Muscle Regeneration in Polio Survivors and Bracing

Question: I am a polio survivor with PPS. Recently I began to suffer severe knee instability, but a sports medicine specialist recommended against braces, saying they would inhibit the muscles from regenerating. It seems to me that polio-atrophied muscles will not regenerate anyway and that braces would at least help to prevent collapse. Your thoughts?

Answer: If your knee instability is a result of polio-involved muscles around the knee weakening – especially the quadriceps muscle that extends the knee and must be sufficiently strong to prevent its buckling – then I totally disagree with the specialist who recommended against a brace. You will need a brace to stabilize the knee joint and prevent its collapse during walking. There are several different brace designs that can be considered, in addition to a traditional “locked-knee” brace, and the optimal brace will depend on your overall strength, alignment issues in adjacent
joints and your functional needs. You are right that doing nothing and waiting for muscle strength to improve by regeneration does not make sense for a polio survivor. If your knee instability is a result of ligament looseness, bracing may still be needed if the quadriceps muscle was significantly affected by polio and is very weak and/or unable to be strengthened by exercise. Please see a physical medicine and rehabilitation specialist familiar with post-polio syndrome for a second opinion.

Post-Polio Health (Vol. 26, No. 2, Winter 2010)