Knee braces provide stability and support, but their effectiveness is reduced when they slip out of position. Downward migration causes a loss of therapeutic support and can lead to skin irritation or chafing. Preventing this movement requires a methodical approach, focusing on foundational fit, materials, and strategic tensioning of the brace.
Verifying Correct Brace Sizing and Alignment
The most frequent cause of knee brace slippage is an incorrect initial fit or improper placement. A brace that is too large will migrate downward, while one that is too small can bunch up and shift. To secure the proper size, accurate measurement is necessary, typically involving the circumference of the thigh and calf about six inches above and below the kneecap, respectively.
The brace must fit snugly without restricting circulation or causing pinching. The length of the brace needs to be appropriate, ensuring the cuffs anchor securely on the thigh and calf without interfering with the ankle or hip joints. For hinged or rigid braces, correct anatomical alignment is also necessary. The mechanical hinges should be centered precisely with the knee joint’s natural axis of rotation, usually aligning with the middle of the kneecap.
Maximizing Friction with Skin and Garments
Once the foundational fit is established, increasing friction between the brace and the leg prevents downward travel. Many modern braces incorporate integrated silicone strips or diamond-patterned dots on the interior lining. This high-friction material gently grips the leg, resisting the forces that cause migration.
Wearing a thin garment underneath the brace can provide a stable, anti-slip layer and manage moisture. A specialized anti-slip sleeve or compression garment made from a grippy, breathable material improves the overall adherence of the brace. Since sweat and natural skin oils reduce friction, ensuring the skin is clean and dry before application is important. For a temporary solution, a medical-grade roll-on body adhesive, originally developed for securing compression stockings, can be applied to the skin where the brace makes contact.
Adjusting Straps for Maximum Hold
The strategic application of tension through the strap system counteracts gravity and muscle movement. Functional knee braces often use a multi-point leverage system to create opposing forces that lock the brace in place. This system typically involves four or more straps, including the anti-migration strap, which is often positioned just above the fullest part of the calf muscle.
This specific strap must be secured first and made the most snug, yet comfortable, to create an upward force that resists the brace’s tendency to slide down. The concept of counter-leverage is employed in rigid braces, where straps are tightened in sequence to create a “pre-load” force on the tibia. This stabilizes the joint and prevents rotation and slippage. Using strategic tension rather than simply overtightening ensures the brace remains securely anchored, maintaining its position without causing discomfort or restricting blood flow.