Ben Fisher

Knee Braces

Do knee braces cause muscle wasting?

It’s often stated that knee braces can cause muscle wasting, if used for too long. However there has been very little research into this. A study this year (2016) by Callaghan et al. (reference below) assessed 108 patients using braces for OA of the patella-femoral joint. They found that the maximum voluntary contraction of the quadricep (thigh) muscles did not reduce with brace use.

So it’s fine to use a knee brace?

All studies have limitations. This study only assessed a flexible knee support, so we can’t apply the findings across all knee braces – these will need to be assessed separately.

Any other limitations?

Yes- the study was only over 18 weeks. We do not know what would happen in people who wear braces longer than this.

In summary?

Using a flexible brace appears not to have a detrimental effect on the quadricep muscles in the short term. Anyone wishing to wear a knee brace longer than this period should discuss this with their physiotherapist.

Reference: Callaghan M, Parkes M, and Felson D  2016 The Effect of Knee Braces on Quadriceps Strength and Inhibition in Subjects With Patellofemoral Osteoarthritis

Journal of Orthopaedic and Sports Physical Therapy


Hip Pain – What’s the Cause?

Top 5 reasons

Hip pain is common in people who play sport. A lot of sports related hip pain is simply a sign of overuse- and will respond well to a few days rest. If it persists, it’s worth getting it assessed. Here are 5 common reasons for hip pain-:

Hip Pain - 2

Clue- its’ all about Location, location, location

Exactly where the pain is in the hip can be a strong clue as to the source of the pain. For example, pain that is deep, and more towards the groin is more likely to be related to the hip joint itself.clue-clipart-dT87enn6c

Pain on the outside of the hip is more likely to be tendon or bursa pain.

 Use the location of pain as a guide.

1. Adductor tendinopathy

The painbrian_kicking1web is usually towards the groin, and is worse with activities where you are on a single leg, or kicking. A very common injury in sports players where lots of kicking or running is involved.

Adductor injuries are common in kicking sports

2. Gluteus Medius tendinopathy / bursitis

hipPainDiagThis is the tendon of on of the gluteal muscles, and just like the tendons at the ankle (achilles) and the knee (patella) can become problematic. The pain tends to be on the outside of the hip (lateral hip pain), and can be painful to touch. The nearby bursa can also be inflamed and a source of pain.

3. Femoral-acetabular impingement (FAI)

faisThis is the funky, trendy diagnosis at present. The pain with FAI is usually deep and in towards the groin. The hypothesis is that people with a difference within the bony contours of the bone, in either the femoral head (the ball) or the the acetabulum (socket) will be more prone to pain from impingement. These are called either CAM or PINCER (see diagram). There is much controversy over how to diagnose this, and how to treat it. However, many patients can be successfully managed conservatively.

The funky and trendy diagnosis of the moment- FAI.

4. Referred pain from the lower back


Injuries in the lower back can refer pain to the hip. The pain is usually deep, or radiating across an area around the hip or upper leg. This is easily diagnosed by a physiotherapist, and treatment for the lumbar spine usually resolves this injury

The lower back can refer pain to the hip

5. Labral / cartilage tear 

This is an unusual injury but can be a cause of hip pain.The location of the pain is often deep, and towards the groin. If pain is associated with painful clicking at the hip then this diagnosis may be a possibility. Read more about Labral Tears here.

Easy Tips to Avoid Neck Pain at Work

Healthy working- five easy tips: So as well as the screen position, what else can you do to avoid neck pain & stay ‘office healthy‘?

1. Bob Marley once said ‘Get up, Stand Up’ and nothing could be truer when it comes to preventing neck pain. One study showed the longer you sit, the more likely you are to have neck pain. Standing up frequently, whether to pop to the water cooler, chat to your colleagues or just go for a walk around- all will help.


Stand up desks are becoming popular. These often adjust between sitting and standing.

2. Don’t keep the neck too still! Avoid holding the same neck position for long periods of time. Especially if looking down. Studies have shown people who look down (we call this ‘neck flexion’) for long periods are more likely to get neck pain. It’s easy to get caught up in a document you’re reading- so remember to move frequently. Sometimes document holders can help.
3. Dead as a Dodo. The Dodo bird became extinct because it was unable to fly- it was suggested it was too slow, heavy and unfit. Don’t become the dodo- there’s lots of research that shows keeping yourself fit prevents neck pain, and has heaps of other health benefits too!
4. Don’t let work get you down! If you are stressed, or unhappy at work, you are more likely to get neck pain. Speak with your boss about changing things that don’t work for you. And try point (3) above- research shows if you do exercise or sport it’s likely you’ll be happier at work.


5. Sit. Stand. Move. Repeat. Regular movement is so important we are mentioning it again. You can have the poshest desk with the most expensive seat, and the latest computer screen. However, if you sit there all day and barely move, you’re still more likely to get neck pain, as well as other problems.

In summary: Movement is key. And if you can add in some exercise (whatever you enjoy doing, it doesn’t need to be the gym) you are minimising your risk of getting neck pain- and also gaining lots of other health benefits!