Therapeutic elastic body support

Elastic athletic or orthopedic supports for body parts such as the knee, thigh or ankle have a generally tubular sleeve made of an elastic "multi-directional" resilient stretch fabric that surrounds the body part. A patch having at least one lamination of neoprene or the like is attached within the sleeve. The patch is sized, shaped and positioned on the support element to provide a therapeutic warming to only a portion of the body part. Preferably the patch includes the second lamination of an absorbent fabric liner that is coextensive with, and secured to, the neoprene layer. The neoprene layer has a plurality of holes that extend through it to remove moisture. The liner can have like aligned holes. The liner and the patch are sewn, edge-sewn, adhered, heat-laminated, or otherwise attached to one another and to the sleeve. For a knee or elbow, the patch is generally diamond shape with its wide ends truncated and the elastic sleeve may have an opening at the rear of the knee or the inside of the elbow. For a wrist, ankle or thigh, the patch is generally a strip that wraps or extends over the injured region, with openings in the wrist and ankle sleeves for the thumb and heel, respectively. For an ankle, the strip curves downwardly at its ends to cover the ankle bone directly.

BACKGROUND OF THE INVENTION 
This invention relates in general to elastic athletic and orthopedic 
supports for the human body. More specifically, it relates to an improved 
support which provides a therapeutic degree of heating only to a 
strategically placed portion of a body region, and does so without an 
unacceptable level of perspiration build-up, overheating, or chafing due 
to fabric rub or bite. 
A wide variety of externally applied elastic supports and rigid, 
joint-immobilizing braces are known to protect healthy and injured joints 
and to promote healing of certain injuries. Supports and braces are 
commonly used for injuries and other medical problems at the knee, thighs, 
elbow, waist, wrist and back. Common injuries that can be helped by a 
support include strained or torn ligaments, tendinitis, arthritis, and 
pulled or strained muscles. 
Elastic or "soft" supports are usually preferred over braces where the body 
part is generally healthy and the intent is to support it in order to 
prevent injury e.g. of a joint and surrounding tissue. Soft supports are 
also used to protect and promote the healing of injured members where 
there are no broken bones and the patient is mobile. A support may be 
worn, for example, before engaging in work or a sports activity that is 
expected to involve unusual stretching or load bearing. The elasticity of 
the support is important not only to apply a supporting externally applied 
compression, but also to maintain the support in a selected position on 
the body. Ideally the a support in constructed so that in flexes easily 
and interferes as little as possible with the normal range of motion of 
the body part. The elasticity of the support also accommodates change in 
the size of the body part produced by physical exertion, changes in the 
condition of an injury (e.g., a reduction in swelling), or mere changes in 
the elevation of the body part, e.g., when an injured ankle is elevated. 
The most common form of elas tic support-is a simple tubular sleeve of a 
stretch fabric such as the stretch nylon material used in Ace.RTM. brand 
bandages and supports. The sleeve is pulled over and grips the body part 
to be protected as well as adjoining regions. When used on joints, a major 
problems are the chafing and bite of the fabric during flexure, 
particularly at the interior of a joint such as the back of a knee or the 
"inside" of a elbow. Flexures of body parts and changes in body size can 
also result in a migration of the position of the support on the body. 
To overcome some of those problems, it is also known to construct flat or 
"unfolding type" supports which wrap around the body part and are secured 
with straps with hook-and-loop or other fasteners. U.S. Pat. Nos. 
4,353,362 to Demarco and U.S. Pat. No. 5,221,252 to the present applicant 
and another are examples of such supports for knees. 
It is also known to combine the support function of these devices with 
therapeutic heating or cooling functions and protective padding functions. 
U.S. Pat. No. 5,014,354 to Dumont, for example, uses pads secured to a 
main elastic body to protect the underlying body portion against falls or 
other impacts. U.S. Pat. No. 5,168,577 to Detty discloses the use of a 
continuous layer of neoprene in the material forming the main elastic body 
where the neoprene acts as an insulator to retain body heat, and thereby 
increase blood flow to the area. U.S. Pat. No. 5,136,727 to Brisco 
describes a pair of athletic shorts formed from a pair of conventional 
ventilated fabric briefs attached to neoprene legs that surround the 
thighs of the wearer. U.S. Pat. No. 4,964,402 to Grin et al. is 
illustrative of another approach, the use of pockets formed in the main 
elastic body where the pockets are adapted to hold hot or cold packets and 
thereby heat or cool the body region under the pack. 
Pockets and thermal packs are not in wide use. They require that packs be 
heated, cooled or activated, and then supplied to the support for 
immediate use. These pack heat or cool only for a limited period of time. 
They must then be removed and replenished or replaced, which typically 
requires removing the entire support and "reloading" the pockets. The 
packs are also bulky and they present a significant cost increase as 
compound to conventional soft supports, and even soft supports with 
neoprene linings. 
A major problem with neoprene and other closed-cell, heat-retaining 
materials is that they trap perspiration and excessive heat under the 
support. Trapped moisture and high heat levels quickly produce discomfort 
and chafing. Moisture also promotes migration because it lubricates the 
support-skin interface. Such devices cannot be used for extended periods 
of time, e.g. usually not more than a few hours at the maximum. Another 
problem is that the neoprene adds to the weight and resistance to flexure 
of the support as well as promoting chafing and bite. Unless that are 
enclosed or otherwise protected, neoprene and like products are also 
susceptible to edge fraying, that is, a ripping and/or crumbling away of 
the material at its edges. 
U.S. Pat. No. 4,832,010 to Lerman discloses a soft support formed from 
three layer laminate material of neoprene sandwiched between and adhered 
to two layers of a stretch fabric. The neoprene therefore extends 
throughout the support. The resilient strength of the neoprene layer is an 
important source of the supporting compression force. Lerman uses holes 
that extend only through the neoprene layer to allow an air flow to the 
body part that removes perspiration and excess heat. Because the holes 
weaken the neoprene, Lerman teaches that the neoprene must be dense and 
that the two stretch fabric layers must both be adhered to the neoprene so 
that their inherent resilience can supplement the compressive force of the 
neoprene. 
Other perforated, closed-cell laminates are known. Cushion sole inserts 
long for shoes, for example, have a layer of a closed cell foam sandwiched 
between fabric layers with air holes extending through all three layers. 
It is therefore a principal object of this invention to provide an elastic 
support for a body part, particularly a joint, which also provides a 
strategically placed therapeutic heating without thermal packs or other 
external sources of thermal energy. 
Another object is to provide the foregoing advantages which also control 
the build up of moisture at the heated portion of the body part and 
control chafing and bite, especially during joint flexure. 
A further advantage of the present invention is to provide a support with 
the foregoing advantages which is highly flexible and operate effectively 
over a range of sizes of the body part. 
Still another advantage of the present invention is to provide the 
foregoing advantages without any significant increase in bulk over a 
simple elastic sleeve support. 
A further object of this invention is to provide all of the foregoing 
advantages while retaining a favorable cost of manufacture. 
SUMMARY OF THE INVENTION 
An elastic support for a body part, particularly a joint such as the ankle, 
elbow, wrist or knee, has a main elastic member formed of a 
multi-directional stretch fabric which, when positioned over the body 
part, surrounds the body part in a stretched condition to develop a 
compressive supporting force. The main elastic member is preferably a 
tubular sleeve of a two, three, or four way stretch nylon that is pulled 
over the body part. 
The sleeve carries a patch or panel with at least one layer formed from a 
flexible sheet of a heat-retaining material such as a closed-cell foam. 
Neoprene is preferred. The patch preferably also has a stretch fabric 
liner that is generally coextensive with the heat-retaining layer and 
disposed between that layer and the body part. The liner is preferably 
formed of a fabric such as stretch nylon or a polypropylene which wicks 
moisture (perspiration) and controls chafing due to repeated relative 
movements of the liner with respect to the body part. To control a build 
up of moisture under the heat-retaining layer, it has a plurality of small 
diameter holes formed in it which extend between its faces. The liner may 
have a like pattern of holes aligned with those in the heat-retaining 
layer to facilitate a circulation of air through the patch to remove 
excess moisture. The patch can include a second fabric layer to sandwich 
the heat-retaining layer, but it is not necessary. 
The liner is secured to the patch to maintain then in an overlapping, 
mutually aligned relationship despite manipulation during manufacture and 
shear forces during use. The patch, in turn, is secured to the main 
elastic sleeve at a selected location over the body part to be 
therapeutically treated. Both of these securing can be by (i) edge 
stitching, (ii) spot gluing and edge stitching, (iii) other stitching, 
(iv) adhesion, (v) heat lamination, (vi) hook-and-loop materials, or (vii) 
combinations of the foregoing. 
For knees and elbows, the patch is preferably generally diamond shaped, 
centered over the knee cap or elbow, and sized to cover the knee cap or 
elbow and adjacent soft tissue. For ankles and wrists the patch is a strip 
that partially circles the wrist or the ankle joint. For ankles, the ends 
of the strip preferably curve downwardly to cover the protruding ankle 
bone. For thighs the patch is a strip that extends vertically over a 
muscle group in the thigh to be treated, e.g. a hamstring muscle. For 
knees and elbows, the main elastic sleeve preferably has an interior 
opening at the rear of the joint to avoid fabric bite during a flexure of 
the joint. For ankles and wrists, the main elastic sleeve preferably has 
an interior opening sized and positioned to receive the heel and thumb, 
respectively. 
These and other object and features will be more readily understood from 
the following detailed description which should be read in light of the 
accompanying drawings.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
FIGS. 1-19 show elastic supports 10 according to the present invention 
adapted for use on human body parts including the elbow, knee, ankle, 
wrist and thigh. In each of these forms, the support 10 is constructed 
about a generally tubular or sleeve-like main support member 14. For ease 
of reference, the member 12 may be referred to herein as a "sleeve", but 
it will be understood that the sleeve may have openings and may be an 
"unfolded" type of support that is wrapped around the body part and 
secured by fasteners or straps and fasteners. 
The sleeve 14 is formed of a multi-directional, resilient, stretch material 
such as a two, three or four-way stretch nylon, and preferably the woven 
two way stretch nylon material commonly used in ACE.RTM. brand bandages 
and conventional sleeve-type supports. The direction of stretch is 
oriented to allow the sleeve to expand radially about the body part, but 
to resist stretching along the body part, e.g., vertically along the leg 
or along the central axis of the arm. As shown, end openings and other 
openings in the sleeve 14 are turned under and stitched, as at 16, or 
double stitched, as at 18, 18, to avoid end fraying and provide a smooth 
edge at the openings to facilitate sliding the support onto and off the 
body part. The sleeve 14 is the principal source of compressive force in 
the elastic support 10 constructed according to the present invention. It 
is sized so that when it is drawn over the associated body part it is 
placed in a stretched condition. Its inherent resiliency produces a 
compressive force that surrounds and supports the body part. The sleeve is 
porous to air. 
The compressive force generated by the sleeve should be sufficient to 
provide therapeutic support for the body part and to hold the support in 
place despite flexures of joints and changes in body size due to changes 
in blood flow, blood pressure, swelling, or edema. It should also produce 
the desired force levels or a reasonable range of sizes of the body parts 
so that most adults can be accommodated by one of four pre-set sizes, as 
is standard for conventional sleeve-type supports currently on the market. 
A principal feature of the present invention is a panel or patch 20 
attached to the sleeve 14. The patch is a laminate construction having at 
least one layer 24 of a flexible heat-retaining material such as a 
closed-cell foam, and preferably neoprene. In the preferred form shown in 
FIGS. 1-19, the patch also includes a liner 26 that is generally 
co-extensive with the heat-retaining layer 24. The liner is a stretch 
fabric that can wick moisture, and preferably is a woven, four-way stretch 
nylon. The liner is also soft to control chafing of the body part. It also 
protects the heat-retaining layer against mechanical degradation, 
particularly at the edges. 
As will be described in more detail below, the patch is sized, shaped and 
located on the sleeve so that is overlies only a portion 28 of the body 
part 12 which requires heat therapy or protection (the heat being 
supplemental to the support therapy of the elastic sleeve). For example, 
for a knee support, the patch may cover only the patella (knee cap) and 
its immediately surrounding tissue. The patch thus focuses its therapeutic 
heating action on the injured or vulnerable portions of the body part. 
This allows the rest of the body part to expand and contract more freely 
then it would if completely surrounded by a neoprene layer and to "breath" 
directly through the sleeve 14. This in turn increases the comfort of the 
support 10 and increases the period of time that it can be worn 
comfortably and provide heat therapeutic benefits to the body portion 28. 
These therapeutic benefits include (i) increasing the blood supply to an 
injury such as sprained or torn ligament or muscle, or medical problem 
such as arthritis or tendinitis, (ii) treating conditions such as 
swelling, and edema, and (iii) providing a mechanical protection (padding) 
against injury or aggravation of an existing injury or condition due to an 
externally applied blow. 
The liner 26 does not need to be continuously bonded to the neoprene layer 
24, although it may be. It is sufficient that the liner be held in a fixed 
position interposed between the layer 24 and the body portion 28. To 
facilitate manufacture, it is preferred that the liner 26 is secured to 
the layer 24, whether temporarily or permanently, and then the laminated 
double layer patch is permanently secured to the sleeve, preferably at its 
inner surface. The precise method of attachment of lamination of the patch 
layer and of its patch to the sleeve is not critical. It can be a 
continuous adhering, a sewing, an edge-sewing, heat lamination, spot 
gluing and sewing (especially edge-sewing), hook-and-loop materials such 
as VELCRO.RTM., and combinations of these techniques. The presently 
preferred method is to spot glue the liner to the neoprene layer to hold 
then in the desired assembled condition, and then edge-stitch the 
assembled and tacked-together patch to the sleeve, which simultaneously 
stitches the liner to the heat-retaining layer. Edge stitching 30 is shown 
in FIGS. 1-19. It serves both to secure the elements 14, 24, and 26 to one 
another and, in combination with the liner 26, to protect the edges of the 
layer 24 from fraying or other mechanical abuse such as rips and gouges. 
The layer 24 has a plurality of openings 32 that extend through the layer 
24, from one face to the other. As shown, they are cylindrical. The size 
and spacing of the holes is sufficient to produce a circulation of air 
through the porous fabric liner 26 to body portion 28 which promotes an 
effective evaporation of perspiration. In the illustrated support, using 
1/8 inch thick neoprene, the holes are about 1/16 inch in diameter and 
spaced uniformly with about 1/4 inch spacing between holes, center to 
center. 
The openings 32 work in cooperation with the liner 26 which, because it is 
woven, porous, and produces a capillary or wicking action for moisture 
that has accumulated under the layer 24, transports air and moisture to 
the openings 32. In the presently preferred form, at least for the elbow, 
ankle and wrist, the liner 26 also has a set of internal openings 33 that 
are aligned with the holes 32 in the heat-retaining layer. The openings 33 
increase the evaporative action since portions of the body directly under 
the holes 33 have direct access to the air passages 32, and there is an 
increased flow accessibility between the rest of the liner 26 and the 
holes 32. The holes 32 and 33 are produced by any known technique for such 
materials such as punching or drilling. 
When used on a joint, a tubular sleeve is prone to a buckling of the sleeve 
fabric at the interior of the joint when it bends. Adjacent folds of the 
fabric can pinch or "bite" the skin at the "back" of the joint. There is 
also an enhanced chafing due to a rubbing of the folded sleeve material 
which is pressed against and moves over the skin at in joint during the 
bending. To reduce chafing and bite, in its presently preferred form the 
invention utilizes comparatively large internal openings 34 in the sleeve. 
The openings are located over the inner, central portion of the joint. 
They are sized and shaped so that there is substantially no bite over the 
normal range of notion for that joint. As shown, the presently preferred 
form for the openings 34 is oval or circular, depending on which body part 
is being treated. 
FIGS. 1-3 show a support 10 particularly adapted for use on an elbow. As 
shown, the support is positioned with the patch 20 covering the protruding 
elbow bone and adjacent tissue. As best seen in FIG. 2, the patch is in 
the general shape of a diamond but with the two laterally extending ends 
36,36 truncated. The shape can also be viewed as a "puckered" or 
middle-bulging strip. The patch extends along the arm, between rounded 
corners 38, 38, and along the lateral direction between ends 36, 36, for 
sufficient distances that the region of the body needing treatment is 
covered, and remains covered, throughout flexures of the elbow. The patch 
is spot glued and edge-stitched. It has a layer 24 of 1/8 inch thick 
neoprene and a four way stretch nylon liner 26. Holes 32 and 33 in the 
patch are aligned. When unstretched, the opening 34 is slightly oval with 
the major axis directed along the arm to accommodate a fairly large 
angular travel of the forearm with respect to the upper arm. 
FIGS. 4-7 show a support 10 adapted for use on a knee. The patch 20 is 
again generally diamond shaped with truncated ends 36, 36 and rounded ends 
38, 38. Again, the shape can be viewed as a "puckered" or middle-bulging 
strip. The centered widening ensures coverage of the knee cap and 
vertically adjacent tissue by the layer 24 even when the knee is fully 
flexed. The inherent elasticity of the sleeve 14, layer 24, and liner 26 
facilitate a flexure of the knee while maintaining the therapeutic patch 
coverage. The patch is preferably spot glued and edge-stitched at 30. It 
has an opening 34 at the rear of the knee to control bite and chafing 
there. The opening 34 is generally circular when it is not stretched, as 
shown in FIG. 6. The sleeve 14 narrows from top to bottom to accommodate 
variations in the size of the thigh and calf. As is best seen in FIG. 7, 
the liner 26 is preferably a stretch fabric with no openings 33 since the 
knee cap is typically more prone to irritation due to a chafing arising 
from a sliding of the liner over the knee cap than to a build up of 
perspiration. Note that because the patch is interrupted by the opening 
34, it does not encircle and cannot itself generate any significant level 
of compressive force on the knee. The present invention thus decouples the 
support and therapy functions which are inherently combined in 
conventional supports with continuous, body-surrounding neoprene layers. 
FIG. 7 also demonstrates visually that the layer 24 can also serve a 
padding function. 
FIGS. 8-12 shows a support 10 adapted for use on an ankle. The patch 20 is 
more on the form of a laterally extending strip with downwardly curved, 
rounded ends 40,40 positioned to overlie the laterally protruding ankle 
bone at both sides of the ankle. A central portion 42 of the patch extends 
around the back of the ankle to cover the Achilles tendon region above the 
heel 44. The patch 20 thus covers, and can provide therapy to, the ankle 
joint and a major tendon group. At the same time it supports the rest of 
the ankle joint and adjacent portions of the foot without overheating and 
without any significant increase in bulk as compared to such a support 
formed entirely with a layer of a heat-retaining material, e.g., a support 
made entirely of Lerman-type laminate as described in U.S. Pat. No. 
4,832,010. The opening 34 for an ankle is a relatively flat oval, or 
slitlike, when not stretched. It receives the heel and facilitates the 
initially straight tubular sleeve 14 in assuming a generally L-shaped 
orientation when worn. It also allows the sleeve 14 to be woven with less 
fabric at the front of the support, opposite the heel, to reduce folding, 
biting and chafing. The sleeve tapers slightly from top to bottom to 
reflect the usually larger diameter of the lower leg as compared to the 
middle of the foot. As shown in FIG. 12, the liner 26 preferably has holes 
33. 
FIGS. 13-16 show a support 10 adapted for use as a wrist support. The 
sleeve 14 has a slight taper, narrowing toward the hand, and a 
thumb-receiving opening 34 positioned at the upper "side" of the support. 
The patch 20 is a generally parallel-edged strip which encloses most of 
the wrist, as shown. The patch is again spot glued and edge stitched to 
the inner surface of the sleeve. The wrist can generate significant 
perspiration, and therefore the liner 26 is perforated with the holes 33. 
The support 10 provides mechanical support to the wrist and adjacent 
parts, but provides heat therapy focused only on the wrist joint itself. 
FIGS. 17-19 show a support 10 adapted for use on a thigh. The sleeve 14 
tapers to a lower, narrower end near the knee. The patch 20 is a generally 
parallel-sided strip that extends generally vertically when worn by a 
person who is standing, as shown in FIG. 17. The patch 20 extends 
substantially the full height of the sleeve, and is wide enough to cover a 
selected major muscle or tendon group that extends along the thigh. The 
patch is shown positioned over the front of the thigh to the quadracep 
extensor muscles at this location. It can be rotated to the rear of the 
thigh to treat a hamstring muscle pull, or a variety of other injuries or 
conditions in the thigh. The liner 26 is continuous, without openings 33. 
There has been described an elastic support for joints and other body parts 
that provides both mechanical support and strategically positioned 
therapeutic heating where the heating is generated by retaining body heat, 
not by thermal packs, electrical heating coils, or other external sources 
of thermal energy. The support provides these advantages while controlling 
the adverse effects of excessive moisture, chafing, and bite. The support 
is highly flexible, light-weight, and compact. It also provides an 
enhanced degree of protection against injury or injury aggravation induced 
by external blows as compared to conventional sleeve-type supports. The 
support can be worn during physical activity and for extended periods of 
time without a level of discomfort that forces the wearer to remove the 
support prematurely. It uses commonly available materials and construction 
techniques. It uses reduced quantities of neoprene, or an equivalent 
material, as compared to supports made entirely with a heat-retaining 
layer; it therefore offers a reduced cost of materials. The support is 
rugged, durable, washable, and easily foldable to pack for travel or for 
point-of-sale packaging. 
While this invention has been described with reference to its preferred 
embodiments, it will be understood that various modifications and 
alterations will occur to those skilled in the art from the foregoing 
detailed description and the accompanying drawings. For example, while the 
invention has been described with reference to supports for certain body 
parts, the features of this invention described herein can be readily 
adapted to produce for other body parts such as the lower back, calf, 
shoulder, and foot. Further, while the patch has been described with a 
single liner 26, it can be formed from a material with two layers of 
stretch fabric which cover a heat-retaining layer, with or without holes 
33 in one or both fabric layers, and with a variety of attachment 
mechanisms. However, because the present patch 20 is used in combination 
with the elastic sleeve 14, such a third fabric layer, and its continuous 
adherence to a heat-retaining layer, are not necessary. The patch can even 
be a single heat-retaining layer with no liner, but this arrangement 
presents significant moisture and over-heating problems when worn over a 
layer of clothing or the like. The holes 32 and 33 can assume other forms, 
such as elongated slots or ovals, provided that sufficient air circulation 
is maintained and the structural integrity of the patch is not 
significantly degraded. The liner 26 has been shown as being co-extensive 
with the layer 24, but it can cover less then all of the layer 24, or it 
can extend beyond it to form a complete or partial lining of the entire 
inner surface of the sleeve 14, as well as the entire layer 24. There are 
clear, comfort, durability, and cost disadvantages associated with these 
modifications. Also, while the stretch fabrics have been described as 
preferably a woven nylon, they can be formed of other materials with like 
properties and formed of knitted as well as woven fabrics. However, there 
may be disadvantageous trade-offs in stretch, resilient force, durability, 
washability, odor retention or other factors well known to those skilled 
in the art. These and other such modifications and variations are intended 
to fall within the scope of the appended claims.