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Author Topic: Osteoarthritis of the Knees, Braces, Orthotics, and Physio  (Read 1641 times)

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Offline Osiris

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Osteoarthritis of the Knees, Braces, Orthotics, and Physio
« on: February 23, 2015, 07:54:39 PM »
I am a 55 year old male, with a very active and athletic history.  Over the past year and a half, I've had increasing knee pain, particularly on the left side.  This led me to see my sports med doctor in early June, 2014, who opined there was a meniscus tear in the left knee.  An MRI was scheduled, but he cautioned that paying for a private MRI was likely a waste of money as confirmation of a meniscus tear would not change treatment unless the knee started locking up.  Surgery was not an option, as long as the knee was free from collapsing or locking, as the current reasoning is the more cartilage left in the knee joint the better.

By posting, I'm hoping to save others some time, and share my experiences as I've had little luck in finding reviews of unloader knee braces anywhere online, or anywhere else.  This amazes me, as there must be millions of people wearing unloader braces.

Last summer was spent attempting to balance golf, exercise including a program designed by a physio to help support the knee, and anti-inflammatories.  I also tried orthotics.  Six months later I abandoned the orthotics as they had achieved nothing.  Glad I bought off the shelf rather than custom fit ones.

By early October, I was back with the doctor since nothing had changed.  The hope was the knee would settle down, just as my right knee had in 2009.  No such luck this time.  A standing x-ray was ordered, while we waited on the MRI.  The x-ray showed an advancement of osteoarthritis in both knees.  It was recommended I try an unloader knee brace in the hope it would speed healing in the short term, and reduce pain in the long term.

The first brace I had was a loaner from Ossur, the Unloader One, while my custom fitted brace was being manufactured.  The pain in my left knee subsided very quickly.  Mind you, at the point a brace was prescribed I stopped all golf activity and also the exercises the physio had given me, so the pain reduction may have also been because of a reduction in activities that made my knee "grumpy."  The brace appeared to work well for the 10 days I had it though, and there was only mild abrasion on the top of my calf.

When the custom Ossur brace arrived, I thought it would only be better.  It was not.  It rubbed the skin entirely off my calf in three places, with each would being roughly a half inch square.  I am very active, and wore the brace while working out, although this generally only involved stationary bike sprints.  When I pointed out the abrasions to Ossur, they recommended different padding and even offered that I should not wear the brace while working out!  Ridiculous!  I told them with my workout regime I am most at risk while exercising (atypically for a 55 year old, I do 20 chin ups, various pushing and pulling weight machines, and bike sprints over the course of an hour twice a week).  I still hadn't even tried the lower body exercises given to me by my physio.  Even with the new padding, the Ossur unloader continued to chew my leg.  I returned it a week or so later for a full refund.  I also noted that although custom measurements were taken in fitting the brace, there was a gap of almost half an inch between my tibia and the brace that was custom made for me.

I almost purchased an off the shelf Ossur brace from ebay.  A demo model of the kind that did not try to eat me could be had for about $200 USD, which compared favourably with the retail price of about $600 USD.

I returned to my sports med doctor, who grudgingly gave me a prescription for another outlet that offers braces from 5 different manufacturers.  When I shared my story of the Ossur brace, which I still had in my possession at the time prior to its return, they confirmed that the Ossur unloader braces in their experience are notorious for tearing into the calves of users.  At this location I tried on several braces, walked around in them, walked steps with them, and settled on a rather new brace by a company in Quebec, Canada known as ODRA.  It seemed very good, light, small, and with a system that was also torsion resistant.  To make a long story short, upon going back for an initial adjustment, the tech person broke the brace and it had to be replaced.  This made me wonder about the technology, as a big deal had been made about the 3D scanning of my legs to fit them for braces, which it turned out would be adjusted by a 22 year old techie armed with a bench vice.

They were very good about replacing the one brace and adjusting both.  A more experienced tech was seconded to the store to adjust my braces, and he set them up very much tighter at the top of my calf.  No way I could imagine golfing in these things.  He was also very specific about how I cinch up the straps.  I offered to photograph his setup to make sure I could duplicate it, which is when he mentioned the ODRA brace only really works if worn properly, whereas most of the others will still be somewhat effective if improperly placed!  Keep in mind the custom Ossur cost about $1100 USD, while the ODRA brace is also twice that price.

By the way, in December, 2014 there was a cancellation, so I had an MRI on my left knee, and a meniscus tear was confirmed.

While all the brace fitting and trials were on the go, I kept after my former trainer who is affiliated with TPI (Titleist Performance Institute).  He was good enough to see me finally just after Christmas.  He was on his way up when we met about 5 years ago to deal with my right knee, and has since progressed to deal almost exclusively with golf tour pros.  Now in the loop, I asked him for a referral to one of their physios.

The physio has been amazing.  He corrected the balance of some of the muscle groups around my pelvis, and gave me exercises to do each morning to lock in the change.  It's only been a week, but both of my knees are almost pain free.  Tomorrow I expect to be adding dynamic stability exercises to the static stability exercises I've already been doing.  I will also be re-evaluated on his 50 point system, and expect to do well enough to start up lower body exercises and golf in the next few weeks.

If all goes well, I expect to golfing and training without braces or orthotics for a long time.  I will keep in touch with the physio every 6 months, much like you take your car for a tune up.

This is a long way of saying, before you invest in orthotics or braces or surgery, try to find the best physio you can.  It may cost more, but work to find someone who deals with professional athletes - people who need to get back in the game as fast as possible.  Hope this helps.  I'd be happy to answer any questions.
« Last Edit: February 23, 2015, 07:57:30 PM by Osiris »