The complex structure of the human knee joint is one of the beautiful marvels of nature and creation. Did you know that for every pound you weigh, your knee receives four times the amount of stress? Constituting the distal end of the femur (the thigh bone), the patella (knee cap), and the proximal end of the tibia (the shin bone), all held together in its place by numerous tendons, ligaments, muscles and cartilages, including the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL), it is safe to say that the joint acts as a scaffolding to the entire body. 

You can run down an entire flight of stairs and come to an abrupt halt without your thigh bone slipping off the head of your shin bone. Why is that? In any sport, when you sprint and put on sudden breaks with the help of your feet, what’s stopping the upper two-thirds of your frame from slipping forward and stumbling over? The answer is the harmonious functioning between the beautifully interconnected links within the knee joint which is the largest joint in the body, and without it, you can forget about day-to-day activities like walking, running, climbing, sitting etc. Particularly if you’re an aspiring or professional sportsperson, the knee joint doesn’t just support and carry the weight of your frame but also your hopes and dreams! And in sports, this joint is at a constant risk of being destabilized and injured. This is why it is of paramount importance to protect and take care of your knee joint and understand what would happen if you don't.

What is knee instability?  

As kids, we would climb stairs two at a time or while coming down, jump the last three or four steps, land perfectly and be pleased with ourselves. Some of us would have carried these habits into adulthood without ever sparing a thought about how much the muscles and ligaments in our knee joint work to prevent our knees from collapsing every time we do such things. But do bear in mind that the possibility of your knees giving away, or collapsing is very much real.

Knee instability can be caused by single or multiple injuries to any of the ligaments, tendons, or cartilage that hold the joint together. It could be a feeling of looseness at the joints, where you constantly feel as if you’re about to fall and it may be associated with pain, redness and swelling at the site, depending upon the severity of the injury. The simple act of slowly walking down a flight of stairs and stopping could make you lose your balance.

The severity of the instability depends on the causative injury and the impact it has on your quality of life. Mild sprains of the muscles or ligaments, commonly occurring in sports are very common causes of knee instability and can be managed conservatively. On the other hand, injury to a cartilage can lead to arthritis and chronic pain and instability if left unchecked. The most severe forms of knee instability are caused by ligament tears, especially of the ACL or the MCL. A partial tear if neglected can progress to a complete tear causing severe complications. 

This is why prevention, and if not, then early detection is vital. Knee instabilities of low to moderate severity, can often be managed conservatively without surgical intervention. However, consult an orthopaedic surgeon immediately if you notice any of the following symptoms:

• Looseness and a lack of balance.
• Hearing a popping sound in the knee.   
• Difficulty in straightening the knee after bending.
• Pain and swelling.

Conservative management of an injured knee.

Doctors recommend the RICE regimen for conservative management of an injured knee.  RICE is short for rest, ice, compression and elevation. Immediately after an injury where you’re suspecting a strain or a sprain, rest your foot at an angle where it's elevated from the body, with an ice pack on the site to prevent further inflammation. Compression can be carried out with the help of braces or bandages.

Rehabilitation includes anti-inflammatory medications and physical therapy to strengthen the muscles and ligaments of the joint.

Knee Braces or knee stabilisers in particular, have become quite popular in the last few decades especially among athletes and sporting professionals for their effectiveness in preventing injuries to the knee as well as their usefulness during recovery from a knee injury. It’s an ongoing topic of debate among the medical community due to lack of research surrounding its effects, but its use is being increasingly endorsed by sports surgeons, trainers, coaches and physiotherapists after seeing results in patients and from personal experiences.

If you are suffering from instability or discomfort in your knee joint, or simply looking to be on the safer side and prevent anything untoward from happening, it is advisable to see an orthopaedician today who will tell you if you need braces, and if you do, which one to select.

Depending upon why they’re being used, braces can be classified as prophylactic braces, functional braces, unloader braces or rehabilitative braces. Except for prophylactic braces, which are purely for protection and prevention of sports injuries, all other kinds of braces serve in one way or another, the repair and recovery of an injured knee joint. Functional braces help prevent the recurrence of a past injury whereas unloader braces help shift the weight of the injured portion in patients with arthritis, helping in pain relief. Rehabilitative braces are worn immediately after an injury to aid in recovery.

Role of Mediolateral stabilizers in treating instability.

A knee stabilizer need not belong exclusively to any one category mentioned above. There are various types of braces in the market, beginning from knee sleeves that aren’t technically braces but provide support through compression around the knee joint, to braces that combine the function of prophylactic, functional, unloader and rehabilitative braces in various capacities.

The Medial Collateral Ligament (MCL) and the Lateral Collateral Ligament (LCL) provide medial and lateral stability to the knee, respectively. They, after ACL, are also the most likely to tear in a serious event of injury caused by twisting or sudden turning. Mediolateral knee stabilizers are customized to prevent and/or address any instability caused by the MCL or LCL in particular, apart from providing other functions of a knee brace. They serve the purpose of protection, immobilization and prevention of inflammation. They resist the mediolateral ( side to side) displacement of the patella and are quite useful while recovering from a damaged meniscus. Even in cases where surgical interventions were required, it is advisable to sport these stabilizers to control post-operative swelling.

They also come equipped with the ability to relieve stress from the site of injury by shifting the weight from the affected site to an unaffected portion. This is very helpful for patients suffering from degenerative diseases like arthritis.

With advancements in biomedical engineering, these stabilizers are constantly undergoing changes and being updated to functionally supplement the biomechanical functions of the musculature and ligaments of a joint as closely as possible. Although years ago, a diagnosis of a ligament tear in the knee would spell the end of a career for most athletes due to long rehabilitation time and a high rate of recurrence, it is not the case now. With functional knee stabilizers, plenty of athletes who recovered from serious injuries of the ligament with adequate rest and rehabilitation are getting a second chance at their dreams and most orthopedic surgeons report a considerable drop in recurrence while using these braces.