Tennis elbow or lateral epicondylitis is a pain syndrome that occurs along the outer part of the elbow joint. It is caused by overloading of the extensor muscles of the forearm. In rare cases, the problem lies in the extensor muscles of the shoulder. The cause of the pain is inflammation at the attachment point of the muscle tendon to the bone.
One popular way to reduce pain before going to the doctor is to use an elbow brace or brace. By creating pressure around the area of the injury, the brace reduces pain.
Below we will introduce the main groups of braces. The groups differ in design and use. Each group contains the top 3 products as rated by Amazon.
I. Braces in the form of clasp straps.
These products are miniature and versatile. They are easy to adjust to your forearm size. Often, you will be able to use them for any localization of pain (both outer and inner). They are worth adding to your arsenal if you spend a lot of time at the computer or any monotonous hand work. A bonus is the affordable price.
The advantage of these straps is also their disadvantage. The small compression area does not allow you to relieve your muscles well and change their pulling angle. Also, you cannot use them if you have injured your shoulder triceps.
Perhaps these retainers will work for you with a small area of tendon inflammation. Yes, it is worth noting their short duration. But it’s offset by the nice price.
An interesting bonus. If you put the product in the freezer for a couple of hours, the gel pad cools the injured area.
The 3 most popular products on Amazon from this group (2021):
1. Senteq tennis elbow brace tendonitis for men and women
Strap-shaped brace with adjustable compression strength and gel cushion to apply pressure to epicondylitis area.
— Made of durable neoprene. This material holds the gel pad well during movement and creates an even, constant compression. The Velcro buckle material mimics burlap hooks and gives a secure strap fit. The less often you fasten the strap, the longer it lasts
— Width. Perhaps one of the few options where the width of the product is well chosen. On the one hand, it creates a good pressure on the center of pain. On the other hand, the even compression of the forearm changes the angle of traction of the muscles, which also reduces pain. These proportions do not interfere with movement.
— Velcro material wears out with frequent use and suffers from poor fixation
— Design does not allow use in medial epicondylitis
— Despite good air permeability, some users have reported misting of the retention area.
2. Pacearth golf tennis elbow brace with metal buckle
Elegant strap with adjustable compression force and wide gel padding. A good option for the initial stage of a tennis or golf player’s elbow.
— Made of neoprene and PVC. These materials are strong and durable, air permeable and do not irritate the skin
— Convenient design. You will be able to place the strap at any pain point. Metal brackets for securing the strap are durable
— Adjustable size. Two types of straps of different lengths allow you to adjust the product to any forearm size
— Standard package includes 2 pieces.
— Small buckle area. With a lot of force, the clasp may not hold and the fixation will become loose. Constant re-gluing of the strap leads to its wear and tear
— A narrow strap. Its area is insufficient for sufficient pressure on the muscles, so it may not be suitable for chronic tennis elbow form
— Design. The bright logo interferes with office use. It will not fit the classic clothing style
3. Elbow brace 2 pack for tennis & golfer’s elbow pain relief
Something in between the first and second version. The manufacturer has relied on the materials of construction. The combination of ethylene vinyl acetate (a bit like rubber), spandex, synthetic rubber, and nylon increases the wear resistance and gives the product good breathability. But, the buckle…It is the Achilles heel of this brace. A nice bonus is that it comes with 2 straps for a good price.
II. Compression Sleeves.
A kind of cover for your elbow. They create a large compression area for the muscles of the forearm and lower third of the shoulder. They are most often made with a special knitting technique. This technology distributes the pressure of the fabric evenly over the area of the arm, which is not bad for unloading it.
The first thing that distinguishes compression sleeves from other braces is the spectacular appearance. Such a thing will make you look like an alpha athlete on the court or golf course.
In spite of a fair number of fans, such breeches have certain inconveniences. The first is the difficulty in finding the right size. Yes, the manufacturers write how to measure your hand correctly, but the line offers only 3 to 6 sizes. This is inconvenient. Proper sizing is the cornerstone of the effectiveness of these retainers. If there is insufficient compression, they are ineffective.
Another significant problem is maintenance. These retainers need to be washed by hand, in cool water and without the addition of harsh chemicals. Your powder can ruin it. Of course, it all depends on the material from which the retainer is sewn, but this disadvantage spoils the reputation of compression sleeves.
Here’s what most people buy on Amazon from this group:
1. Kunto fitness elbow brace compression support sleeve
A compression sleeve made of nylon, spandex, and rubber (polymeric durable material). In our opinion, this design has more disadvantages compared to the narrow clasp. The quality of its work depends on the right size. If you manage to find the perfect size, you will be satisfied.
— The elbow pad has a knit structure. This design distributes pressure evenly over the forearm and lower third of the shoulder and relieves the muscles well. Unloaded muscles do not irritate the inflamed area
— During play, the product will not stretch or unbuckle, as it has no locking straps
— If sized incorrectly, the compression may be strong or insufficient. In the first case, the elbow pad restricts movement. In the second case, it does not perform its function. Also, if the elbow brace is too small for you, it pinches the intradermal lymph vessels and veins. Microcirculation is disturbed, which leads to swelling of the hand or forearm.
— Inconvenient washing. Only in cool water and not with all detergents
— Dry only in a warm dry place so as not to spoil the material. If you spend a lot of time exercising, the brace will not have time to dry.
— In chronic forms of lateral epicondylitis, compression is insufficient. Pain worsens or stays the same.
2. PowerLix elbow brace compression support
This product is made of spandex and nylon and has a slightly different appearance than the previous product. However, it retains all its advantages and disadvantages. Separately, it should be noted that the seller guarantees a 100% refund if necessary.
3. Bauerfeind — epitrain — elbow support
We took a little step back from the Amazon rankings to give this type of brace a chance. In our opinion, the idea of elbow sleeves is good in theory. In practice, this idea was best implemented by the German company Bauerfeind. Their brace EpiTrain — Elbow Support — is Mike Tyson among braces, because it works for sure. Once you put it on, you won’t be able to give it up. And, of course, its price is an order of magnitude higher than that of its counterparts.
This brace is our recommendation for chronic epicondylitis.
— Manufacturers’ expertise. Bauerfeind was founded in 1929 and specializes in orthopedic products
— Unique knitting technology. The elbow pad is knitted from a knitted material that fits around your arm as if it were your own skin. Unlike similar products, the material holds tightly and does not roll up
— The fabric is perfectly permeable to air and moisture. You won’t feel any irritation even after a few hours of play
— Silicone insert with stiffening ribs. This part perfectly relieves the area of the inflamed tendon. This makes pain management easier and more reliable.
— Price. Almost $80 on amazon. This is one case where a quality item will last a long time. You will be able to pass it down to your children. The price is justified.
— Care. Despite the excellent properties, washing and drying this brace requires special attention
— Size selection. Yes, even champions have problems. In spite of the 6 standard sizes, sometimes it is difficult to find the right one.
III. Combinations of variants I and II
Some manufacturers try to take the best from the competition and make a combination of options I and II. Sometimes they come up with effective solutions.
Here’s what amazon’s customer ratings say about it:
1. Yavoun adjustable tennis elbow support brace.
This neoprene brace is the top three most popular on Amazon in this group. It has a large surface area and two straps to adjust the size around your biceps and forearm. You adjust the strength of the compression yourself, depending on the intensity of your symptoms.
This product is good for you if your elbow pain occurs during everyday physical activities. It is not suitable for sports.
— Wearing a brace fixes the most problematic areas — the upper forearm and lower arm. Pressure in these areas relieves muscle tension in the points of attachment to the bones
— Large fixation area creates support for the elbow joint, which reduces pain when bending the arm
— The low price makes the product affordable.
— Limits flexion at the elbow. You won’t be able to fully bench press a barbell from the chest or take a good swing to hit a tennis ball
— Velcro straps. We’ve already written that this type of fastener is not durable.
2. Vive elbow brace
Vive Elbow Brace is sewn of nylon. It is padded at the elbow and relieves pressure in the case of elbow bursitis. The straps are secured with additional loops for a perfect fit.
We recommend this brace for everyday use. For sports, this design is not comfortable.
— Versatile design. This brace will fit both right and left elbows
— Large fixation area creates support for the elbow joint, which reduces pain when bending in the hand
— Will help with elbow bursitis — inflammation at the top of the elbow.
— Restricts bending at the elbow. You won’t be able to fully bench press a barbell from the chest or take a good swing to hit a tennis ball
— Velcro straps. We’ve already written that this type of fastener is not durable.
3. Corpower elbow brace
The main feature of this brace is the presence of metal inserts (stiffeners). With this brace, you will relieve a lot of pressure on your elbow because the inserts provide a significant amount of stiffness. This brace is good for you if your elbow pain is not relieved even without strain. Those are probably all the essential benefits.
The Corpower elbow brace has disadvantages similar to its bandmates. It is uncomfortable to use for sports and restricts elbow flexion.
The cause and symptoms of epicondylitis
Tendons have a low threshold of elasticity. They are an intermediate link between bone and muscle. To move a part of the body, the muscle contracts, and the energy of contraction is given to the bone through the tendon.
With frequent, sharp contractions (throwing, hitting with a racket, active finger work) or prolonged compression (working with power tools), the tendon does not have time to recover and becomes inflamed. Prolonged inflammation changes the structure of the tendon and makes it weaker. The inflammation leads to pain and limitation of movement.
Pain varies in nature. It varies from localized and weak, to generalized and severe. Initially, the pain only bothers you during physical work (sports or working with your hands). Gradually, the entire tendon and some part of the muscle becomes inflamed. This leads to the progression of symptoms. The discomfort is felt in everyday life and when moving the arm normally.
Peter AA Struijs and all in their study of Orthotic devices for the treatment of tennis elbow analyzed articles on the treatment of epicondylitis from 1966-1999 and concluded that braces and fixators are not helpful in the treatment of this condition1. Only a combination of NSAIDs (anti-inflammatory drugs) physical therapy (exercise) and exercise correction helps to get rid of pain or reduce it significantly. Any fixation is used as a prevention of re-injury.
Doctors view epicondylitis as a mechanical tissue injury. They base their treatment on this belief.
The mechanism of the disease suggests that the tennis elbow is a tendinopathy (a change in the structure of the tendon against a background of long-term inflammation) rather than a partial rupture of the tendon.
Jill Cook in his article — Is tendon pathology a continuum? A pathology model to explain the clinical presentation of load-induced tendinopathy, showed how the collagen structure of ligaments and tendons breaks down2. She described how their repair occurs.
Today, medicine knows that the severity of the disease directly depends on the percentage of different types of collagen in the injured tendon. Such an assessment helps to develop treatment tactics and give a prognosis for recovery.
For example, in the case of an acute injury (pain first appeared), type I collagen converts to type II collagen. This transition is considered reversible, because collagen type two is able to return to collagen type one.
Chronic pain syndrome (pain persists for more than 6 months) indicates prolonged inflammation.
It leads to pronounced wear and tear of the tendon. Its structure is saturated with rough collagen of the third type. Unfortunately, this situation has a poor prognosis. The doctor and physiotherapist only fight for the part of the tendon that is still healthy.
Depending on the severity of the pain, different treatments may be prescribed. It is worth seeing your doctor to find the right treatment.
What should I do before seeing a doctor?
First of all, you should reduce the intensity of the load. This will create conditions for the healing of damaged tissues. Ideally, you should change your sport. If you can’t imagine your life without tennis or baseball, you should work with your physical therapist. He will help to correct your hitting or throwing technique, choose the exercises for tendon restoration and strengthening the forearm extensor muscles.
In a conversation with the doctor, ask to prescribe anti-inflammatory drugs (NSAId). They have been shown to be effective3. Taking these medications reduces the strength of inflammation and pain. But it is worth remembering that without correcting the load, the pain will return again.
In neglected cases, surgical treatment is resorted to. Its task is to change the vector of load on the muscle. After surgery, the muscles will pull the bone at a different angle, which will significantly reduce the pain. Unfortunately, statistics show the low effectiveness of this method, because scars appear in the place of surgery. They interfere with the normal function of the muscles.
We’ve told you about the most popular braces on amazon in the first half of 2021. It may seem that an inexpensive retainer will solve many problems, but it won’t. Braces are not a panacea for epicondylitis. They significantly alleviate the symptoms, but do not eliminate the cause of the disease.
Only a doctor, together with a physical therapist can cure you. Before you make a purchase, consult an orthopedist and take the necessary examinations. Do not forget that elbow pain is a symptom of a whole group of diseases of the upper extremity.
The most important thing is not to despair. Even Thanos with his philosophy of inevitability was defeated. Needless to say, victory over an inflamed tendon? You will get over it. That is the way!
List of references:
— Struijs PAA, Smidt N, Arola H, van Dijk CN, Buchbinder R, Assendelft WJJ.
Orthopaedic devices for the treatment of tennis elbow
— J L Cook, C R Purdam. Is tendon pathology a continuum? A pathology model to explain the clinical picture of load-induced tendinopathy
— Pattanittum P, Turner T, Green S, Buchbinder R. Nonsteroidal anti-inflammatory drugs (NSAIDs) for the treatment of lateral elbow