Regular exercise and weight reduction are not only important for maintaining general health, they are also strongly recommended conservative modalities for managing knee osteoarthritis (OA). The objective of this paper is to discuss the mechanics of knee joint loading and to review the most recent literature with respect to the functionality and efficacy of unloader braces for managing knee OA, specifically from the perspective of the middle-aged athlete. Evidence suggests valgus braces for medial compartment knee OA significantly reduce knee adduction angle measures and improve measures relating to medial knee joint loading, as well as gait symmetry and speed. Benefits were demonstrated during walking and during more demanding functional measures such as running and negotiating stairs. No studies have investigated the efficacy of bracing for relatively young athletic OA patients and, thus, the role of bracing for this population during sports remains unclear.