Opinions vary on whether wearing back belts and other braces actually creates muscle weakness.

Brace Yourself
Are these devices supporting and protecting or creating weakness and dependence?

A FRIEND once told me I was addicted to lip balm: My occasional use for dry, cracked lips had developed into regular applications throughout the day. As a result, this friend contended, my lips had forgotten how to lubricate themselves and had developed a dependence on lip balm.

Similar reasoning crops up every so often about sports braces. For ankles and knees. Back belts. Tennis-elbow straps. Are these devices truly helpful, or do they cultivate a dependence that's counter-productive to our strength and mobility?

Few if any folks argue that braces can be helpful immediately after an injury. But a problem can arise when one is used in place of rehabilitating that injury.

I've been guilty of this, when my eagerness to return to basketball after spraining an ankle wasn't matched by a devotion to exercises to help restore strength and range of motion. I've slipped on one of those canvas lace-up ankle braces with metal rods down each side and gone ahead anyway, usually giving it up once I'd regained more confidence.

Many folks, though, who have sprained ankles repeatedly - or want to keep from doing so - wear braces during all their sporting activities.

Fitness news you can use Lip-balm support It turns out I'm not alone in lip-balm dependence. Lip Balm Anonymous' Web site www.kevdo.com/lipbalm includes a self-evaluation quiz, 12-step program, testimonials, questions and answers, an "industry of addiction" section, "Important Dates in Lip Balm Anonymous History" and "The I Hate LBA Page," which has the subtitle, "Some people just don't get it." It's up to the visitor to decide whether the whole thing is tongue-in-cheek. Anti-depressive Aerobic exercise can significantly improve mental health and may be as effective as medication for relief of depression, according to research done at Duke University Medical Center. The study placed 156 volunteers with clinical depression into three treatment groups: antidepressants, group aerobics, and both. After 16 weeks, two-thirds of patients were no longer depressed, and those in all three groups were equally likely to have recovered. In a follow-up study six months later, those in the exercise group were less likely to relapse. Psychologist James Blumenthal speculated that the exercisers' sense of responsibility for their recovery might improve their long-term prospects for mental health, though he said the study didn't indicate antidepressants or psychotherapy weren't needed.

"Mostly I think braces will help a little bit, but you've got to do the rehab," said Howard Roth, a physical therapist and certified athletic trainer at Washington Institute of Sports Medicine in Kirkland. "Chronic ankle sprains usually need to get stronger. But you also need to work on flexibility, proprioception and motor sensory skills, to make your foot more aware of where it is in space."

Some ankle sprains aren't easily rehabilitated, said Bob Grams, an athletic trainer and assistant professor in the athletic department at Seattle Pacific University. "If ligaments have been damaged, you can do all the rehab in the world and you're still going to have ankle problems." Furthermore, he said, "Evidence is simply not there that wearing a brace weakens the ankle in any way."

Knee-brace approaches can vary, Grams said. A neoprene sleeve with a hole in the middle can help stabilize the kneecap, generally over the short term as thigh muscles are developed. A brace with hinge stays on each side can be employed to prevent reinjury from lateral forces; users often are weaned off after four to five weeks. A functional or de-rotational brace helps someone who's suffered a cruciate ligament tear, perhaps for six months to a year if the injury has been repaired, or even indefinitely for a partial tear that won't tighten up (again, thigh strengthening might help).

Tennis elbow straps are yet another story, Grams said. "They sort of change the biomechanical attachment of the tendon to the bone," shifting the stress to other tissue. Some people might be able to use one while improving stroke form, but Grams said others prone to developing elbow tendinitis may wear such a strap to prevent new flare-ups.

Back braces and weight-lifting belts may be the most hotly debated. Some studies show they ease stress on the discs between the back's vertebrae by providing intra-abdominal pressure, the clamping down of muscles (as in during childbirth). Other researchers contend that over time such bracing leads to weaker abdominal and back muscles.

"Most people don't hurt their backs lifting weights, they actually hurt them bending over to pick something up," said Heidi Orloff, chair of the exercise-science department at the University of Puget Sound. Muscles need to be strong yet also fire in the correct order, she said. "I'm not sure the muscles are learning that wearing a lifting belt."

Back belts may be useful for someone recovering from an injury, Orloff said, and she wouldn't encourage anyone to not wear one. "But I think if the purpose is to get stronger, you actually would be exercising more of your musculature by lifting less weight, without a belt."

Ongoing elbow pain from an overzealous painting session a few months ago has me considering one of those tennis-elbow straps. My knee, wrist and ankle braces are in storage, however, and I hope to keep them there.

Just don't ask me to give up my lip balm.

Molly Martin is assistant editor of Pacific Northwest magazine.