Can knee braces cause femur fractures?︱Cross Training Enduro
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- Опубликовано: 8 фев 2025
- From www.crosstraini... Can knee braces cause breaks of the femur in the upper leg, the biggest bone in the body? We know knee braces more than halve the risk of common knee injuries. But some riders claim a knee brace will protect the knee but transfers the force to the femur in major accidents. While the femur is a very strong bone, these riders believe that a knee injury is preferable to a fractured femur in these major impacts. Unfortunately, there is almost no research and just anecdotal evidence that suggests braces could be involved in femur fractures for motocross riders.
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Do knee braces make a difference? Yes. The same study found that knee braces at least halved knee injuries for dirt riders, and suggested they have an even greater effect on the MCL which is injured by twisting motions. But what about femur fractures? There is good news from the biggest knee brace study to date. With over three thousand riders clocking up 40000 hours of riding. The incidence of motocross injuries: a 12-year investigation says all injuries most common from cornering when knee used as a pivot, at least in mx. next is from jumps. ACL from hyperextending landing from a jump, or losing balance on jump and putting leg out when landing, or foot slipping off the peg onto the ground. The same study of more than 2000 dirt riders found that 43% knee injuries were the ACL, the ligament that joins your upper and lower leg bones. 20% involved the meniscus, the cartilage that absorbs impacts to the joint, and 15% to the MCL, a ligament that prevents sideways movement of the knee joint. It would be good to see more studies done in this area, but to me, this strongly suggests there is very little risk of a femure fracture from knee braces for the average dirt rider. The anecdotal evidence suggests femur fractures for riders with knee braces appear to be more likely for the fast riders and those getting a lot of air on the big jumps. Fractures occur at the expected spot, where the top of the brace would push against the upper leg. So if riders aren't racing or doing masive jumps then knee braces would seem to be a very sensible choice for all those minor to moderate impacts. What about motocross riders? A quarter of the riders in this study were in motocross, so this study does suggest the risk of a femur fracture would appear to be low, but ideally we need more research on this so riders can make informed decisions. There is a small but potentially deadly chance a broken femur can cut the femoral artery. If it's a compound fracture, there is a risk of infection that can be life-threatening.
While a lot of fractures just mean six weeks in plaster, a femur fracture can take a long time to knit and involve surgery that has a small but significant chance of dangeous post-operative infections.
Any long bone fracture in the lower extremity is worse than a knee ligament injury. I think that having a knee joint, which is a naturally occurring break in the lower extemity, is a natural defense against long bone fractures which would be fatal in a caveman. Most of the MXers I have treated and/or advised on these websites were wearing knee braces when the fractured their femurs... While a knee injury is painful and takes a lot of rehabilitation, specialists believe in most cases theycan achieve a full, or nearly full recovery of knee function... Most of the femur fractures I have personally cared for and most of those that I have encountered while advising on this and other websites have curiously occurred at the upper junction of the brace and femur... My experience as a rider and as an orthopedic surgeon has led me to conclude that the best protection for the knee, and other parts too, is a high level of cardiovascular fitness, and riding skills. Over 30% of my practice comes from off-road motorcycle injuries. The typical mid-shaft femur fracture looks awful at the track but I’d rather treat it than a blown out knee. I can put a rod in the femur,
have the rider walking in two weeks, riding in six weeks and racing in twelve weeks! While I’ve heard people say that knee braces can cause femur fractures I know of no data that supports the claim. We have not found any statistically significant link between knee braces and fractures. I have certainly seen fractures in both cases.
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FAKE KNEE BRACES? Beware of some EVS 'braces' (and other brands) that are just knee guards. ruclips.net/video/KRjnc1aFVVY/видео.html
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FURTHER READING
Knee Injuries & Use of Prophylactic Knee Bracing pubmed.ncbi.nlm.nih.gov/21297006/
The incidence of motocross injuries: a 12-year investigation link.springer.com/article/10.1007/s00167-004-0510-z
Femur fracture associated with knee brace wear in the motocross athlete www.hindawi.com/journals/crior/2018/1498541/
Knee injuries and the use of prophylactic knee bracing in off-road motorcycling journals.sagepub.com/doi/abs/10.1177/0363546510394431
Accident causes and prevention of injuries in Enduro-motorbike sport europepmc.org/article/med/1925924
Interesting Barry, that study is very close to what I've seen in my clinic for 26 years as a Physical Therapist. I have had numerous patients with knee injuries over the years, almost all were motocross riders or freestyle jumpers, and maybe only 2 femur fractures from riding a dirt bike, and both were freestyle riders. I've actually seen more cyclists with femur fractures than dirt bikers. I can't remember having a patient with any injury from trials riding, or cross training, although I'm sure there are some out there. Coming from motocross myself, all of my bad injuries could be blamed on those dreaded 120 foot gappers, and getting to old and tired to know when to quit at the end of a hard day..... Great vid bud...
120 foot? you crazy mx buggers lol! i filmed some guys recently and i have nothing but massive respect for your craziness of course. i'm glad your anecdotal evidence backs my tentative findings.....
There is nothing like the euphoria of flight my friend.....but that sudden stop followed by a yard sale really sucks....
I've watched a friend recover from a broken femur (non-dirtbike) and my wife recover from an ACL rebuild, I would choose the bone all day. it's been a year and the wife is just now back to "normal". buddy with the femur was up and going 100% in 7 months.
jan last year I had acl reconstruction and wanted to race the night races in June .I got a set of mobius braces and went for it .had a good get off and it bruised the hell out of my thigh but saved my knee so I will have to agree with what your video and research suggests . great videos as always
I'm 44 and have been riding dirt bikes since I was 6. I'm also on the shorter side at 5'7" so I tend to have a few tip overs when I can't get a foot down so I've been wearing carbon knee braces since they came onto the market.
I had one ride some years ago where I had a decent tumble but got up and kept going no worries. When I got back to the car and was taking my gear off, I found I had partially shattered and delaminated the carbon on the left brace. That brace was worth every penny.
Roll forward a bunch of years and mid Jan 2016 I was out on a training ride on the mountain bike and had an ugly, ugly fall. Obliterated the ACL, grade 2 tear to the LCL, extensive damage to both the lateral and medal meniscus, grade 3 muscle tearing to a number of major structures and extensive bone bruising. The pain post surgery was intense - even when loaded to the eye-balls on IV pain killers. Rehab hurt every bit as much but I was able to get back on the bike 8 months later which was a lot earlier than both my surgeon and physio initially estimated. Trust me....you never, ever want to have major knee surgery if you can avoid it - it hurts like hell and costs more than a set of braces to fix even with insurance.
Can't say I want to break a femur either but having used braces for many years and had plenty of falls while wearing them, I reckon they have saved my knees more than once and never caused other injuries.
Others may hold different views but I will never ride my moto without my braces and I also wear them skiing given they are two of my passions and I want to be able to enjoy for as long as I possibly can.
glad you eventually recovered enough to ride again garrett. i was lucky to avoid major injuries but definitely always braces nowadays!
get the knee braces. Its kind of nice to be able to walk when your older. All of those wreaks will start to haunt you later in life
Barry you've bloody got me thinking again! Currently dealing with a temp dislocated knee cap and my physio advised against braces due to broken bone risk. That study mentioned proves otherwise though...
there certainly isn't any hard evidence saying braces cause femur fractures... to be absolutely sure i'd like to see a study of high level mx riders but i'd say the rest of us normal dirt riders are safe!
I've already had a significant knee injury that ended my days of racing MX. ACL, PCL, MCL and much more... Frankly I don't want ANY more leg injuries. But I have to believe knee braces, like seat belts in autos and helmets, are by far more beneficial than any potential hazard they may preaent. I'll wear braces, thank you. Actually, a season ending ankle injury last Oct, combined with re-watching your boot video inspired me to seek better boots. In fact, my new SIDI Crossfire 2 SRS just arrived today! Woohoo! Now if there just wasn't 2 foot of snow on the ground still...
go the mighty sidis! well, not in 2 feet of snow maybe.... :)
given my chance again id have gone with the brace blew my knee apart while going slow just landed twisted up not fun
easier to protect it than fix it and it never be the same
i fell off my dirt bike and my Leatt knee braces saved my bacon big time! Only a badly brused leg and no breakages.
- Knee braces have knee locks available, that prevent full extension of the knee joint - when this is used (even slight bend), whole leg should be OK.
- Honestly I bought my carbon PODs 2 yrs ago and never used them, because I was lazy to getting used to them. With the first extreme race in the new season I forced myself to put them on and actually it was OK. After 15 mins I didnt notice I had them.
that is usually a good sign you have a reasonably good fit, mikhail. within minutes you forget about them and only remember when you get off the bike and try walking lol.
3 months ago I had an angled head-on collision with a crew-cab truck while on a dirt road between 2 trails. The end result was a broken radius and massively broken femur. At the time I was wearing knee braces. Based on my injuries and the accident itself I am convinced that the braces have nothing to do with the femur break and saved me from much worse consequences.
Since I hit the front of the truck at an angle the bars twisted to the right breaking my radius. The truck then hit my left leg which shattered at the height of the front of the bonnet; I was thrown over the top of the truck with my leg caught between it and the bike. The breaks were near the top of the femur, well above the knee brace. The carbon frame of the brace snapped in the impact but may well have saved my knee from a serious crush or twist injury.
What was really telling were the injuries to my other leg - the one that did not suffer the direct impact. After the accident the swelling on this leg was as bad as the broken leg. When this subsided I was left with deep purple bruising down my leg where it was in contact with the brace and the straps. Effectively I suffered a serious whiplash injury to the leg which would have certainly torn my knee apart had I not been wearing braces.
The recovery from my injuries will be long - I had metalwork inserted and after 8 weeks was walking without crutches, the arm I was able to use within a couple of days although I still had a cast for the first couple of weeks. I am back on crutches now because of problems with the screws securing the rod to the femur above my knee but this should only be for a couple of weeks. I have been told that, due to the severity of the fracture, it will be at least 6 months from the accident for the bone to mend with no athletic activity in this time. Then I need to regain my fitness.
The alternative though would be much worse. My physio tells me that the recovery from knee surgery takes a similar time as from a femur break. The problem is that I would have damaged both legs and they can only fix one leg at a time. Give me a choice between a smashed femur or a smashed femur and probably both knees I know which I would choose.
damn, you've been in the wars IRoss. i'm surprised it only too eight weeks to start hobbling around at first. all the best for your recovery....
Thanks Barry.
My other battle will be persuading the other half that it is safe enough out there to return to riding. I was already attempting to make my riding more X-training biased but obviously I did not go far enough. As I only have one bike I'm not sure I want to go as far as just having a trials bike in future but a hybrid might help me stay away from traffic, or perhaps I should just make sure I don't ride at the front of the group.
The day I said "nah I don't need to wear these", slipped and landed on my knee 😅. That being said, I just wear my lifting sleeves now. Found guards were to cluttering and braces not entirely necessary yet.
both R & L rebuilds on knees here > Destroyed ACL LCL MCL & Meniscus in both about 2 yrs apart They haven't been right since . I still ride with knee protectors & good set of boots Zoom Zoom i have donjoy braces & rarely use them
I watched this video 4 weeks out of surgery, rod threw my snapped femur. I cased a big ass jump, I was not wearing knee braces, and sustained no other injuries in the accident. I have had a few crashes and after crashing hard enough to snap my femur I honestly don't believe knee braces would have absolutely any effect what so ever on breaking your femur, if your breaking it, your breaking it, nothing is going to alter that outcome, and I certainly dont feel vraces would increase the possibility. The force required to do it is significant, I really dont see how a knee braces are relative to the femur area in general, knee braces stop rotation and jarring.
One thing I have thought about is weather or not having had knee braces on would have made the post accident wait better or worse. In my unlucky situation, I waited for an hour and 20mins for the ambulance, my lower leg was rotated and the force had the 2 snapped bone ends pushed into each other making even the tiniest movement agonisingly painful. Braces would have either held everything in a relatively normal position and stopped the incorrect lower leg rotation which may have been better, on the other hand from my experience with knee braces the tension of pulling upper and lower leg together may have increased the pressure of the snapped femur ends into each other, which would have been absolute hell and I mean it was already in hell.
Just don't crash or case 😂
Ouch. Definitely sounds like one of the most potentially painful fractures.
Do femur fractures cause knee braces though. Great video
there is little in the standard model of physics to say that time (or more correctly space-time) can't run backwards in which case this would be true. :)
I have severed my ACL in my left knee, Torn my MCL in my right. I find the most comfortable setup for me is a compression style brace with the flexi bones worn underneath a regular knee guard. I dont like the hard hinged braces as they cause pressure points on the inside of my knee when riding. Just prersonal preference id say
I should add that both my knee injuries healed quite well and faily quickly with physio therapy. the ACL knee doesnt cause me any problems at all, and the MCL acts up somtimes but its ussualy from extended periods of standing rather than riding
Opposite for the old man. Broke both tib and fib at the knee where knee brace bar, the shock of the bones have now stuffed his knee 3 years later.
You made a better man out of myself Barry. Safety protection is a priority. Got myself already a neck brace.. not really sure b if necessary, but a broken neck is dreadful. next will be knee braces.. just a bit expensive though.
the good gear does get expensive, manuel! i might attempt a vid on neck braces soon but it's tricky with so little research done. :(
fractured my tibial spine riding bmx in october sure wish i had a brace then. my knee is still hurting and probably should go back to the doc
thanks for the femoral artery suggestions. thats some scary shit. i just bought some cti2s
never know when you just might save someone's life one day. :)
i can not say about a knee injury, but 30 or so years back, it took 9 months and a installed battery to get my tib and fib to just start knitting back together. total time off work was 2-1/2 years.
but then the bones were not just broken they were crushed,
ouch. my shattered lower leg took about three months before i was walking and that felt like a long long time, larry.... :(
that's why I prefer simple knee/shin pads then full blown knee braces. Breaking femur is serious injury.
I love the first doctor saying how a femur break could be life threatening for a caveman. I hope never to be a situation where I'm a cave man but if I am, I'll also have to watch out for simple infections, tooth decay, carnivores, over exposure to the elements, etc... Also, how effective would a caveman be if he/she blew out their ACL and couldn't physically support themselves reliably? Having recovered from an ACL tear, I can tell you the 9 months before I could ride again were pretty frustrating but my knee is better than ever now. I can also tell you that without wearing knee braces now, I might have reinjured my knees a few times. Just part of technical riding. BTW, I wasn't riding when I tore my ACL, it had nothing to do with dirt bikes or even sports in general.
great to hear you had the full recovery fredman!
That's like my cousin saying he knew someone who wasn't wearing a seatbelt or locked his car doors and was thrown clear of an accident ended up with the car in deep water. Being thrown clear may have saved his life. So my cousin uses that as an excuse NOT to wear seat belts or lock his doors while driving, despite the mountains of evidence clearly pointing to the safety of belts and locked doors. One time in thousands it works is enough to sway some people's minds.
I think the knee brace velcro and straps will give before a femur breaks
For what it's worth, Leatt's C-frame braces also have fusible links built in. They're intended to break at less force than that required to fracture the tibia and femur. The detail is in their white paper. www.leatt.com/product_uploads/white_papers/C-FRAME_WHITE_PAPER_A1.pdf
this is very interesting, atpaw. they don't seem to discuss whether it is better to prevent the fractures, or just protect the joint at all costs and let a possible fracture occur. i know leatt work hard on their gear, but i wonder if they've researched this or have just decided to incorporate this feature without fully exploring if it's:
a: needed at all when the research is inconclusive to date
b: actually better to protect the joint with the strongest bracing.
all food for thought, and more research i needed!
Yeah, not sure if the fusible links were included due to actual risk (e.g. femur break IS more likely with knee braces) or perceived risk (to allay peoples' fears of femur break, when the frequency/risk of femur break is identical with or without braces).
From an engineering standpoint, though, it takes a lot less energy/force to bugger the knee than it does to break a leg - destroying the knee brace takes energy, so destruction of the brace will absorb at least some of the impact energy before the knee takes a hit.
And in the really extreme cases - As with any other protective gear, there's going to be a point where the amount of energy involved and rate of energy exchange overwhelm what the body can deal with, with or without gear.
my thoughts exactly atpaw.... without further research i don't think fusible links or 'crumple zones' would figure in my choice for a knee brace but i would really like to know IF they are good thing!
The concern over knee braces and femur fractures is a lot like the debunked notion that steel-toed work boots would slice your toes off. A femur-snapping impact is a femur-snapping impact regardless of your choice of rigid stocking garters. Maybe there is some incredibly specific, outlier scenario in which the leverage of the knee brace gives your crash that "extra oomph" that snaps your femur, but it's surely no more likely than an errant sharp rock under your femur when you crash on any day with any gear.
yep i think that's a good summary of what the research shows so far, OAKLR. it would be good to see some specific research within the mx community but i'm not going to hold my breath.
I broke my femur when I was 8 but it wasn't from riding, and it in the 70's so I was in plaster from my waist to my toes and had a wooden brace attached to both knees and had to be wheeled around on a trolley 😤 wouldn't want that now days but I think treatment would be better now with rods inserted to help moving again. As painful as a broken femur is I think I would rather that then go through another knee reco.
Hey Barry....I have a set of asterisk which caused an oblique fracture of the head of the left leg fibula....the orthopaedic surgeon felt it was caused by the base of the hinge which impacted the bone as the lower leg was pushed out to the side. I was jogging on it after 4 weeks as it is non load bearing...hurt a lot at the time but seemed to be a quick recovery compared to a ligament.
ouch. :( glad it healed quickly though.
Both my knees have been total losses for many years . And at seventy can still pull myself up onto the pegs . Just siphon them off and refill twice a year and Woa Loa , Look he's pulled it off again , bring the good pain killers with those knee guards and MX boots . Thanks
🙂 firstly thank you for your videos and the link. I had to smile to my self because I have settled on a new pair of leatt knee "guards " for now. I tried on several knee braces at my local bike shop with the help of their "expert ". I have spent some time in a leg brace and there was way too much movement of my legs in the braces. I will look into CTI braces. And l have been trying to cycle a couple of times a week.
I hope you find the ones that fit well and do the job, Peter. I know in one of the vids Stephen Gall shows precisely what to look for when checking fitment. The knee guards will still be useful, I still have mine as back up for dual sport rides or if the dirt ride will be very cruisy.
I saw Stephen Gall's video on cti and the way he measured the leg was very similar to the way my orthopaedic surgeons set my braces. Definitely going to skip the OTS braces, save money and go straight ish to custom made. Thanks for your input.
I was wearing knee braces when i broke my femur, i was riding mx too. Im sure it makes it easier for your leg to break, but if I hadnt been wearing knee braces the blow to my knee would have been much worse than my femur brake. Heres the vid if you want to see it for research, or for fun. ruclips.net/video/lMbHM5HGFP4/видео.html
They put a rod in the middle with screws on the top and bottom. They FORCED me to walk the next day. Pretty crazy.
those doctors can be vicious lol!
Watch the video, I'm glad you're ok.
Yeah man they arent joking. Have you seen videos on how they put a femur rod in? BRUTAL
Thanks Fredman1085, Its been 3 years or so and the leg feels just like my other one!
What happened to your front end? was some scary shit...
I had broken my femur in knee braces, could only image the injury to my knee if I hadn't tho.
just ordered some leatt knee braces after watching your vids on wearing them , I'm hoping they are good ,
did you check fitment in a shop first, jonny? we've got a vid on how to check for a good fit, you lose a fair bit of protection otherwise.
CROSS TRAINING ENDURO SKILLS watched video on sizing and checked leatt size guide so I'm hoping over ordered the correct size if not I can exchange them , rode in them today little funny at 1 st but forgot on when riding but did slip down so need a bit, maybe need to adjust a little.
Thanks CTES for the vids, I appreciate them.
Any chance of divulging where those two training circuit are located?
private properties sergio, all the guys have asked me not to reveal various locations. :(
do you ever ride mx yourself?
because I know that enduro bike can do fairly well on an mx track.
i'm pretty bad at it, speed isn't really my strong point lol
Hey Barry, I hate to take away from your video making time but I have to ask. How do you find places to ride? I can't seem to find any using the internet. Thanks.
mostly private properties nowadays. and occasionally in state forests.
maybe ask Toby price , what was he wearing when he broke his femur in January , l am sure he would have some insight to this , or maybe not , 🤔
i did talk to stephen gall about this as he supplied toby with his cti customs. he's very keen to quiz him about all of it.
Under the same logic wouldn't riding boots have the same effect on your shin bones?
there would be less of a leverage effect joe, but if the front part of your boot was completely inflexible, there was a major impact right at the top of your boot, AND you weren't wearing any knee guards at all.... maybe it could have the same effect? interesting point... but from what iv'e seen of my boots even the toughest ones have a little bit of give in the boot's shin guard.
I heard of someone who broke their leg near the top of the boot when their foot hit an object. The extra weight of the boot may have caused the break due to the sudden stop at the foot.
excellent!
What does Stephan Gall think?
big believer in knee braces. he is keen to see more evidence on any supposed link with femur fractures but reckons for the everyday dirt rider they are almost a must.
I agree with him
Although, i used to hear all the same rhetoric regarding breaking femur bones, even 20 years ago. And it did indeed happen to 2 mates, but they seem to break bones all the time (2 brothers).
A Grade MX riders that came into bush riding.
They both broke bones doing stupid things, like landing off a jump all sideways and placing your extended leg down as you land.
They have always used custom knee braces ever since MX racing.
I would not consider this to be any kind of supporting evidence, as these 2 brothers constantly broke bones during their riding career when the rest of us didn't.
Knee Brace or at least Knee Guards for me, ever taken a bluestone rock launched from a big bore bike at close range to the knee cap before, it smarts for a long time!
Try compression knee braces instead of rigid plastic. With side support. They won't put pressure on the femur. Similar to the braces weight lifters use.
leatt knee braces are designed to break far before your femur does
Owen Boonzaier I've just ordered some leatt, so I'm hoping they are good
so are EVS web braces, owen. personally i still think there' not enough research yet to confirm whether this would be a good thing or not, i wish dr leatt had included more or the research and explanation for putting in 'crumple' zones.
Jonny g I have a pair and so far no problem...I've also seen my arse more times than I can remeber and so far I can say my knees arw still in tact
Te 300 or xc 300
Some anecdotal data for you :)
A riding buddy of mine broke his femur. He thinks that the EVS knee braces he was wearing may have had something to do with it... It was a relatively low speed crash, but his leg basically got in the middle of a bike-vs-tree fight. Hard to win one of of those
ruclips.net/video/nuL2LanqcM8/видео.htmlm00s
Dmitriy M that was me! but yes I do believe the Asterisk knee braces I had caused my broken femur, as it broke right at the top of the brace when my body tried to go over the bike. but my leg was trapped against the bike. I think it still was the best outcome as I'm sure I would have really messed up my knee without braces. now I only have some achy days here and there, and it is in my knee, not my femur.
The only braces I buy are for radiators.
I need to buy some but fuck they are expensive
yep. :( personally i think the mobius are about the cheapest that can act as a proper knee brace if they fit your leg well. but ideally you want to get into the mid-level price range if possible.
the time youl be off work will be paid to you at your first stack i thought the same till i was off work for 3 weeks till i was cleared to get back to it 500-700 for a set is worth the 3-4 grand youl lose by not being at work
not to mention if you goof up cartilage or other stuff that cant ever be fixed like it was before the spill
That's an urban myth, kinda like the myth about oysters 😄
for the majority of dirt riders i tend to agree tony.... be good to see more research focused on top mx riders to either confirm or deny the rumours there.
I rather have femur frakture then tear up my knee.
The knee is more complex to fix
Certainly pros and cons for each.
@@crosstrainingenduro yes
knee injury is lot more dangeroys than bone break
wrong, the're not more dangerous. They are only more hard to fix.
SonOfGod wrong. Femur fractures can be life threatening.
life threatening?
yep bones heal fast compared to months of physio to build muscle strength after being non weight bearing for months
Mr Fiction. Yeah if the break severs your femural artery you could bleed out on the inside. You ever seen saving private ryan?
i prefer riding enduro/mx naked
Omfg i just want to go ride! The burning inside of my chest! Aah FUCK only going to the gym is just sooo fucking boring! I have tried make going to the gym fun. I have installed TV in to the gym and i have watched flight instruction vids from 80s, porn, some movies and i can't make it fun anymore! FUCK IT! I'm going to ride tomorrow
cool
V
Neck braces...................I wouldnt wear one if you paid me