Result of Knee Sleeve Poll

by Steve Gardner, IAWA President

Announcement – Knee Sleeves – An IAWA Worldwide Members Poll

As you will all be aware, there was a proposal recently being put to IAWA about allowing the use of ‘Knee Sleeves’ to be worn in all lifts when competing with IAWA. The Knee Sleeves were not being proposed to be performance enhancing or assisting, but simply, we were led to believe, to help keep the lifters knee joints warm and comfortable. Whilst that proposal could be easily understood there would of course be concern that this might well lead eventually to items being worn that would in fact become performance enhancing. It was decided that in this unusual circumstance, rather than let the issue be decided by the group of members that happen to be in Kansas this October, it would be a far better way to decide the issue if we conducted an individual poll of all IAWA members in all Countries. Many of those who did comment, made the point that it was easy enough to wear such an item whilst training and warming up, and then remove them whilst going onto the platform to perform lifts. Of those who spoke for allowing the move, most said that they not wish to see knee supports used as an aide to lifting, and many then went on to say that in fact, they couldn’t really see the point of bringing in such a move if it wasn’t going to be of any real assistance. IAWA does allow the use of wrist wraps, a belt (and knee wraps for the front and back squat only) and in the event, it seems that is how the IAWA membership want to see it remain.

My thanks go to Al Myers in the USA and Robin Lukosious in Australia for helping me conduct the poll, which was quite an undertaking. My thanks again to all those members who returned poll forms, and for the many constructive comments that were made ‘for and against’ and thank you to Dan Wagman from the US who forwarded a full report on the matter. The poll return was roughly 40% of the total membership who were polled. Of those that made returns, the result was 40% for the proposal and 60% against the proposal. The matter is now closed, and IAWA will continue without knee sleeves as per the majority vote result, in line with our democratic principle.

Last Day for Knee Sleeve Poll

by Al Myers

I just want to remind everybody that today is the LAST DAY to cast your vote in the knee sleeve poll.  The deadline is September 1st, so tomorrow I will be turning the USAWA poll results into IAWA President Steve Gardner so he can tabulate the “Worldwide vote”.  At that time you have “missed the boat” to cast a vote in this poll.   Shortly after that, the poll results will be announced on the website. 

This issue has been a “hotly contested” discussion item on the USAWA Discussion Forum.  It has been the most discussed single thread the forum has seen, and has “by far” the most views (closing in on 1000 views!!!).  I want to thank everyone who participated in this forum discussion, because the opinions expressed by everyone represent the voice of the USAWA.   I know there are those that have strong feelings on this (for and against) and will be disappointed however the poll turns out (either way), but I hope that those “hard feelings” can be placed to the side, and a sense of pride can be felt by knowing the fact that the USAWA now operates in a democratic fashion, with the direction of the organization determined by the majority vote of the membership.  I grant that there are still “rules in the book” that seem hypocritical, but this healthy debate brought those issues to the surface and now can be addressed in the future.

IF YOU HAVEN’T VOTED YET – CAST YOUR VOTE TODAY

Knee Sleeve Analysis

By Dan Wagman, PhD., CSCS

Consultant, Body Intellect

Publisher/Editor in Chief, Journal of Pure PowerBody Intellect Sports Performance Enhancement Consortium

As part of my training for worlds, I have visited the USAWA website off and on. A topic that caught my attention is the consideration by the IAWA to allow lifters to use knee sleeves. I thought that a rational and scientific analysis of this question might aid in the decision-making. Thus, I will look at what this sport stands for, what research shows on the topic of knee sleeves from a health and performance enhancement perspective, and what the sum of that information indicates in terms of allowing knee sleeves in all-round weightlifting.

ADVOCATING RAW STRENGTH

As step one let’s clarify what the sport of all-round weightlifting stands for. The mission of all-round weightlifting is to test pure, raw, unadulterated maximal strength in a large number of different exercises. A review of IAWA rules supports this. Only in the squat and front squat is the type of equipment that artificially enhances the strength of an athlete—in the form of knee wraps—allowed. This, despite the fact that many other lifts also test the muscles that provide strength and stability to the knee.

In the case of the squat and front squat the main mission of all-round weightlifting seems to be compromised. But consider that in all other lifts the use of performance-enhancing devices isn’t permitted and one must still come to the conclusion that in this sport the use of implements that artificially inflate an athlete’s strength is contrary to the sport’s purpose, mission, and conviction. Indeed, even the use of minor aids such as taping of the thumbs and/or fingers (as permitted in weightlifting) or the use of baby powder for the deadlift (permitted in powerlifting) is not allowed in all-round weightlifting. Though the use of wrist wraps and a belt is authorized, they don’t fall into the same category as knee wraps; the former’s primary function is to only provide joint stability as opposed to outright performance enhancement by aiding in the movement of the joint through its range of motion as knee wraps do. Admittedly, there does appear to be a lack of consistency within the rules of the sport regarding the use of equipment. However, it is equally apparent that because in the overwhelming majority of lifts no outright performance enhancing equipment such as knee wraps is allowed, the sport’s main mission is to remain pure and uncontaminated in the test of maximal strength.

WHY STRAY?

With the fundamental purity of all-round weightlifting in mind, what argument would support changing the rules to allow for the use of knee sleeves? Could it be overall knee health? From a sports medicine perspective, there is absolutely no reason, nor evidence, as to why a healthy knee would require any degree of support, or warming, or anything else in order to move through its full range of motion, even under the sort of substantial load you would experience from, say, a heavy squat.

Consider that one of the ligaments of the knee (posterior cruciate ligament or PCL), designed to keep the thigh and leg together firmly, has been found to have an ultimate strength of up to around 1,000 pounds and another (anterior cruciate ligament or ACL) up to 540 pounds (10, 12, 15), and that the forces of a squat would actually be distributed among a total of four ligaments (though to varying degrees), not to mention tendons and muscles and bones, then it seems clear that the knee joint doesn’t need any artificial help. Of course you might argue that the stresses of lifting weights adds to the stresses of the knee. But first you ought to consider that there is a training effect. In other words, as you train to get stronger so does the rest of your body, including all structures of the knee from exercises that stress that joint. Then consider that research has shown that the max forces of a 615-pound squat only amount to about 450 pounds of shearing forces upon the most highly stressed ligament of the knee during that exercise (PCL) (9), and you’ll have to again conclude that the knee doesn’t require any additional help.

ON HEALTH

But what about an unhealthy knee, say a knee with arthritis? Might that knee benefit from a knee sleeve? And does that benefit constitute the type of performance enhancement that would violate the spirit of all-round weightlifting? Allow me to share my findings with you from a search of all relevant sports medicine research on knee sleeves.

In a review study that looked at a total of 444 people with arthritic knees, knee sleeves improved pain over just taking medication (non-steroidal anti-inflammatory drugs).(2) In another study that looked at overuse injuries to the knee (not arthritis) in 395 army recruits, those that wore a simple elastic knee sleeve had significantly better comfort levels than those who didn’t.(5) Another study wanted to find out about the time-period of improvement.(11) Here, in the beginning weeks of the study patients with osteoarthritis who took meds and wore a knee sleeve did better than those who only took meds. But toward the end of the two-month study there was no difference between using a knee sleeve or just taking meds. Another study also found that wearing an elastic knee sleeve provided immediate pain relief for subjects with osteoarthritis who participated in a stair-climbing power test.(3)

So what about the heat-retaining aspect of a knee sleeve? Many athletes believe this to be perhaps the most important aspect of a knee sleeve. A study conducted at the Indiana University School of Medicine found that the differences were so minor between the knee sleeve and the no knee sleeve conditions, that the investigators couldn’t draw any meaningful conclusions.(8) Of course you have to take exercise into consideration, too. So a study seeking to find out what differences might exist in treating an arthritic knee with exercise, a knee brace, exercise and knee brace, or exercise and knee sleeve found no statistical differences between any of the treatments.(7) In other words, if you exercise, you get just as much pain relief as you would from adding a knee brace or a knee sleeve.

PERFORMANCE ENHANCEMENT

A critical concern for any sports organization has to deal with what sort of ergogenic aids it will or won’t allow. As it pertains to knee sleeves, one must obviously consider the type of knee sleeve because they aren’t all created equal. I have a knee sleeve that I received as a promotional gift from Titan Support Systems. It is difficult to argue that this knee sleeve is the same as what you would get from a pharmacy or physical therapist; it’s very thick, tight, and rather non-elastic providing much spring to a squat. Unfortunately, there is no research available that sought to quantify the differences in ergogenic properties from this sort of knee sleeve to the one manufactured for people suffering from arthritis. Despite the lack of empirical evidence, it seems rather clear that there is little difference between the Titan knee sleeve and knee wraps, especially if you also consider that a tighter knee sleeve, one that might require two people to don, just like tighter knee wraps will enhance performance more than loser ones. And of course, the more stability a knee sleeve provides the joint, it naturally follows that it will also provide resistance to bending the joint, which in turn means more assistance during lockout.

But performance enhancement doesn’t need to be limited to the obvious, such as aiding the knee in locking out. It can also entail more subtle things such as how a knee sleeve might be able to benefit your balance, kinesthetic feedback, brain signaling, etc. Naturally, the person who doesn’t get this sort of benefit is at a sporting disadvantage. Please consider that all of the findings that follow employed a medical knee sleeve, not the kind you find in powerlifting circles. Now, obviously balance is a big part in most if not all lifts contested in all-round weightlifting, but perhaps most in one-armed lifts. With that in mind, consider that patients wearing a knee sleeve were able to balance better in static and dynamic conditions compared to those who didn’t wear such a sleeve.(4)

Part of being able to balance effectively means that you actually have a sense of where your body is in space. A lot of this sort of kinesthetic feedback comes from the joints. So might wearing a knee sleeve improve a person’s sense of knee joint position during a leg extension and leg press? Yes, but perhaps the most interesting finding of a study that looked precisely at that was that the degree of benefit derived from wearing a knee sleeve was highly person-dependent.(1) In other words, some people got a lot from it, others much less. Another similar study found that wearing a knee sleeve consistently improved proprioceptive acuity, meaning that your sense of position and movements are enhanced.(6) Of course as an athlete you have to deal with the effects of fatigue. Obviously, as you fatigue your performance will suffer. A study published in the Scandinavian Journal of Medicine and Science in Sports found that by wearing a knee sleeve while fatigued, joint position senses were significantly enhanced.(14)

From a scientific perspective, it seems rather clear that wearing a knee sleeve can be beneficial in terms of enhancing performance. But what could be causing this? Scientists from the Department of Rehabilitation Sciences and Physiotherapy at Ghent University Hospital in Belgium looked at brain activity while wearing a knee sleeve.(13) They used a method called functional magnetic resonance imaging, which allows you to watch changes in the brain as they occur. What they found is that wearing a knee sleeve while moving influences brain activity in a positive way.

FAIR COMPETITION?

A logical and rational approach to answering the question regarding knee sleeves in all-round weightlifting must first address whether doing so would compromise what the organizations that govern this sport stand for. In this case, it seems clear that the overwhelming evidence stands for testing maximal strength sans any type of equipment that might enhance performance. Of the over 100 lifts that can be contested, only the squat and front squat allow for performance-enhancing knee wraps. Though perhaps misguided, to the rational person this only constitutes an aberration to the overall mission of the sport, not necessarily a precedent for allowing additional equipment.

And yet one must ask that if it’s indeed permissible to use knee wraps in two lifts, by what logic would it not be permissible to use the exact same equipment in all similar lifts? And by this extension of rational thought, why would knee sleeves not be permissible? Of course if they do become permissible, one must also ascertain under what rules of logic would it then not be permissible to use elbow sleeves? After all, an argument based on anatomy and physiology would fall way short in allowing for a sleeve around the large and powerful knee joint, yet not for the elbow joint.

Clearly the research on knee sleeves in an arthritic population shows that it can hold many benefits from pain reduction to increased proprioception and being able to deal with the effects of fatigue. A legitimate need to wear a knee sleeve would be having an arthritic knee. But from an organizational perspective, how does one determine the degree of arthritis and the extent to which it limits the athlete and causes pain? Does that athlete have to bring a doctor’s note to competition? How else would one determine wether a competitor suffers from this sort of medical condition, or a related one, or just wants to have an unfair advantage over his/her competition? And why should an allowance be made in the first place for an injured athlete? Isn’t sport supposed to test the most capable of bodies? It’s one thing to allow a person to use drugs to control pain, an entirely different situation for allowing the use of mechanical devices a person wears to control pain (and thus enhance performance).

In the final analysis it seems that the first test is what the sport of all-round weightlifting stands for. With that in mind, the only rational answer to the knee sleeve question is not to permit it for any lift. The second tier of reasoning ought to look at any anatomical, physiological, or biological need for the use of knee sleeves. As we have learned, the knee and its associated structures are immensely strong, rendering the need of knee sleeves gratuitous, even in the arthritic knee as exercise controls pain well. And in all-round weightlifting, we sure exercise.

References

1. Birmingham, T.B., et al. Effect of a neoprene sleeve on knee joint position sense during sitting open kinetic chain and supine closed kinetic chain tests. American Journal of Sports Medicine. 26(4):562-566, 1998.

2. Brouwer, R., et al. Braces and orthoses for treating osteoarthritis of the knee. Cochrane Database Systematic Reviews. 25;(1):CD004020, 2005.

3. Bryk, F., et al. Immediate effect of the elastic knee sleeve use on individuals with osteoarthritis. Revista Brasileira De Reumatologia. 51(5):440-446, 2011.

4. Chuang, SH., et al. Effect of knee sleeve on static and dynamic balance in patients with knee osteoarthritis. Journal of Medicine and Science. 23(8):405-411, 2007.

5. Finestone, A., et al. Treatment of overuse patellofemoral pain. Prospective randomized controlled clinical trial in a military setting. Clinical Orthopaedics And Related Research. 293:208-10, 1993.

6. Herrington, L., et al. The effect of a neoprene sleeve on knee joint position sense. Research in Sports Medicine. 13(1):37-46, 2005.

7. Lun, V., et al. Effectiveness of patellar bracing for treatment of patellofemoral pain syndrome. Clinical Journal of Sports Medicine. 15(4):235-240, 2005.

8. Mazzuca, S.A., et al. Pilot study of the effects of a heat-retaining knee sleeve on joint pain, stiffness, and function in patients with knee osteoarthritis. Arthritis and Rheumatism. 51(5):716-721, 2004.

9. Nissel, R., et al. Joint load during the parallel squat in powerlifting and force analysis of in vivo bilateral quadriceps tendon rupture. Scandinavian Journal of Sports Science. 8:63-70, 1986.

10. Noyes, F., et al. Biomechanical analysis of human ligament grafts used in knee-ligament reparis and reconstructions. Journal of Bone and Joint Surgery. 66A:344-352, 1984.

11. Pajareya, K., et al. Effectiveness of an elastic knee sleeve for patients with knee osteoarthritis: a randomized single-blinded controlled trial. Journal of the Medical Association of Thailand. 86(6):535-42, 2003.

12. Race, A., et al. The mechanical properties of the two bundles of the human posterior cruciate ligament. Journal of Biomechanics. 27:13-24, 1994.

13. Thijs Y., et al. Does bracing influence brain activity during knee movement: An fMRI study. Knee Surgery, Sports Traumatology, Arthroscopy. 18(8):1145-1149, 2010.

14. Van Tiggelen, D., et al. The use of a neoprene knee sleeve to compensate the deficit in knee joint position sense caused by muscle fatigue. Scandinavian Journal of Medicine and Science in Sports. 18(1):62-66, 2008.

15. Woo, S., et al. Tensile properties of the human femur-anterior cruciata ligament-tibia complex. The effects of specimen age and orientation. American Journal of Sports Medicine. 19:217-225, 1991.

More on Knee Sleeves

by Al Myers

In today’s blog,  the IAWA President Steve Gardner revealed a poll concerning the use of knee sleeves in the IAWA, of which the USAWA is a part of internationally.  This issue was brought forward at the USAWA National Meeting in Las Vegas, and a motion was made and passed to refer it the IAWA Technical Committee to evaluate the “pros and cons” of it before presentation at the IAWA World Meeting in Salina this fall, for the IAWA membership to vote and decide.  I felt this was the right move, as I have said, this issue is WAY BIGGER than the USAWA, and ALL countries should have a vote in it.  If the USAWA allowed knee sleeves while everyone else in the IAWA didn’t, USAWA lifters would be lifting with different rules at the IAWA competitions.  And what about World IAWA records?  It would technically make all USAWA events not eligible for World Record consideration if the USAWA allowed knee wraps while the “rest of the World” didn’t. 

I feel the IAWA Technical Committee is doing the right thing here in polling all members of the organization in their feelings on this issue.  That way, it is clear how the membership feels as a whole, not just the membership that is present at the World Meeting.  This makes this poll very important.  Also, this is not an absolute vote for or against the use of knee sleeves, but just a poll to determine how the majority feels.  That way at the meeting the voting membership present will know the true overall feelings of the IAWA membership in helping decide how to vote. 

Steve included a form to fill out and send in.  If you just prefer to email me your opinion on this that is acceptable, even if you are neutral.  I have printed off the membership roster and will mark “yes or no” beside your name.   This is one poll that your vote counts – so if you have feelings on this issue please send me your vote.  I hope to get at least responses from over half the membership.   I will take non-responses as one of two ways – you don’t care one way or the other, or as Bill used to say in his Strength Journal, you are a lifter who is either “DEAD and/or COMATOSE”.

I also welcome commentaries from lifters who have strong feelings one way or the other on this issue.  Please send your comments to me and I will run them on the website.  Take this as an opportunity to lobby for your cause!!!

REMEMBER – the deadline for this poll is the first of September.

Poll on Knee Sleeves

by Steve Gardner,  IAWA International President                        

Dear IAWA member:

An issue will arise at the World Council meeting in October 2012 that will need to be decided.  We consider it serious enough to warrant a poll of all members to find the exact strength of opinion  to decide the matter, rather than it be left to a show of hands amongst those who happen to be  present in Salina Kansas USA in October.

The proposal that is submitted from members of USAWA, is that an elastic ‘non supportive’ knee sleeve should be allowed to be worn by lifters during IAWA competitions. (Note: this is not knee wraps, but rather described as a knee cover that is not supportive or aiding a lifters ability to lift more weight).

The proposer’ will put forward the case that it is a knee aide for joint comfort and keeping the knee warm.

A view of conflict with the previous stance taken by IAWA since its inception is that IAWA does not allow any form of lifting aide other than a belt and wrist wraps and knee wraps for front and back squat. And though proposed as a knee comfort or warming device, others might feel this is still a move towards more lifting aides.

If the motion is passed at the Council Meeting in October, then IAWA will announce exactly what the allowable ‘non supportive’ elastic knee sleeve will be, and there will be no allowable deviation from that example allowed.

We want your view please so that we can make an informed decision that reflects the wishes of the majority of our IAWA membership to conform to our democratic principle.

Please return this form with your vote to:

(Steve Gardner in the UK,  Al Myers in the USA, Robin Lukosius in Australia)  

ALL REPLIES MUST BE RECEIVED BY THE DEADLINE OF 1st SEPTEMBER 

Post This Form To: Steve Gardner  IAWA(UK) – 18 Holly Road, Barton, Staffs DE13 8LP

Name:  ______________________________________                          

(please tick one of the following)           

    Vote For:                                         Vote Against:

Any further comment on the matter you wish to make: