What Do Knee Sleeves Do?

Knee sleeves are common gym accessories worn by competitive lifters, athletes using strength training for sport, and even recreational gym goers in an effort to reduce pain and the risk of injury while also improving performance. It makes sense, too, as the knee joint is an area where people often report pain during activity, both inside the gym and out. [1]

Between the purported benefits and the history of knee accessories to help with pain dating back to about 2500 BC in Egypt, it may seem like investing in knee sleeves should be a no-brainer. [2] However, there are many questions surrounding knee sleeves, like do they actually work and, if so, how should one go about picking the right knee sleeve?

In this article, we’ll cover what knee sleeves are and aren’t, whether or not they work for performance, pain, and injury, how to pick the right knee sleeve, and more. Let’s start with some science and see if knee sleeves are worth the hype. 

What Are Knee Sleeves?

Knee sleeves are a specific type of knee braces that are differentiated by the materials used, the amount of support offered, and their clinical use.

Knee Sleeves

Recently, a review in a leading orthopedic surgery journal described a number of different categories of knee braces: (1) prophylactic knee braces, (2) functional knee braces, (3) unloader braces, (4) patellofemoral braces, (5) rehabilitative braces, and (6) knee sleeves. [3] We won’t go into the specifics of each type as this is beyond the scope of this article, but knee sleeves and wraps are commonly used during resistance training, so we’ll give you some information on those.

Knee wraps are typically made from woven elastic materials and are wrapped tightly around the knee. During the descent of the squat, the knee wraps store elastic energy with knee flexion, which is then applied during the upward phase and knee extension. [4] As a result, most people will squat more weight with knee wraps, which correlates with longer and/or more tightly wrapped knee wraps. The technical rules in competitive powerlifting typically set limits on a knee wrap’s maximum width length, with longer, wider wraps typically being more supportive. For example, The International Powerlifting Federation allows competitors to use wraps that have a maximum length of two meters and a maximum width of eight centimeters.

In contrast, knee sleeves are made from neoprene or similar elastic material that does not provide structural support or store appreciable amounts of elastic energy with knee flexion. Rather than being “wrapped” around the knee, they are a hollow cylinder that is pulled over the knee joint.

Now that you know what exactly knee sleeves are, let’s take a closer look at how they work and why you should wear one.

How Do Knee Sleeves Work?

Let’s first clear any misconceptions. Knee sleeves don’t actually provide any structural support due to their construction. However, they do facilitate movements that have a greater range of motion and allow individuals to lift heavier. And how do they do this, exactly?

Well, it’s widely believed that they work because they offer warmth and compression, as well as some feedback on joint position. [5,6,7]

These mechanisms are reasonable hypotheses for “how” knee sleeves work, but more research is needed to feel confident about them. Let’s look at some research on outcomes.

What Are The Benefits of Wearing Knee Sleeves?

There’s ample research on knee sleeves and pain, but not much on injury risk or performance during activity, especially lifting weights. Still, the existing science can provide insights into what one should expect from wearing knee sleeves, should they choose to do so. 

Decreasing Risks of Pain And Injury

As mentioned above, there’s not much data on knee sleeves and injury risk reduction, especially as it pertains to exercise. If forced to speculate, it is unlikely that knee sleeves alter the incidence of knee injury during activity.

If forced to speculate, the effects are likely similar to using a lifting belt, where multiple studies across various fields have continually shown that lifting belts don’t reduce the risk of injuries, nor do they improve performance enough to make up for lost or restricted training days. So, we could say the same for knee sleeves. [7,8,9]

However, when we talk about decreases in knee pain while using sleeves, we have more solid evidence to discuss. Patients with knee osteoarthritis commonly show deficits in quadriceps muscle strength, which correlates well with both function and pain. [10]

In those with knee pain secondary to osteoarthritis, knee sleeves have been shown to reduce pain severity, improve knee stability, and increase the individual’s ability to participate in exercise, which is important to managing the condition. [11,12,13]

Improvements in Strength Performance

With respect to strength, knee sleeves do not appear to change squat mechanics significantly. However, they do appear to have a rather modest effect on maximal strength performance in the squat based on available evidence. The use of knee sleeves tends to improve subjective ratings of comfort and stability compared to bare knees while also adding about ~ 3% to a squat 1RM in trained subjects compared to placebo knee sleeves, which were very loose and offered no compression. [14]

It should also be noted that wearing an even tighter knee sleeve, e.g. one size down from what the manufacturer recommended, did not further increase squat 1RM performance. [15] It should be noted that not all studies on knee sleeves and squat performance show an improvement, though none show harm to performance either. [16]

Our main takeaway from all this information is that wearing knee sleeves may increase strength performance during squats and similar movements. Using sleeves may also improve function and reduce knee pain in some individuals during activity, especially in those with osteoarthritis who prefer a knee sleeve.

In the next sections, we’ll discuss our experience for when to wear knee sleeves as well as how-to go about choosing the right one for you.

When to Wear a Knee Sleeve

Using Knee Sleeves

Knee sleeves are probably best used during squats and squat-pattern type movements, e.g. leg press, split squats, lunges, and so on. They also can be helpful for higher velocity movements sometimes performed in training such as the Olympic lifts and various strongman exercises.

While some people do wear them during deadlifts, we do not routinely recommend this unless someone has knee pain during deadlifts, which is relatively rare. With proper deadlift mechanics, the knee sleeves can get in the way of the bar path and compromise efficiency.

Still, Wearing them is mostly personal preference that should boil down to a simple question: Does wearing the knee sleeve allow training this exercise more productively than without?

In this case, productive means with less pain, fear of movement, more volume, and at the appropriate intensity.

If you’re on the fence about it, a good rule of thumb is that if the movement is relatively light, and/or involves a tempo component, can be performed pain free, and/or is one sided/unilateral, the knee sleeves can probably stay in the gym bag.

How to Choose a Knee Sleeve (Best Knee Sleeves)

As far as choosing a knee sleeve, it’s best to use the manufacturer’s recommended sizing and measuring technique. We would not recommend sizing down since there’s little apparent benefit there to performance, but they do tend to be harder to put on. Ultimately though, sizing is a personal preference.

Knee Sleeves for Powerlifting and Strength Training: SBD Apparel Powerlifting Knee Sleeves

For those interested in maximal support, e.g for powerlifting or strength training, we recommend a 7mm knee sleeve like that from SBD, though there are other brands offering good products too. SBD also offers these in alternate colorways: SBD Apparel Momentum Powerlifting Knee Sleeves.

The SBD knee sleeves are relatively easy to put on when sized appropriately, hold up well over time, and offer great support during heavy lifting, while not being too stiff to reduce range of motion or alter squat mechanics.

For competitors, these sleeves are also competition-legal, as they meet IPF, IWF, and USAPL standards. Before going to a meet, make sure your equipment is on the approved list to avoid any mixups before the competition.

Knee Sleeves for Strength Training That Are Easy to Put On: Rogue 7MM Knee Sleeve

For those who still want a good amount of support while lifting, but who want an easier knee sleeve to put on, it’s hard to beat the classic Rogue or Rehband 7mm knee sleeve.

They’re easy to but on because they are a little more flexible, which also makes them versatile for strength training, metcons, strongman events, and/or Olympic lifting. They are also approved by both the IPF and IWF for competitions.

Knee Sleeves for Exercising With Knee Pain That Are Easy to Put On: Rogue 5MM Knee Sleeve or SBD Apparel Weightlifting Knee Sleeves

If you’re looking for something with support that’s super easy to put on but not quite as stiff of a knee sleeve, we recommend a 5mm thick knee sleeve from SBD, Rogue, Rehband, or similar.

These are good choices in the setting of knee pain in folks who exercise and are active but who would balk at trying to put on a stiff, strength-focused knee sleeve. For clients, parents, or even your own use in more dynamic activities, a 5mm knee sleeve can be very handy.

As an aside, this author used 5mm knee sleeves during a recent powerlifting meet and was able to squat a then-PR 280 kilograms (616 pounds).

So, that wraps it up for our knee sleeve recommendations. While we believe that these are some great options on the market, we acknowledge that we have not personally used or seen every knee sleeve available. There are a lot of good products, but these are some of our tried and tested favorites.

Knee Sleeves Recap

Overall, knee sleeves are likely to improve performance and may reduce knee pain during exercise. Here are some key points:

  • Knee sleeves provide warmth and compression while enhancing proprioception in some individuals.
  • Knee sleeves can improve lifting performance and reduce knee pain.
  • Knee sleeves are best used in squats, squat variations and other heavy lifts. However, we suggest you avoid using them during deadlifts, unless you’re experiencing knee pain.
  • Avoid sizing down. You want a snug and comfortable fit that can provide the right amount of compression without cutting off blood flow.
  • 7mm sleeves are ideal for powerlifters and other heavy lifts, while 5mm sleeves are ideal for functional training and dynamic lifts.
  • Knee sleeves are not necessary, and you should try them out to see if they can aid your lifting performance at all before making a purchase.

Like most other types of supportive equipment, using them is personal preference. We have different knee sleeves we recommend that were discussed in the section above. All in all, choosing the right sleeve, or choosing one at all, depends on your specific training preferences and needs.

References

  1. Aasa U, Svartholm I, Andersson F, et alInjuries among weightlifters and powerlifters: a systematic reviewBritish Journal of Sports Medicine 2017;51:211-219.
  2. Clark, William Arthur. “HISTORY OF FRACTURE TREATMENT UP TO THE SIXTEENTH CENTURY.” Journal of Bone and Joint Surgery, American Volume 19 (1937): 47-63.
  3. Kemker, B. P., 3rd, Kankaria, R., Patel, N., & Golladay, G. (2021). Hip and Knee Bracing: Categorization, Treatment Algorithm, and Systematic Review. Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews, 5(6), e20.00181-12. https://doi.org/10.5435/JAAOSGlobal-D-20-00181
  4. Lake, J. P., Carden, P. J., & Shorter, K. A. (2012). Wearing knee wraps affects mechanical output and performance characteristics of back squat exercise. Journal of strength and conditioning research, 26(10), 2844–2849. https://doi.org/10.1519/JSC.0b013e3182429840
  5. Tiggelen DV, Coorevits P, Witvrouw E. The effects of a neoprene knee sleeve on subjects with a poor versus good joint position sense subjected to an isokinetic fatigue protocol. Clin J Sport Med. 2008 May;18(3):259-65. doi: 10.1097/JSM.0b013e31816d78c1. PMID: 18469568.
  6. Bottoni G, Herten A, Kofler P, Hasler M, Nachbauer W. The effect of knee brace and knee sleeve on the proprioception of the knee in young non-professional healthy sportsmen. Knee. 2013 Dec;20(6):490-2. doi: 10.1016/j.knee.2013.05.001. Epub 2013 May 28. PMID: 23726648.
  7. Wassell, J T et al. “A prospective study of back belts for prevention of back pain and injury.” JAMA vol. 284,21 (2000): 2727-32. doi:10.1001/jama.284.21.2727
  8. Martimo, Kari-Pekka et al. “Effect of training and lifting equipment for preventing back pain in lifting and handling: systematic review.” BMJ (Clinical research ed.) vol.336,7641 (2008): 429-31. doi:10.1136/bmj.39463.418380.BE
  9. Reddell, C R et al. “An evaluation of a weightlifting belt and back injury prevention training class for airline baggage handlers.” Applied ergonomics vol. 23,5 (1992): 319-29. doi:10.1016/0003-6870(92)90293-5
  10.  van der Esch M, Knoop J, van der Leeden M, Voorneman R, Gerritsen M, Reiding D, Romviel S, Knol DL, Lems WF, Dekker J, Roorda LD. Self-reported knee instability and activity limitations in patients with knee osteoarthritis: results of the Amsterdam osteoarthritis cohort. Clin Rheumatol. 2012 Oct;31(10):1505-10. doi: 10.1007/s10067-012-2025-1. Epub 2012 Jun 23. PMID: 22729472.
  11. Bryk FF, Jesus JF, Fukuda TY, Moreira EG, Marcondes FB, Santos MG. Immediate effect of the elastic knee sleeve use on individuals with osteoarthritis. Rev Bras Reumatol. 2011 Sep-Oct;51(5):440-6. English, Portuguese. PMID: 21952996.
  12. Cudejko T, van der Esch M, van der Leeden M, Roorda LD, Pallari J, Bennell KL, Lund H, Dekker J. Effect of Soft Braces on Pain and Physical Function in Patients With Knee Osteoarthritis: Systematic Review With Meta-Analyses. Arch Phys Med Rehabil. 2018 Jan;99(1):153-163. doi: 10.1016/j.apmr.2017.04.029. Epub 2017 Jul 4. PMID: 28687317.
  13. Finestone A, Radin EL, Lev B, Shlamkovitch N, Wiener M, Milgrom C. Treatment of overuse patellofemoral pain. Prospective randomized controlled clinical trial in a military setting. Clin Orthop Relat Res. 1993 Aug;(293):208-10. PMID: 7687940
  14. Sinclair, J., Mann, J., Weston, G. et al. Acute effects of knee wraps/sleeve on kinetics, kinematics and muscle forces during the barbell back squat. Sport Sci Health 16, 227–237 (2020). https://doi.org/10.1007/s11332-019-00595-5
  15. Machek SB, Cardaci TD, Wilburn DT, Cholewinski MC, Latt SL, Harris DR, Willoughby DS. Neoprene Knee Sleeves of Varying Tightness Augment Barbell Squat One Repetition Maximum Performance Without Improving Other Indices of Muscular Strength, Power, or Endurance. J Strength Cond Res. 2021 Feb 1;35(Suppl 1):S6-S15. doi: 10.1519/JSC.0000000000003869. PMID: 33201154.
  16. Bennett, H., Trypuc, A., Valenzuela, K., & Sievert, Z. (2021). Wearing knee sleeves during back squats does not improve mass lifted or affect knee biomechanics. Human Movement, 22(2), 32-42. https://doi.org/10.5114/hm.2021.100012

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