A knee brace or support is any kind of device which is worn on the knee with the purpose of supporting the joint. Knee braces are in wide use amongst many sectors of the community, including those involved in sports and exercise.

Walkers and hikers commonly use knee supports either to prevent an injury, ease knee discomfort or to protect an existing injury. There are so many different types of support out there, how do you know which would be the best for you?

The important factor is knowing why you are getting a knee support in the first place! It is helpful to know exactly what the problem with the knee is and so a trip to a professional who can assess your knee pain is highly recommended. Once you know what is causing your pain it will be easier to work out what kind of support you need.

The types of support available vary considerably, but there are 3 important considerations:

1)      How much support do you need?

2)      What material is it made out of?

3)      Is there patella support?

How much support do you need?

Knee supports come with variable amounts of support. This is usually dictated by the amount of metal they contain, although various straps and other features can make a difference. A hinged knee brace is the most supportive type, which is used when there is some degree of instability at the joint. These are commonly used in ligament tears and cartilage injuries.

Stabilised supports have more lightweight metal stays or springs which are embedded into the sides of the support. These provide some resistance against twisting and sideways movements at the knee, although not as much as the hinged versions. On the plus side they tend to be more lightweight and not as bulky. These may be used when there is little to no instability at the knee, such as mild ligament injuries and arthritis.

A simple knee support is also an option for walkers. These contain no metal parts and mainly provide heat retention and compression. The benefits of this are maintaining muscle and joint warmth, flexibility, blood flow and reducing swelling. These are ideal for minor aches and pains.

What material is it made out of?

Neoprene is the most commonly used material in knee supports, due to its excellent heat retention and compression properties. This material is particularly good for easing arthritic pain.

However, the drawback with neoprene is that for exercise and in warmer climates, they do get quite hot and dare I say it….sweaty! So, if going on a walking holiday in Spain, in August, this may not be for you!

Other more breathable material supports are available, such as elasticated and Kevlar supports, although these are much more limited. Latex allergies must also be considered, as neoprene may not be suitable.

Is there Patella support?

Pain around the knee cap, especially on walking down hills and stairs is a common complaint. In a lot of cases, this is due to excess movement at the kneecap, known as patellofemoral syndrome, or patella mal-tracking.

If excess (usually lateral – outer) movement of the knee cap is an issue, then wearing a support with a patella buttress may help. Usually these will be open at the front and will have either a circular, U-shaped of J shaped area of padding around or to the outside of the knee cap. This helps to prevent the patella from moving too far from its natural line.

By following these three steps you should be able to identify which knee support would be most suitable for you and your injury.

Still not sure? Visit http://www.return2fitness.co.uk/Supports_And_Braces/Knee_Supports for a wide range of knee supports and expert advice available over the phone or online chat!

What is an Exercise Ball?

An exercise ball is a large round plastic ball which is inflated with air and used in many different ways for exercise and physical therapy. An exercise ball may also be known by any of the following names: Swiss ball; gym ball; birth ball; stability ball; physio ball; therapy ball or Yoga ball. This variation in name is due to its wide range of uses.

Why use an Exercise Ball?

The main benefit of using an exercise ball is that that the body must respond to the unstable surface, recruiting the small stabilizing muscles which control posture, balance and core stability.

Core strengthening has become something of a ‘buzz word’ within the fitness industry, with classes such as Pilates still growing in popularity. The ‘Core’ muscles are a group of deep muscles within the trunk which work together to stabilise the spine. These include the much talked about Transversus Abdominus, the pelvic floor muscles and some small, intrinsic back muscles.  The aim of this kind of strengthening is to control and maintain contraction of the core muscles throughout daily activities, in order to improve stability and positioning of the spine.

Without contraction of the core muscles, the spine is left relatively unsupported, which during activities such as walking and running, increases the risk of injury or back pain. Core strengthening is recommended for everyone who is involved in any form of physical activity of who suffers from lower back pain or postural problems.

Just sitting on the gym ball helps to focus your attention on your core muscles and automatically enables their activation. Most strengthening exercises can be performed on the ball, using it in place of a weights bench to sit or lay on. Upper body resistance exercises, abdominal exercises such as crunches and leg strengtheners including bridges and hamstring curls can all be performed with a gym ball.

Benefits to Walkers

Working out using a Swiss ball can be of benefit to walkers in preventing injuries both due to postural problems and strength imbalances, as well as traumatic injuries such as ankle sprains or knee ligament injuries.

Improvements in posture and core strength help to prevent overuse injuries and general aches and pains, including lower back pain and sciatica. Improvements in balance may help in preventing falls and slips over rough ground which can result in painful, acute injuries.

Stress fractures to any of the bones in the foot are common amongst walkers and soldiers, hence the name a ‘march fracture’.

The most common bones to develop a stress fracture are the metatarsals – the long bones in the mid foot. The heel bone (the calcaneus) is also sometimes involved, as are some of the tarsal bones (smaller rear foot bones).

A stress fracture develops due to repetitive forces passing through the foot. This may happen in people who suddenly increase the amount of walking or running they are doing, or those who walk in unsuitable footwear, or on hard surfaces. It is important to have shoes with adequate support and cushioning to prevent this kind of injury.

Treatment for stress fracturesgenerally involves resting for a period of 6-8 weeks. The first two weeks should be almost complete rest, and a walking boot or crutches can be used to help in this. Following this, full weight bearing can be resumed provided it is pain free, although a return to activity should be avoided for a further 4-6 weeks.

Feet blisters are a massive complaint amongst walkers. Everyone can relate to the pain and longstanding discomfort they can cause. However, there are a number of methods which walkers can use to firstly prevent them occurring in the first place, and secondly, treat them as quickly as possible is they are unlucky enough to suffer.

Prevention is of course the best cure. So the most important steps include:

• Wearing properly fitting shoes/boots which have space for the feet to move without rubbing on the inside of the shoe.
• Keeping the feet dry – wet feet are more prone to blisters!
• Wearing double layer socks – some socks are specially designed and have a ‘blister free guarantee’.
• Using vaseline (petroleum jelly) on prone areas.
• Tape such as zinc oxide can be applied to areas prone to friction.

Treatment of a blister

• Stop as soon as possible.
• Gently wash and dry the feet thoroughly.
• Apply a blister plaster to cover and protect the area.
• DO NOT pop blisters as this increases the risk of infection.
• Wear open or very loose fitting shoes to prevent further rubbing.
• Most blisters will heal thoroughly within a week.

The achilles tendon is the long, thick tendon which attaches the calf muscles to the heel bone. Pain in this area is a common complaint, especially amongst walkers and runners.

A big cause of achilles pain is tight calf muscles. If these are tight they pull on the tendon, increasing the strain and tension passed through it.

Achilles pain described as aching and stiffness is most often a case of achilles tendonitis. This is a degenerative condition of the tendon. If left untreated, the tendon starts to appear thicker than the other side and may be redder. It is usually tender to touch and may creak on movement. Stiffness in the morning or after periods of rest is another common complaint.

Treatment includes rest, ice, calf stretching, sports massage and electrotherapy such as ultrasound in the short term. Once pain has decreased, eccentric strengthening exercises are used to ensure there is no recurrence. Correction of biomechanical problems such as overpronation should also be addressed.

A ruptured achilles tendon may be the cause of pain in this area, although with this injury it is clear what has happened and there is a definite point of injury. Some have described a sound like a gun shot when the tendon ruptures!

Treatment of a rupture may involve surgery to repair the tear, or may simply be casted in a shortened position to heal naturally.

Plantar Fasciitis is not the only condition which may cause pain under the arch of the foot. Posterior Tibialis Tendonitis is a degenerative condition of the tendon of the Tibialis Posterior muscle. This muscle runs down the back of the lower leg (deep to the gastroc and soleus calf muscles) and the tendon then runs behind and below the medial malleolus (bony part on the inside of the ankle) before passing under the foot to attach to several of the tarsals and metatarsals of the mid-foot.

This muscle is responsible for inverting the foot, meaning to turn the foot so that the sole faces inwards. It also assists the other calf muscles in plantarflexion (pointing the foot downwards, or lifting the heels off the floor).

As with many foot injuries, especially those from walking and running, there is a definite link between foot biomechanics (movement patterns) and injury. In this case, those who overpronate (meaning the foot rolls inwards and arch collapses as we walk) are at a higher risk of developing Tendonitis of this muscle.

This highlights the need to ensure you have supportive footwear for walking. In most cases, correcting the footwear to ensure the medial arch is well supported, alongside a stretching program for the lower leg muscles and a bit of rest will have this condition cleared up in no time!