So there I was playing goalie, in the midst of a pick up game. I passed the puck up the boards, my team got the breakout and I started meandering leisurely back towards my net. My skate blade caught in a groove in the ice. My knee twisted. I crumbled in front of my net, mute from the intensity of the pain.
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The other team got the puck down to my end of the ice. Lying in a ball of pain, I could hear them skating around for a few minutes before someone made the brilliant observation, Hey, I think the goalie might be hurt. Gee, what gave them that idea?
They begged me to stay, saying, Cant you just lay there until the game is over? You play pretty good lying down. I convinced them that if I wasnt certain of my need for medical attention, I would love to help. Being a tough guy (read moron), I didnt go to the doctor until the next evening, hoping that my knee would instantaneously heal itself.
It turned out that I needed rather substantial arthroscopic knee surgery. I elected to go with an epidural rather than a general anesthesia so that I could watch the procedure on the video monitor. Dont get me wrong, I hate the sight of other peoples blood, but my own wounds hold some morbid fascination. Hey, this was a once in a lifetime chance to watch my own surgery, live on television.
I sat in the operating room while the anesthesiologist gave me a sedative to relax me before the operation. They had me sitting upright on the operating table while he prepared the spinal block. A rather hefty male nurse held my shoulders as I sat there. I was thinking Why is this guy holding on to me? Im fine.
Thats the last thing I remember before waking up six hours later with my knee in a passive motion machine. My surgery which was to take about an hour and a half ended up taking a little over four hours.
▪ Knee Braces
A knee brace is something that you dont want to have to wear. Lots of people have started wearing them just for that reason. Prevent the injury from happening by wearing a knee brace so that you dont have to wear a knee brace. Sounds a little ironic, or even oxymoronic, but wearing a brace is far more appealing than the surgery.
I find the number of people wearing $10 neoprene knee braces rather amazing. There are a lot of people who have sore knees I guess. Unfortunately there isnt much that a $10 knee cuff is going to do to prevent sore knees from getting worse. Even the more expensive ones that have metal hinges in them offer little to no protection from further knee injury.
The knee is one of the strongest joints in the body. It works very well until it gets bent the wrong way. Any belief that anything less than orthopedic quality products offer an increase in protection to a strong joint is misplaced.
This is not to say that the neoprene devices are totally without use. I have one that I wear to keep the straps on my goalie pads from digging into my knees. I suspect that they also offer some help in the way of warming up stiff joints and loosening them up. However, that is not the specific task of a knee brace.
A good knee brace should stabilize the knee, augmenting the weakened joint and make it very difficult, if not impossible, for the knee to bend in the wrong fashion again. While a few of the orthopedic quality braces do incorporate a neoprene layer, they are much longer and sturdier than the drugstore version. Most are very bulky, post operation braces with six straps and nearly full leg coverage nothing that would be practical to wear for daily use or sports.
Athletes have heavily trended towards aluminum, steel and fiberglass knee braces. These are lighter, more protective and have a low enough profile to fit under equipment.
▪ The Don Joy SE-4 Legend
My orthopedist told me to get a custom Don Joy SE-4 made. I had him write me a prescription for it so that my insurance company would cough up the $1600 price (thank you very much). However, the non-custom version of the brace is quite a bit more affordable. Ive seen them as cheap as $315 although other places have been selling them for $600 and more. The SE-4 Legend is worth every penny if you have any type of knee instability.
The Legend comes in six sizes: Extra Small, Small, Medium, Large, Extra Large and Double Extra Large. These will fit legs measuring 13 inches to 29 ½ inches in circumference measured about 6 inches above the knee. The only reason to get the custom version of the brace would be in the event that your legs dont fit in that range or your insurance company is dropping the extra $1250.
The Se-4 Legend is constructed of what is apparently a top-secret alloy since no amount of research has yielded the answer. I will go out on a limb and guess that it is aluminum. Regardless it is light and strong.
Doeskin chamois lines the metal portion of the brace where it contacts the wearer. The chamois is very comfortable and can be removed to clean or replace. The straps are a combination of nylon, very heavy elastic, and Velcro. The same type doeskin chamois forms pockets around these straps to increase the comfort.
The unit is also very stress resistant. Mine has taken well over five hundred hours of me playing goalie in it. This includes countless shots directly hitting the knee brace which has always ended up being more painful for me than the brace itself. A few chips in the metallic blue paint job were the only damage my SE-4 Legend has taken.
My physical therapy stalled after about eight weeks of improvement. I was stuck about 5 degrees short of fully extending my leg and 15 degrees short of full flexion. Most of this was the result of having been on crutches for the first six weeks after my surgery and significant atrophy that occurred as the result.
At three months after my surgery I was itching to get on the ice again even if my leg strength and flexibility wasnt where it should be. This was about the time that my doctor sent me to go get measured for the brace. I figured they would use a tape measure and then stick me in a stock brace. However this wasnt the case. The measurement was done by a rather impressive device that checks not only the size of my leg, but all of the angles of my knee that varied slightly from anyone elses knee.
My debut return to the ice came almost four months to the day after my initial surgery. My doctor hadnt cleared me to even start running, my Physical Therapist however said skating in the brace would be acceptable. I figured skating, hockey, its all the same. Besides the custom version of the Legend came with a $10,000 guarantee that my ACL would not fail while using it. I was sure I didnt want to go through the surgery again, but I figured if they were that sure, I would be alright.
It turned out to be a bad day for my first time back on the ice. Six skaters and one goalie showed up to play. This translated into half ice, three on three hockey and absolutely no rest for the out of shape, fat goalie with one bad wheel. Well, I lived trough it. My knee was a little sore at the end, but nowhere near as bad as my back felt.
I went to the Physical Therapist the next day. She checked my progress and after several weeks of no improvement was glad to see that I had made substantial progress. Youve only got 5 degrees of flexion to go and your extension is almost perfect now. You worked really hard since Monday, havent you?
Well, I played goalie yesterday. I replied sheepishly.
Oh my God, dont tell your doctor! she told me. But I have to admit, thats probably what got you this far. Just be careful.
A week later I was released from Physical Therapy at full mobility in my leg. Two months after I first played goalie again, the orthopedist gave me the green light for full contact sports. I didnt mention his permission came two months late.
My Legend came a month later in the ACL, five-strap configuration. There is a six strap version and a five strap PCL version as well. There was a little bit of getting used to the strapping system. It is pretty easy to over-tighten some of the straps on the SE-4 Legend. Most notable for me was a tendency in the beginning to pull the calf strap a little too tight. While this is easily correctable in some sports, having a pair of goalie pads on, made readjustment a bit of a challenge for me.
Fortunately, the $1600 price tag came with a great deal of personal instruction on how the brace should fit and feel. They informed me of how tightly each strap should be and what part of the leg they protected. All of this I promptly forgot.
Essentially, the knee cups on the brace are what keeps it in place. The Legend comes with several different sizes so that this fit is customizable. It is very important to make sure that this part fits or the brace can slide down the leg. These are easy to change if need be. Velcro holds them in place and a small sock covers them for comfort.
The straps are numbered. This is a reminder of which one to tighten first. Following the order is very helpful at first because it does actually help keep from over-tightening straps. Simply make each one comfortable in order, snug but not irritating.
The brace also comes with adjustable flexion and extension stops. These are very helpful if youve ever hyper-extended you knee or over flexed it. You can simply change the stops in 10-degree increments to assist in recovery.
By far the most questions that I get regarding my brace are on the comfort issue. How can you play hockey in that thing? Honestly, I was a little skeptical at first. Any orthopedic quality knee brace looks a little too bulky to be comfortable.
At first I had some minor issues with the SE-4 getting caught on my goalie pads and twisting them slightly. The purchase of one of the otherwise worthless neoprene style knee protectors solves that problem. I simply put an extra large over my donjoy and there was no surface for my pads to catch on anymore.
Even playing out of the net, where shin guards are plastic and fit much tighter to the leg was not a problem with the SE-4. It fits flush enough to the leg that the shin guard straddled it, rising up only slightly further than it does without the brace on.
Whether playing goalie or forward, I always forgot that I even had the SE-4 on once I hit the ice. It is lightweight, comfortable and never shifts during play. It simply isnt a factor except in offering confidence after an injury.
▪ Other info on the SE-4
The SE-4 Legend is the knee brace of choice by more pro athletes than any other brace. They are the medical supplier to the US Ski Team and Snowboard teams. The SE-4 Legend is also the most recommended brace by orthopedists.
The SE-4 is approved for use in both fresh and salt-water activities.
Donjoys SE-4 Legend comes in a variety of colors. There are a few colors available in the off the shelf model. In the custom version, they have every thing from basic black, to hot pink, gold, grey and the metallic cobalt blue that I went with.
When I picked mine up, they told me that I would likely need new straps in a year. The straps are about $70 a set, so I wasnt too excited to hear that. However, mine are now four years old and aside from one repair I made, are in excellent condition.
There is an impact guard available for the brace that is essentially a knee and shin guard. Donjoy claims this is sturdy enough for motocross, so I suspect it would work for hockey or soccer quite nicely as well.
The standard SE-4 has a six-month warranty on the frame and hinges. The custom version has a lifetime warranty on frame and hinges.
▪ Final Thoughts
I found the SE-4 to be not only comfortable and effective, but psychologically calming. One of the toughest things in coming back from any injury is simply having the confidence in your body to perform the way it used to. I dont know if I would have had the ability to play goalie again without this brace.
I dont wear the brace when I skate out of net anymore. My knee is likely stronger now than it was before the injury as I had been walking about without an ACL for 13 years. (A previous injury was misdiagnosed as a meniscus tear that would heal by itself).
Still, even four years after the injury I wont play goalie without a knee brace. Goalie is not a position for people who have weak or unstable knees. I probably could play without the brace, but why would I? If I had one on that day when I tore up my knee, my injury probably wouldnt have happened. Which brings us right back to the start . . . I wear a knee brace now because I dont want to have to wear a knee brace.
Thanks to openroad for adding this item so I could review it.
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