braces/splints/supports - general questions

[Clarabel]

This seems a daft question, but there are so many different options that do different things, and I think I probably need something that does lots of stuff. I don't have a lot of hope of anyone medically qualified coming near me because I have refused to go back to community physio (she is a witch and kicks me out after 13 weeks every time) thus I must be "anti-exercise" and "want a splint to do it all for me"

Anyway... enough about them. The main thing I am looking for a frequent wear splint/support/etc. for is a knee. I have small problems with them hyperextending, but that gets miles worse when I have over-walked on it and they go back miles, left side in particular. Most frequently they wiggle within the joint (actually, they do that all the time, but it hurts more in some situations), mostly side to side, so a hyper-extension stop type of hard brace won't help that, but it's what one physio said I needed to stop the knee falling backwards by mistake and crashing me to the floor. So then they said put a Tubigrip on it (which is latex, I am allergic, whole other thread!) so I am wondering if there is any combination of lycra support with hard brace on top type of thing. I'm confused!! I am not after a recommendation, as I am going down south to a medical supplies shop that will do recommendations, but I don't want to go having no clue what they are showing me as I am at their mercy for an expensive sale then.

What do you have, and what does it actually do?

[Retro]

Hi Clarabel,

Orthotics or physio are really the best people to recommend the correct brace for you. I got mine from Orthotics and my wrist splints. I have a hinged knee brace which stops me hyperextending backwards but does also stop the side to side movement to. I only use it when my knee is playing up or has a bad sublux...must remember to get in touch with her to get another one for the rare occasions when both knees go at once

Lindsey

[sarahh]

Hi Clarabel

I have Tubigrips on both knees and my elbows I have them to stop my knees giving way and locking but still have the movement. Physio's I know what you mean mine thinks crutches and splints etc are only ok for short term. I saw the OT for the first time on tuesday and she was great and helped so much. I have hand splints at the moment but she is going to get me resting splints for night, thumb splints, loo raise and one of those things that goes round the loo, I now have thicker cutlery which helps she suggested so much which I hadn't thought of. (so much for me doing 2 years of health and care I should have known what I needed lol).

Sarah x

[Sez]

Aside from my compression gloves, which I wear at night to keep my hands from going numb, my most frequently used splint is for my thumbs. I wear it for short periods in the day, such as when I have quite a bit of typing to do, or when I am being "active" with my hands (such as managing pens or cutlery) and it helps provide a bit of support for the thumb and wrist and, most importantly, creates a "normal" range of movement to stop the thumb hyperextending. I really need to go back and see my OT again about my knee, which keeps subluxing and hyperextending even when I'm not doing anything.

I think the problem is that some physiotherapists believe that we can all be "cured" of hypermobility with exercise. While keeping the muscles strong is incredibly important (I subscribe very much to "use it or lose it") and HMS symptoms can be eased with correct exercise, it won't go away and the extra support of a splint or brace can make a massive difference, especially when using the affected joint. We are all prone to bad days, especially for us ladies around the time of our periods, so the additional support can help us to stay as active as possible during these times.
If you haven't already, I highly recommend seeing an OT. You can self-refer through Social Services, and they will come out and assess you at home for any equipment that may be necessary, and you can also self-refer for assessments for splints and braces (usually through a different department - I had to go through the rheumatology team at the local hospital).

[Clarabel]

How do you get to see an OT that is to do with splints and stuff? I had one out to the house who basically said she could give me loads of stuff if I didn't have children but because lots of the stuff is unsafe around kids or can only be provided by the authority if I can prove I will never use it with my baby on my knee (stairlift, etc. - how am I meant to get the baby up the stairs then?!) she can give me ONE type of bath support which I found unsuitable as it made the shower curtain leak and I couldn't get in the bath any more with it on and I can have a rail on the side of my bed. Well, all problems solved then! If I speak to my GP about supports he says that has to go through the physio who just tells me I have to do core stability exercises and everything will go away (including knee problems and dislocated thumbs!). The only time I got in with a long-term physio he told me to use braces when I need them so long as I keep up my exercises but then discharged me from the system as I didn't want any new exercises. So now I don't even know enough about braces to source my own, and why should I have to buy my own out of a paltry income? I know what you mean about braces actually increasing your exercise threshold too, if I could stabilise my knee I could walk further and go up some steps!

The hinge braces stop things going backwards, but do they help with the "little wobble" type problem? Apart from the horribly allergic Tubigrip, what would keep a joint from "wobbling" to and fro a little without immobilising it? Perhaps I should wear 4 pairs of support tights!!

[Sez]

For an OT for equipment at home, I just popped into the Social Services building and asked to see someone from the disabilities team. The OT came out, assessed my needs, wrote a report and about two weeks later I had a delivery of a new kettle tipper, a perching stool for the kitchen, a bath lift, a toilet seat riser and a commode for the bedroom (our bathroom is downstairs), plus a load of information about funding for a stairlift.

When I needed to see someone for splints and supports, I went to see the nurse at my GP's surgery and she advised me to give the hospital a ring, and to ask to speak to the Rheumatology team's Occupational Therapists. I explained what I wanted over the phone, and it took about eight weeks to get an appointment, but it was incredibly worthwhile.

I can't understand why basic home equipment would be dangerous for your children? I can perhaps see the reasons behind not carrying a child on the stairlift, but everything else is for YOUR use and not really any more dangerous than without the adaptations (i.e. so long as the kettle is empty when not in use, a kettle tipper is no more dangerous than a kettle without one, and a toilet seat riser can't make the loo more dangerous).

[naama]

just to point out that what you can get help with and what joints OTs will deal with on the NHS varies HUGELY depending on where you live. We don't even have rheumatology physios, let alone OTs. The OTs will only deal with hands and wrists. The physio's answer to splints and braces used to be to give me a catalogue and leave me to determine what I thought was best. However, if I lived less than 20 miles east of where I do live I am told I would get braces free from OT and they do have rheumy specialists. The NHS postcode lottery is alive and well, at least in England.
As for knee braces, I found two problems - firstly my knees aren't straight so most don't fit me; secondly, the neoprene ones with metal stays weren't much use because the neoprene meant that if I hyperextended then the neoprene stretched rather than stopping it. I bought a really expensive carbon fibre one in the end because it was the only way I could get back to work. It prevents my knee from hyperextending because it won't give but still enables me to bend my knee in the normal range of motion.
I think I'm right i saying that braces are usually better for long term use because they maintain normal movement but brace against abnormal movement. If you need to immobilise a joint for a short period then a splint prevents movement completely.
I hope that helps you a bit. If you are buying the item yourself then some websites give you guidance about what the product is ideal for.

[sarahh]

Hi Clarabel I have just seen your message. With regards to getting splints from the OT I phone up the OT dept at my hospital and it took 2 weeks for someone to get back to me as they didn't have a clue what I wanted. Eventually someone phoned and said I needed a refferal from either my GP or Rheumatologist to say that I needed splints etc, I got rheumy to do the refferal when I saw him in february and have just seen the OT last tuesday as she was booked up. I discussed with her how things are, she knew about hms which helped so didn't have to explain to her. I have splints for everyday at the moment and next time I see her she is going to get me resting splints for night time and thumb splints. She suggested thicker handled cutlery which I now have but you have to buy these yourself I got mine for £12.72 from a disability shop. I saw a Rhuematologist physio. I would definatly phone your OT dept and ask them do you need a refferal or can you self refer. I am glad I saw an OT and she is helping me.

Sarah x

[Zoe*]

Naama - have you tried the ' choice' thing on the NHS?
It basically means u can choose where u get treatment. I did it when i lived in middlesbrough to get treatment in leeds.

http://www.nhs.uk/conditions/patient-ch ... is-it.aspx

dont really know how to do links but thats a little about it.
Its really useful so try talking to your GP about it!
Hope that helps a little in getting some more useful treatment
x

[paw]

I am going to answer based on what my daughter told me about her knee and the supports I got for her.

She was having a bad time with her knees hyperextending and she strained a ligament on the medial side of one knee. She was really hurting and asked for a support. They have chairs by the pharmacy area so she tried a couple on. We got her a neoprene support with straps that velcro so you can adjust how tight you want it. She put it on and said "This feels GOOD " then she took it off so I could pay for it and said "Owwwww". After I laughed (it was silly!) I told her to put it back on and I just showed the clerk the box and told her she was wearing it so I could pay for the support.

I also got her a couple pull on elastic knee supports. She likes those too because they fit easier under her jeans.

She said the neoprene support still allows the knee to bend but it only has a "normal" range of motion. It keeps her from bending so far backwards -- which is just what she needed. The elastic ones are not as restrictive and they are good for days when she is a little wobbly but not injured.

I did find some lightweight supports that pull on that are made with lycra and not elastic and they are latex free. Maybe you can try something like that for your problem areas? Since you are sensitive to the neoprene, would wearing a sock or some cloth under the support be enough to keep you from reacting? Don't even try this if you have ever had a breathing reaction to the latex! It might work if you only have a mild skin reaction -- you can decide if you want to try it or if you should stay away from it entirely.

[sarahh]

Hi I have wrist/hand supports also waiting for thumb ones and night splints. I have found them really useful. My wrists hurt without them and feel week. A couple of weeks or so ago when I took my wrist splint off my left wrist subluxed they have really helped to support them. I can even drive in mine which helps.

[naama]

Our little corner of the world hasn't joined the dizzy heights of 'choice' yet. The only thing I was ever offered a choice for was gynae. Everything else has always been referred to the local hospital. Any referrals to London have been done by the hospital, not by the GP.

[sarahh]

Patient choice is everywhere now or rather it should be by now as the new ruling came in last month. My gp has reffered me to the Prof no problem. I know it used to be gp reffered to pct then pct would decide either yes or no for patient to be reffered.

[Rosie]

Hi Sarah

When you say 'everywhere' do you mean England? I have seen no sign of it here (wildest Wales) and I know that other NHS changes, like cutting waiting lists, are different here. I wouldn't be surprised if it is different in Scotland as well, they often seem to get things in place before anywhere else.



Rosie

[sarahh]

Hi Rosie

I thought it was everywhere its happened here anyway the freedom of choice where you want to be treted and by whom. Englad seems to have it anyway I thought it was the whole of the uk.