Knee Braces and Pickleball: Should We Award Extra Points for Wearing the Most?
By Mark C. Engasser, MD — Board-Certified Orthopedic Surgeon
In some pickleball circles, I think we should award extra points to the player wearing the most braces.
Look around the courts. Knee braces, elbow straps, wrist supports, ankle braces—and occasionally enough Velcro to outfit an entire orthopedic clinic.
As we get older, a little extra support can be a wonderful thing. But before strapping on another piece of orthopedic equipment, it's worth asking a simple question:
What exactly am I trying to accomplish with this brace?
First, Understand Why You're Wearing It
Bracing can be helpful, particularly for mature athletes dealing with chronic joint problems. But there's an important distinction between supporting a knee that has a chronic condition and attempting to play through an injury that hasn't adequately healed.
If you're recovering from a significant knee injury and simply cannot play without a brace, you may not be ready to return to the court. Your time might be better spent completing rehabilitation, restoring strength, and improving stability.
A brace should complement rehabilitation—not replace it.
There is also a longstanding concern that relying excessively on certain braces might encourage people to neglect the muscles that normally stabilize their joints. Evidence that routine knee bracing directly causes muscle weakness is limited, but the underlying message remains important:
Don't let the brace become a substitute for maintaining strength and conditioning.
For chronic conditions such as knee osteoarthritis, however, a well-chosen brace can make activity more comfortable and help keep you playing.
What Does a Knee Brace Actually Do?
For most recreational senior athletes, knee bracing provides some combination of:
- Compression and a sense of support
- Warmth around the joint
- Improved comfort during activity
- Increased awareness of knee position
- In selected designs, additional patellar guidance or unloading of a painful compartment
What it generally cannot do is turn a seriously unstable knee into a completely stable one.
For example, a player with chronic ACL deficiency and substantial instability shouldn't assume that an ordinary elastic sleeve will prevent the knee from giving way. Certain specialized functional braces may provide additional support, but they don't restore normal ligament function.
And here's another consideration: More brace doesn't necessarily mean more benefit.
There's always a trade-off between support, restriction, breathability, and comfort. Some braces are so bulky, hot, or uncomfortable that they spend more time in a drawer than on a knee.
I've seen plenty of expensive orthopedic devices meet that fate.
You Probably Don't Need an Expensive Custom Brace
One of the most useful things for senior pickleball players to understand is that many common knee supports can be selected and fitted without a physician's prescription or a custom fitting.
For mild arthritis symptoms, occasional aching, or a desire for compression and comfort, an inexpensive over-the-counter sleeve may be entirely adequate.
You can often find suitable braces at a pharmacy, sporting goods store, or online retailer.
Start with a simple, reasonably priced option. Follow the manufacturer's sizing instructions, usually based on measurements around the knee or leg. The brace should feel snug but not painfully tight, restrict circulation, or cause numbness.
Then try walking, bending, squatting, and moving as you would on the pickleball court.
Does it stay in place? Can you move comfortably? Does it provide the support you're looking for?
If the answer is yes, you may have found your brace.
You don't necessarily need the most expensive model—or the one that looks like it belongs on an NFL offensive lineman.
Of course, significant ligament instability, postoperative restrictions, or specialized unloading needs may require professional evaluation and fitting.
Knee Brace Materials: What's the Difference?
There are several common materials and designs, each with advantages and disadvantages.
1. Neoprene: The Traditional Workhorse
Neoprene is a synthetic rubber material that is flexible, durable, and provides compression and warmth.
It's been used in orthopedic supports for decades and remains popular.
Manufacturers offering neoprene-style braces include Mueller, McDavid, Breg, DonJoy, and others.
Advantages: Durable, supportive, relatively inexpensive, and available in many designs with straps, cutouts, pads, or hinges.
Disadvantages: Neoprene doesn't breathe particularly well. On a hot Naples pickleball court, it can trap heat and perspiration, retain odors, and occasionally irritate the skin.
It's excellent if you want warmth. Less excellent if your knee already feels like it's playing in a sauna.
2. Knit Compression Sleeves: My Practical Favorite for Many Players
Modern knitted compression sleeves are often a terrific alternative.
Manufacturers such as Bauerfeind, ACE, and FUTURO offer breathable fabric designs that are lightweight, comfortable, and easy to use.
Some incorporate silicone pads around the kneecap to provide localized compression or patellar guidance.
Advantages: Comfortable, breathable, washable, easy to put on, and generally less bulky than neoprene.
Disadvantages: Some gradually lose elasticity with repeated use and washing, and they don't provide the mechanical stability of a properly fitted hinged brace.
For many senior pickleball players seeking modest support and comfort, this is an excellent place to start.
3. Drytex: A More Breathable Alternative
Drytex is a material used in certain DonJoy braces as an alternative to neoprene.
It combines synthetic fabrics designed to provide compression and support while allowing better airflow.
This can be particularly appealing for players who dislike the heat and moisture associated with traditional neoprene.
It offers a useful middle ground between the feel of a conventional brace and the comfort of a more breathable fabric.
4. Silicone Web Braces: An Interesting Design
Some braces use flexible silicone web structures rather than traditional fabric sleeves.
One example is the DonJoy Reaction WEB brace.
Its open design allows airflow, while the flexible web is intended to help distribute forces and provide support around the front of the knee.
These designs may appeal to players with certain types of anterior knee pain, particularly discomfort around the patellofemoral joint.
Some are worn with an undersleeve to improve comfort and reduce migration.
They are not appropriate for every knee problem, but they illustrate how brace design has evolved beyond a simple neoprene tube.
The Most Important Feature? Comfort.
Here's something I've learned over many years in orthopedic surgery:
The most sophisticated brace in the world is worthless if you won't wear it.
An expensive brace that slides down your leg, pinches behind your knee, or makes you miserable after 20 minutes isn't doing you much good.
A relatively inexpensive compression sleeve that fits properly, feels comfortable, and provides the support you want may be a far better investment.
And don't confuse price with effectiveness. More expensive doesn't automatically mean better.
For many mature recreational athletes, the process can be surprisingly simple:
Start with an affordable brace, make sure it fits correctly, and see how it performs during ordinary activity before relying on it during competitive play.
If your knee repeatedly gives way, locks, swells significantly, or feels unstable despite a brace, that's a different situation—and one worth evaluating rather than simply purchasing a bigger brace.
Dr. Engasser's Perspective
After a career in orthopedics and plenty of time on the pickleball court, I've come to appreciate the value of keeping things simple.
Most senior players don't need a complicated or expensive knee brace. They need something that fits, provides a reasonable degree of support, and allows them to move comfortably.
Don't forget that strengthening your quadriceps, hamstrings, hips, and other supporting muscles is at least as important as the brace you choose.
My rule: The best knee brace is the one that's comfortable, gives you the support you need, stays in place, and simply works.
And if you're wearing braces on both knees, both elbows, and one wrist, perhaps we really should consider awarding you an extra point.
At least for effort.
Dr. Pickleball's Musings offers general medical education and personal observations. It is not a substitute for individualized medical evaluation or treatment.