How Tight Should a Knee Brace Be?
Knee sprains and strains account for over 40% of US emergency department diagnoses. Most of these patients wear a knee brace as part of their treatment and rehabilitation. Now that you're one of these patients, you may be wondering, "how tight should a knee brace be?"
When you wear a knee brace, it should be snug enough that it doesn't move, wiggle, or slip down your leg. However, it shouldn't be too tight that you can no longer slip in two fingers under the brace's strap.
How Tight Should a Knee Brace Be?
Proper knee brace tightness means that the entire device sits as close to your skin as possible. The straps should keep the brace as immovable as possible and in its original position. However, your brace shouldn't be too "unyielding" that it forces you to "drag" rather than move your knee.
What Can I Do to Ensure a Proper Knee Brace Fit?
The first step is to check if your doctor prescribed a specific brace. Your physician may have recommended either a strapped or a non-strapped brace. Strapped braces are highly adjustable, while non-strapped ones come with flexible materials.
Here are a few general guidelines to help ensure you get the right knee brace size for the perfect fit.
Measuring the Upper Knee Area
If you need or want to use an active knee brace, you need to measure the circumference of your upper knee area. A flexible tape measure will help ensure an accurate measurement.
Once you have a tape measure, bend your knee so that the spot behind the kneecap sits at a 30-degree angle. In this position, run the tape measure from the center of your knee (the kneecap or patella) up to your thigh. Take note of the thigh area where you see the 14-centimeter mark.
Next, take the circumference of the 14-centimeter mark. Be sure that the tape measure lies flat and flush on your skin. You can then take note of the measurement either in centimeters or inches.
Measuring the Calf Circumference
If you opt for an orthopedic knee brace, you also have to take your calf's circumference. Most of these braces require this measurement aside from thigh circumference.
You can assume the same position as the one you did when measuring your thigh.
From here, take note of your calf area 13 centimeters (about 5 inches) below the kneecap. Mark this spot, as this is the one you need to take the circumference of.
Measuring for Universal-Sized Knee Braces or Sleeves
"Universal" knee braces and sleeves are like clothes. This means that they come in sizes ranging from small to extra-large. Most of these knee supportive devices factor in kneecap circumference.
So, you need a fully outstretched leg to measure for a universal knee brace or sleeve. You can do this while seated, but make sure you prop your leg up. Then, take the circumference of your patella with your leg at a 180-degree angle.
It's easier and better, though, to have someone else help you.
The Two-Finger Test
The "two-finger" test helps ensure that your brace is neither too tight nor too loose.
To do this, slip into, wrap, or strap up your knee brace. While standing, try to slide two fingers under each strap of the brace. If you can't, that means the brace is too tight, so make sure you loosen it a bit.
If both fingers slip in under the straps too easily, that's a sign the brace is too loose. Tighten the straps a bit more to prevent your knee brace from falling.
After the test, take a few steps to see how your knee brace holds up. If you feel like you're dragging your leg rather than taking steps, that's also a sign that your brace is too tight. It's restricting your knee too much that you can't bend it anymore.
On the other hand, if you don't feel any amount of compression from your knee brace or sleeve at all, then it's too loose. You need to feel some level of restriction from the device; otherwise, it won't do you any good. Rather, it can slip down your leg and result in even more knee injuries.
Is There a Different Guideline on How Tight a Hinged Knee Brace Should Be?
Yes, as post-OP hinged knee braces usually support the entire leg and not only the knee. This means that you have more straps to fasten. The straps should be able to provide a snug fit for your entire thigh and calf.
With that said, make sure you measure the circumference of your upper and lower thigh. Do the same with your upper and lower calf. You can then use these measurements to help ensure you buy a proper-fitting hinged knee brace.
Keep in mind as well that a post-OP hinged brace should restrict the knee as much as possible. As such, your brace should be at its tightest during the early phase of your recovery.
However, high-quality post-OP knee braces come with adjustable range-of-motion (ROM) angles. So, as your knee heals, your doctor will tell you to increase the ROM so that you can slowly start moving your knee again. At this point, your knee brace will feel less restrictive; hence, it'll feel less tight.
What About the Tightness of an Unloader Knee Brace?
In the US alone, one in five people 45 years and older have knee osteoarthritis (OA). As with any type of arthritis, knee OA can cause severe pain, swelling, and restricted motion.
If you have knee osteoarthritis, your doctor may prescribe an unloader brace. Researchers say that unloader knee braces may provide significant OA pain reduction. The less pain you feel, the more you can move, and the lower your risk for further stiffness.
With that said, you still want to use the same two-finger technique when using an OA-specific brace. Aside from the strap test, you should also adjust the hinge of the unloader brace. This way, you can ensure that the supportive device provides maximum support to your knee.
How Tight Should a Knee Sleeve Be Then?
Just like a knee brace, a knee sleeve should also be snug enough that it doesn't slide down your knee and leg. However, some knee sleeves don't come with straps; instead, you slip them on and slide them from the feet up. You can still do the "two-finger" test to check for a proper fit, but you need to slip your fingers under the sleeve itself.
You should also pay attention to the outermost edges of your sleeves. They should be smooth and lie flat on your skin. If there's any gap at all between the sleeve and your skin, that means the sleeve is too loose.
Why Is Proper Knee Brace Fit Important?
One of the primary purposes of knee braces or sleeves is to immobilize the knee. Immobilization is especially vital after sustaining a knee injury or following surgery. That's because restricting knee movement protects it from further injury.
A perfect example is a recurring anterior crucial ligament (ACL) injury. According to researchers, the recurrence rate for these injuries can be up to 24%. This means that you have a one-in-four chance of re-injuring an injured ACL.
That's why proper knee immobilization is crucial to prevent new injuries. If you allow your freshly-injured knee to move a lot, it can aggravate your condition. This can then impair your full recovery, which means you'll take more time to heal completely.
However, you should also avoid wearing a too-tight knee brace, as it can cut off your circulation. This can also slow down your body's healing process, as too little blood flows to your injured knee. Without enough nutrients, your injured knee tissues will take much longer to heal.
The more time your injured knee needs to recover, the higher your risks of stiffness. Stiffness, in turn, can cause you even more pain.
Long-term pain can then make you feel tempted to avoid moving or using your injured knee. Unfortunately, a lack of movement can promote further stiffness.
All these can then trigger a cycle of pain, stiffness, and restricted mobility. That's why your brace mustn't be too tight or too loose.
Ensure a Perfect Fit by Going for an Adjustable Knee Brace
Always keep in mind that a knee brace should be snug enough to remain in place at all times. It shouldn't be too tight that it digs into your skin, cuts off your blood flow, or forces you to drag your leg along. It shouldn't be too loose, either, that it keeps slipping and wiggling all over the place.
Feel free to bookmark this guide on "how tight should a knee brace be?" This way, you can always check back in case you need a refresher. While you're at it, you may also want to check out PowerRebound's selection of knee brace and supports.