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Old    Onnie Jonas (BlondeDragon)      Join Date: Mar 2014       03-16-2014, 7:15 PM Reply   
I've had a knee injury for about three years now and no matter how many times I've been to the doctor and have had MRI's and Xrays they find nothing wrong except that the alignment of my leg is a bit off, knee points in and foot points out. I am told no running because its constant jarring of the knee but anything else is fine. I love wakeboarding and just started last summer. The problem is my knee hurts too bad for me to wakeboard for very long because if I'm keeping it bent without support it becomes very painful. What kind of braces allow some mobility and are comfortable to wear while wakeboarding? Thanks in advance!!
Old     (ToddWake)      Join Date: Feb 2014       03-16-2014, 9:24 PM Reply   
As a trained medical professional and wakeboarding aficionado I can say that based on your medical history you should not be wakeboarding unless you don't really care about being able to walk.
Old    Markj (markj)      Join Date: Apr 2005       03-17-2014, 12:07 AM Reply   
Quote:
Originally Posted by ToddWake View Post
As a trained medical professional and wakeboarding aficionado I can say that based on your medical history you should not be wakeboarding unless you don't really care about being able to walk.
He shouldn't wakeboard any more? I'm sincerely curious to know how you can say that unless you know his case first hand. Have you seen his X-rays and MRI? Did he state some key words or a sentance that made you give this online medical advice? Personally, I always error on the side of caution now that I'm a tad older/wiser (with two knee reconstructions under my belt) and would probably agree somewhat, however, how can you say "unless you don't really care about being able to walk?" Seems a bit extreme but, I'm not a "trained medical professional." please educate us. Thanks.
Old    Surf Addict (Desi) (phathom)      Join Date: Jun 2013       03-17-2014, 5:09 PM Reply   
I'm in this thread to find out about the knee braces that anyone recommends. I haven't had any surgeries or any injuries with tears, but I have had an injury to both knees, one of them a few months ago. I'm back to normal now, but if a brace could help either help prevent another injury by offering more support I'd be interested.
Old    Ben R (brichter14)      Join Date: Jul 2010       03-17-2014, 5:15 PM Reply   
How bout a wake brace for kneeboarding!
Old    Surf Addict (Desi) (phathom)      Join Date: Jun 2013       03-17-2014, 5:17 PM Reply   
You would have to head over to http://www.kneeboardworld.com for that
Old    Ryan (ryanw209)      Join Date: Jan 2010       03-17-2014, 5:48 PM Reply   
Haha some funny replies here but all I can tell you is that everyone gets a CTI brace after they blow out their knee. They will cost you somewhere in the vicinity of $500-$700. DonJoy is another option and similar to CTI. Outside of that I'm not sure anything from CVS will help you


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Old    David Di Donato (davedidonato90)      Join Date: Mar 2013       03-17-2014, 7:28 PM Reply   
Quote:
Originally Posted by BlondeDragon View Post
I've had a knee injury for about three years now and no matter how many times I've been to the doctor and have had MRI's and Xrays they find nothing wrong except that the alignment of my leg is a bit off, knee points in and foot points out. I am told no running because its constant jarring of the knee but anything else is fine. I love wakeboarding and just started last summer. The problem is my knee hurts too bad for me to wakeboard for very long because if I'm keeping it bent without support it becomes very painful. What kind of braces allow some mobility and are comfortable to wear while wakeboarding? Thanks in advance!!
This sounds like a classic case of valgus knee, which is caused by a weak VMO (vastus medialis oblique). there are many ways to strengthen your VMO. I believe if every wakeboarder had a good strength coach and realized how important this small muscle is for knee strength and alignment the number of knee braces in wake boarding would be a lot smaller. Google VMO and ways to strengthen it. The VMO is worked at the extreme range of motions of your knee. Here are a lot of the exercises we use to strengthen our athletes' VMO:

TKE:
http://www.youtube.com/watch?v=ZscBVtoX62U

Poliquin Step UP:
http://www.youtube.com/watch?v=AoS5qiAg9xM

Peterson Step UP:
http://www.youtube.com/watch?v=fkyKax6TPpE

http://www.youtube.com/watch?v=Xxey0hFh7Rk

Bulgarian SS
http://www.youtube.com/watch?v=3dDOWcEvKA8

Split Squat FFE
http://www.youtube.com/watch?v=iVZY7p0ez8U
Old    David Di Donato (davedidonato90)      Join Date: Mar 2013       03-17-2014, 7:29 PM Reply   
Also, you are a girl I find this problem with many females so you'll need to work hard at it
Old    Markj (markj)      Join Date: Apr 2005       03-17-2014, 11:52 PM Reply   
Quote:
Originally Posted by ryanw209 View Post
Haha some funny replies here but all I can tell you is that everyone gets a CTI brace after they blow out their knee. They will cost you somewhere in the vicinity of $500-$700. DonJoy is another option and similar to CTI. Outside of that I'm not sure anything from CVS will help you


Sent from my iPhone using Tapatalk
Agreed. The CTI brace has worked well for me over the last ten years. Mine cost around $500. Also didn't realize the OP was a female. oops.
Old    Brett Guerin (brett_cti_knee_braces)      Join Date: Feb 2009       03-18-2014, 12:48 AM Reply   
First off, I strongly agree with Mark. That was a pretty light "medical history" to already concede that you are to give up on ever riding again. To me, it sounds like you are not going to the right doctors. Like any profession, there are doctors that are good at what they do and some that aren't as good. Just because somebody has become a doctor it does not mean that they are passionate about what they do and willing to do the work and take the time to help patients get back to doing what they love. Everybody's bodies are a little different and you need to find a doctor that is willing to work with you to find out what is wrong and put you on a path to recovery. Not every case is straight forward - find a doctor that is willing to help you by working on your indications and finding a solution.

I work for Ossur/CTI (a brace company) so, obviously, I am going to biased when it comes to bracing. I won't go into differences in knee brace brands, but I will provide a quick, non-biased overview as to why many doctors choose to prescribe their patients a brace - particularly for sports with a high instance of repeat injury like wake:

A brace is meant to act as an exoskeletal support. It is intended to assist in the stability and correct alignment of the knee (and the 4 major ligaments of the knee - ACL, PCL, LCL & MCL) against damaging forces. Most action sports put a lot of unnatural forces on your knees. For instance, your body wasn't designed to absorb landings from a huge double-up into chop. So, a knee brace helps to absorb these forces by providing additional exoskeletal support to your knee by caging your ligaments in place and providing correct alignment and extension control.

My advise (please understand that I am NOT a medical professional) is to seek out a good doctor in your area. Ask around to see who has had a good experience/results. Also, NOBODY can give you a truly accurate diagnosis over a the internet. I do think it is smart to seek advise from other riders, but not until you know what you are dealing with.

Good luck finding out what your knee issues are due to - and in finding a solution. I am confident that you will be back running and riding again!!!

Brett
Old    Boarder 42 (jhartt3)      Join Date: Jan 2012       03-18-2014, 4:20 AM Reply   
I looked into knee braces a while ago as I have a lot of right knee discomfort. After talking with doctors I came to the conclusion that a knee brace isn't the correct thing as it would only cause more harm than good.
Old    Ryan (ryjam)      Join Date: Dec 2006       03-19-2014, 10:03 AM Reply   
Hey there are a ton of threads on knee braces.
Having had ACL reconstruction on both knees, I have a bit of experience with knee braces.
I have a CTI Custom AND a Bledsoe Axiom. Both braces work awesome and have their pro's and con's.
The CTI Custom is extremely sturdy. But it MUST have the anti-migration system or i found it would always slip down my knee once it was wet. The AMS is just a Velcro strap that has neoprene on one side that you put on the knee before attaching the brace. Once you get that...probably the best brace for wakeboarding there is.

The Bledsoe is a great brace too. I have the magnesium version and it is extremely light and it includes an extra front strap compared to the CTI which seems to lock it in place when it gets wet.

My first choice would still be CTI custom, but again Bledsoe has worked very well too.

The first line of defense is having strong muscles as davedidonato90 stated.
However, having injured both knees I can attest I have been very strong before and still hurt my knees. (For reference: at one point I was Free-squatting 405lbs weighing 200lbs, 6ft tall) I believe wakeboarding takes a variety of things. It is not just about being strong,
I would say in this order 1. technique 2. strength 3. flexibility

If any of these 3 are sufficiently lacking, eventually someone wakeboarding will get hurt.
Hope this helps and good luck!
Old    Markj (markj)      Join Date: Apr 2005       03-20-2014, 12:09 AM Reply   
The silence from the "trained medical professional" is deafening.
Old    David Di Donato (davedidonato90)      Join Date: Mar 2013       03-20-2014, 7:08 AM Reply   
Well said Ryan, braces should be used post injury not as a preventative measure.

and for the technique, strength, and flexibility i think it is spot on.

Isn't there a saying you are only as strong as your weakest link?
Old    Josh M (dvsone79)      Join Date: Dec 2012       03-20-2014, 12:22 PM Reply   
This bit of advice is something we've all heard yet continue to neglect: stretch and warm up before you [insert sport/activity here]. Warm joints, muscles, and tendons are less likely to injure. I try to stretch a little before each set. But I don't always. At the end of last season I started using knee sleeves. They are 7mm thick neoprene sleeves that are popular with power lifters. I find that they give good support for my knees, but just as important, they retain heat like no one's business. So my new routine will be put them on when I'm about to take a set and do a quick stretch in them before I ride. My knees were starting to get sore last season after a day on the water. When I used the neoprene knee sleeves I wasn't as sore.
Old     (simplej)      Join Date: Sep 2011       03-20-2014, 6:54 PM Reply   
Quote:
Originally Posted by dvsone79 View Post
This bit of advice is something we've all heard yet continue to neglect: stretch and warm up before you [insert sport/activity here]. Warm joints, muscles, and tendons are less likely to injure.
sorry but this is crap. no amount of extra stretching and warming up would've prevented me from blowing my ACL/meniscus. physics is physics. this isn't weight lifting or running, you're not performing a repetitive, controlled movement without outside forces. You should stretch and warm up because its good for your muscles and make you more limber and ultimately a better athlete. but if you're knees gonna go, its gonna go and you can't do anything to change that. you can train you quads and hamstrings to stabilize but when fatigue kicks in you're still screwed when the angle and force is right...

Last edited by simplej; 03-20-2014 at 6:58 PM.
Old    Josh M (dvsone79)      Join Date: Dec 2012       03-20-2014, 8:56 PM Reply   
Quote:
Originally Posted by simplej View Post
sorry but this is crap. no amount of extra stretching and warming up would've prevented me from blowing my ACL/meniscus. physics is physics. this isn't weight lifting or running, you're not performing a repetitive, controlled movement without outside forces. You should stretch and warm up because its good for your muscles and make you more limber and ultimately a better athlete. but if you're knees gonna go, its gonna go and you can't do anything to change that. you can train you quads and hamstrings to stabilize but when fatigue kicks in you're still screwed when the angle and force is right...
If it makes you sleep better at night thinking you couldn't have avoided an injury, then go ahead and continue that line of thinking. I hope it doesn't lead to another tear. Stretching a ligament would clearly make it less prone to tearing. This is common knowledge among practically every athlete on the planet. Physics is physics.

Would stretching absolutely prevent a torn ligament? No. Nothing can completely prevent things like that. But it could mean the difference between a partial or complete tear. And it certainly couldn't hurt.

So you can keep your apology. I certainly don't need it. If you think it's crap, don't do it.
Old     (simplej)      Join Date: Sep 2011       03-20-2014, 9:53 PM Reply   
Notice that I said extra stretching, I warm up and stretch pre-shred, I even dabble in yoga. Didn't help me...the fact of the matter is once you add an outside force in right set of conditions, boom goes the dynamite. Yea it's good to stretch, it's healthy for your muscles and joints and will keep you from pulling a hammy and if you're lucky spraining an ankle.
So yea I rest easy at night knowing I couldn't have prevented it unless I just didn't wakeboard... I'm sure if dirty dowdy stretched a bit more this wouldn't have been as bad, right?


Also, a massive majority of knee ligament tears are partial and still result in laxity of the joint so a partial vs complete tear won't make a difference

Anyways to the OP. Do lots of strength training and balance/propioception work to help strengthen the muscles supporting the joint. Look into a CTI brace that has some unloading charcateristics, that may help you but a doctor will know better. Their braces are great, nice and light and comfy too. Good luck!
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Last edited by simplej; 03-20-2014 at 9:56 PM.
Old     (Delt725)      Join Date: Mar 2011       03-23-2014, 2:31 PM Reply   
Small ACL tear last summer put me down for five weeks then grabbed a custom fit Don Joy Defiance III brace. It worked great and I plan on using it again this summer. Granted I didn't need any surgery, only a bit of soreness and stiffness but this is the brace I use and am very happy with it.
Old     (simplej)      Join Date: Sep 2011       03-23-2014, 7:14 PM Reply   
Quote:
Originally Posted by Delt725 View Post
Small ACL tear last summer put me down for five weeks then grabbed a custom fit Don Joy Defiance III brace. It worked great and I plan on using it again this summer. Granted I didn't need any surgery, only a bit of soreness and stiffness but this is the brace I use and am very happy with it.
best of luck to you, i was "functional acl deficient" for 6 months it was not fun...
Old    David Posey (granddaddy53)      Join Date: Dec 2013       04-07-2014, 10:03 AM Reply   
the shelf brandfrom acadamy sports does great, though no off the shelf will stop forward back movement for acl. I have had a mcl, acl reco since 1985 and standard neoprene brace with hinge from acadamy works great and my knee doesn't bend past 90 degrees and it prevents me from over bending on landings.. tried one on the other day at academy and was real comfortable with no rubbing behind knee. I am going to get that one to replace my old one, $65 dollars i think. been wearing off the shelf with hing since 1985 no problem. I am not a great wake boarder but i still launch with this brace on water and in terrain park on snow board or skis. the dude with the no no comment, get real!!!!!! I also flow ride with this brace and it can't cut the membrane of the flow rider for
Old    Chris Schweda (chris_schweda)      Join Date: Dec 2006       04-14-2014, 9:47 PM Reply   
I have the cti off the shelf and the donjoy defiance the donjon does not migrate down like the cti. I prefer the donjoy I used the cti for years
Old    Brett Guerin (brett_cti_knee_braces)      Join Date: Feb 2009       04-19-2014, 12:17 AM Reply   
Chris - I am very surprised to hear that you are having migration issues with your CTi OTS. Are you using an AMS wrap? If you want some tips on proper application I'd be happy to give you some more in-depth info. Just PM me with your contact.
Brett
Old    John Martar (davesetter)      Join Date: Jan 2014       04-28-2014, 5:59 AM Reply   
I tore my acl and meniscus in my left knee 10 years ago. I use a donjoy defiance III and bought another for my right knee. Good braces but have to wear a neo sock over them to keep the straps from coming loose. They work okay but I have migration problems. I just found out last week that I've torn my acl, meniscus, chipped a bone and dislocated my knee cap in my right knee. I wasn't wearing the brace when it happened. My doc wants to replace that'll with a tendon from a cadaver instead of using one taken from my patella tendon. He says it's not quite as strong but surgery and recovery are easier. Do any of you guys have any experience with this?
Old    Chris Jobil (cjobil43)      Join Date: Dec 2013       05-02-2014, 5:56 PM Reply   
Dave, sorry to hear about your knee.
As for surgery options, there are a lot of factors to consider. Depending on how old you are, and the level of wakeboarding (or sports) you intend to do once your healed up, should help determine your graft choice.

Personally, after researching this topic for 100+ hours and writing papers on this exact issue, I have formed some educated opinions on the matter. I had to make this decision for myself when I tore my ACL/meniscus in my knee.

Essentially, it is hard to say which one is BEST or STRONGER or EASIEST RECOVERY. What you can look at is what is important to you and how likely a return to action sports will be, for you.

As far as speediness of recovery, NONE of the options (cadaver graft, patellar tendon, or hamstring graft) have a return to action time of less than 6 months. This is because the first 3-4 months after implantation of the graft, your bodily slowly starts to make it part of it's own (blood vessels form, bones channels close in on graft.) These first few months are CRITICAL in long term efficiency of the graft. The second 3-4 months are more about building back muscle lost due to atrophy during initial phase of recovery, as these muscles, namely quad and hamstring, are what provide the most support to your ACL.

So that being said, just keep that 6 month minimum in mind. Now long term results are similar, but certain grafts have showed slightly better performances.

In order of strongest to weakest, research supports that the patellar graft (AKA the Gold Standard) is the strongest, and typically the best option for someone looking to return to a high level of action. Second on the list would be a Double Bundle Hamstring graft, (essentially part of your hamstring folded over and sewed together), and third would be cadaver graft.

In terms of recovery time, refer to what I said about the 6 months, BUT if there is a "back the quickest" option, I have read you can progress a bit quicker with cadaver, and maybe be within the 4-6 month mark. This is mainly due to the fact that your body won't be trying to heal the harvest site, associated with the other grafts.

That being said, cadaver is my least favorite option, and does come with the most associated risk. There is something like a 2% chance of rejection, which although small, is still very real. There are also numerous concerns with disease transfer, and although they are tested multiple times, things can get by. (Or things that are considered bad in 10 years, aren't tested for now.) I vaguely remember disease transfer cases are something like .02%. Lastly, cadaver is the weakest option, not by much, but kt-100 tests have showed that they generally are, in fact, the weakest option.

Long term pain are similar between the 3 options, but many believe the hamstring provides the LEAST painful option long term (7-10 year mark.) The drawback to the hamstring is the increased chance of the graft to develop "laxity" (it stretches out,) rendering it useless if it stretches enough. Again, small percentages of patients experience this, but again, very real possibility. A longer recovery time, usually 8-10 months is recommended to combat these issues.

The patellar graft is the gold standard for a reason. Adrian Petterson, RGIII, and countless other world class athletes choose this graft. The leading orthopedic surgeon in the world, Dr. James Andrews, chooses this to be his graft. Your cleared for sports in 6 months, and at about the year mark, you are fully recovered. Some patients say long term pain is minimal, but can have discomfort when kneeling for long periods of time, as this is putting pressure on the harvest site (your knee cap.)

If you read all that, you have a good STARTING POINT. Do as much research as you can, and then do this:
FIND A REALLY GOOD DOCTOR WHO GENERALLY ONLY DOES THE GRAFT YOU ARE CONSIDERING!!! (sometimes they will do other types for kids or seniors, but they all have a "GO-TO" option)

If you decide you are between the hamstring (or cadaver) and the patellar, find one doctor who swears by patellar, and find one who swears by hamstring (or cadaver). See them individually, have them examine your knee and listen to what they have to say. Ask questions!

Then go home, make your decision, and choose the doctor who specializes in that specific surgery. The biggest mistake you could make would be to see a general orthopedic surgeon, or a guy who will do whatever surgery you ask. Find a knee specialist/orthopedic surgeon or even a knee specialist/sports medicine/ orthopedic surgeon, who does a ton of these surgeries, and won't be surprised by any curve balls once you are on the operating table.

Ask around. If you live in an area with a pro sports team, Google who their orthopedic surgeon is. I live in Tampa, and the TB Rays Ortho did my surgery, with EXCELLENT results (he is even a partner of Dr. James Andrews.) My buddy lives in Jacksonville and the Jags Ortho did his surgery, again great results.

The doctor MAKES this surgery. I promise you that. The graft choices have some differences, but the work the surgeon does is KEY.

After that, it will be up to you to hold yourself accountable and put in the blood, sweat, and tears of physical therapy!!

Good luck!
Old    Chris Jobil (cjobil43)      Join Date: Dec 2013       05-02-2014, 5:58 PM Reply   
P.S. you can't go wrong with Ossur CTI. Best brace for action sports on the market. I prefer the custom, but the OTS provide similar results. ZERO MIGRATION issues with AMS, which came included.
Old    Markj (markj)      Join Date: Apr 2005       05-02-2014, 11:38 PM Reply   
^^^Nice write up. Never heard that the patellar graft was stronger. I went with the hamstring. Maybe that's why it partially tore again. I'll stick to mostly surfing now. Problem solved.
Old     (simplej)      Join Date: Sep 2011       05-04-2014, 6:05 PM Reply   
just wanted to make an amendment to Chris' post above:

"double bundle" hamstring graft does not refer to the the actual graft type, it refers to the type of surgery. You can have a single bundle or double bundle hamstring graft. Double bundle indicates the usage of 2 different grafts placed at slightly different angles to "better" replicate the construction of your natural ACL, which has two "bundles" to control different motions. This method has fallen out of favor by most standards due to the intensive nature of the surgery and little to no long term clinical benefit. Single bundle refers to one single graft, you can have a single bundle or double bundle graft regardless of the graft type. In either case the hamstring is compounded onto itself.

Its not as simple as Chris has stated, the Patellar tendon, hamstring tendon, and cadaver grafts have different advantages. If you are younger you should have an autograft, no doubt. Patellar tendon is good because it offers marginally faster initial healing and helps protect the hamstring muscle, which is critical in stabilizing the tibia. This offers faster initial rehab. Hamstring is favorable because it offers less longterm pain (when people say they can't kneel, its because of the patellar graft) but is harder to recover the hamstring, ask me how i know... Long term, one is not better than the other, they both heal the same. Previously the hamstring graft was easier to tear initially because it was fixed to the bone via a stitch, however now they simple screw the entire ligament into the tunnel. Cadaver tends to be weaker but offers less pain, the recovery is slightly easier.

I have Hamstring single bundle graft, i would highly recommend this surgery if you are willing to do lots of pre-hab. 6 mos. of hard work before surgery allowed me to build up the density and the flexibility of the muscle and tendon. the result speaks for itself, i had 124* of flexion 4 days post op, and my graft "significantly tighter" than most. Proceed with caution during rehab though, i destroyed my hamstring last month being far too aggressive with romanian deadlifts... quite unpleasant.
Old    Markj (markj)      Join Date: Apr 2005       05-05-2014, 12:29 AM Reply   
This is a good discussion because it gives present and future knee injury/ailment patients a resource and plenty of questions to ask their surgeons before taking the plunge with surgical repair. Everyone's experience is a little different and its good to hear different perspectives. It's also interesting how the predominant treatments for knee injuries evolve over time. I have a buddy who tore his ACL 25 years ago and they put him in a plaster cast for 6 weeks after the surgery. That kind of stuff never happens any more.
Old    Brett Guerin (brett_cti_knee_braces)      Join Date: Feb 2009       05-07-2014, 1:17 AM Reply   
Cool to see everyone take the time to help each other out and share their research and experiences with their fellow riders. I work with a lot of different athletes in a lot of different sports - wake has one of the best communities.

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