookie
I swear by these:
I wear them on both knees for 3 years now and would not step on the court without them. It's a well made product and provides great support. Just make sure you get the size right as it needs to be tight-fitted and does not stretch much even with machine washing.GenuTrain Knee Brace | Bauerfeind
GenuTrain® knee brace, knee support, athlete compression support, arthritis, tendinitis, muscle pain, reduce swelling, joint problems
Complimenting that with spin classes 3 times a week then you are off to a very good start.
These work extremely well do not slip down offer medical grade compression which helps with minimizing swelling as well, the also offer a sport model that is very close but not considered medical grade but has the same level of compression the outer layer is different , the medical one is preferred. Not the cheapos you find on amazon for $20 a pair
One Handed Dynasty
Semi-Pro
I’ve never used a brace, but have found compression and percussive therapy to help immensely with lower body pain. Hypervolt and normatec both make great products to increase lower extremity blood flow and keep your muscles and fascia loose and pliable.
EllieK
Hall of Fame
I had quite a bit of right knee pain which was worse coming down after a serve and moving to my left (I’m right handed). Had an MRI which showed bone on bone on the medial knee and a bone bruise at the patella, tibia joint. Doctor says low impact only and I’m getting cortisone injections and PT for now to avoid a partial knee replacement. No more running so I’m taking up Nordic walking and also continuing muscle strengthening. I’m avoiding deep squats and lunges and per PT using a resistance band on my thighs instead. Playing with a brace and working get the patella tracking properly. I still plan on continuing my tennis lessons and practice and will see how it goes.
Shroud
G.O.A.T.
I had a torn meniscus that healed. But I still wear braces to keep the knee stabilized and avoid the pain at the tip of the knee cap.
This is the best brace I have found without resorting to some kind of terminator looking metal brace
This is the best brace I have found without resorting to some kind of terminator looking metal brace
Amazon.com: Bauerfeind Sports Knee Support - Knee Brace for Athletes with Medical Grade Compression - Stabilization and Patellar Knee Pad: Sports & Outdoors
Buy Bauerfeind Sports Knee Support - Knee Brace for Athletes with Medical Grade Compression - Stabilization and Patellar Knee Pad: Knee Braces - Amazon.com ✓ FREE DELIVERY possible on eligible purchases
www.amazon.com
Shroud
G.O.A.T.
I tend to agree with this. However, when I do the exercises for some reason there are tiny muscles that get stiff and while you cant feel they are stiff unless you touch them they throw off the kneecap. The brace helps keep the kneecap stable.
In theory I would stretch and rub out the muscles, but heck its like pulling hair to do the exercises....
SteveI
Legend
Agreed... When you have two repaired knees and a bad back. You can only modify things a certain amount. Do a ton of walking.. can only do half squats and no leg presses. Never injured until I hit 52 .. then court hours and age takes it toll. Would love to be able to do a full workout. My life now is trying to find workouts that are effective and do not cause injury. It is quite a chore..
. One of the biggest keys is to carry as little extra weight as possible. The only decent way to do that in your 50s and 60s is to reduce calories in.
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BGod
G.O.A.T.
Agreed... When you have two repaired knees and a bad back. You can only modify things a certain amount. Do a ton of walking.. can only do half squats and no leg presses. Never injured until I hit 52 .. then court hours and age takes it toll. Would love to be able to do a full workout. My life now is trying to find workouts that are effective and do not cause injury. It is quite a chore..
Can only speak to living without an ACL for 6 years now. But I'm 33. Personally I would do what some of my older friends with issues do and take supplements to offset the biological process. For men though obviously after 50 is a whole other ball game. I've been looking at advances last 6 years and am very much convinced on stem cell therapy and prosthetic ligaments and gel fill for meniscus tearing, etc.
Custom Don Joy Brace is what I have. It basically keeps you from making the wrong turn. So it's a safety net in that regard.
SteveI
Legend
Stem Cell therapy is way behind in the USA... just beginning to be offered. Out of pocket of course. Those are all great therapies you are mentioned. Many USA pro athletes go outside the USA to get advanced help.. not yet offered here.
I take a full range of supplements also. They have helped. Playing shorter points in tennis is the best therapy.. for your entire tennis lifetime..
Great post... Cheers
SteveI
Legend
Yuppers and give up court sports...
Shroud
G.O.A.T.
If you cant do either clay is a good choice
