Neoprene wraps (Introduction)

There was a recent question in the Injury sub-forum at JPFitness.com (the link to JP’s forum is on the sidebar to the right) on knee sleeves in weightlifting. My own experience with knee sleeves and knee wraps has been somewhat limited in terms of using them, but given that I was part of the trial team that looked at knee bracing in patellofemoral syndrome, I’m not entirely unfamiliar with their concept, as we used neoprene knee sleeves as part of a placebo arm in evaluating patellofemoral braces in treating patellofemoral pain. However, I was definitely intrigued to look at the literature in terms of evidence for the use of neoprene sleeves in non-injured populations.

A brief history

Knee wrapping and knee sleeves have been used in weightlifting, and in particular powerlifting for many years. Their use has been primarily for strength augmentation–similar to compression shirts. The principle behind their use is that as an elastic material, they will always strive to return to their original conformation (i.e. the least stretched state possible) and thus will add energy/force to a lift. Thus, by wrapping the knees tightly while one’s legs are extended, the wraps will assist the lifter after they’ve been stretched during knee flexion.

Additional claimed “benefits” to knee wrapping or knee sleeves are that they keep the knees warm, and more stable. And while wearing neoprene sleeves is definitely warming (many of our patients in the sleeve-wearing groups complained they were too hot), what about this claim of stability?

The literature

As with many fitness interventions in healthy populations, the research is sparse. My search strategy for this topic was naturally in PubMed, the most comprehensive database. I ran searches for the raw keywords, “knee wrap”, “knee sleeve”, “neoprene”, and “knee and weightlifting”. For the purposes of this review I did not take a close look at studies looking at patients who had knee osteoarthitis or who had had a previous ACL injury. By all means, this may not be the most comprehensive review, and if you know of a reference that would support the use of knee wraps or knee sleeves in healthy populations, please let me know!

There are four papers that I identified as being relevant papers. The first appeared in the American Journal of Sports Medicine in 1995. All of these papers looked at various aspects of knee sleeves or wraps as a way to improve proprioception–the ability to tell where one’s limbs are in space. And while I’ll go through these four studies in more detail in the near future, one has to wonder if improving proprioception is actually all that important in weight lifting. The focus on injury prevention with respect to knee wrapping (whether wraps or sleeves) has been primarily on traumatic injury (all hail the ACL shrine!) There may even be some evidence to show that knee bracing may be detrimental in such cases!

While this review will look at the quality of the studies on knee wrapping and proprioception, the continued use of knee wrapping in weight lifting should be brought to question. Since, weight lifting does not typically involve the classic “plant and twist” mechanism of movement associated with ACL injury; and since weight lifting seldom involves performing movements in which unexpected external forces come into the overall kinetic equation (unless someone bumps into you); what injuries, exactly, are we trying to prevent with the use of knee wrapping in weight lifting? This question remains unclear.

Coming up: From 1995, Birmingham et al.