Tennis elbow or lateral epicondylitis is a pain syndrome that occurs along the outer part of the elbow joint. It is caused by the 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. 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. In each group are placed the top 3 products as rated by Amazon.
I. Braces in the form of clasp straps
These products are petite and versatile. They are easy to fit to your forearm size. Often, you will be able to use them for any localisation of pain (both external and internal). They are worth adding to your arsenal if you spend a lot of time at the computer or doing any monotonous hand work. A bonus is the affordable price.
The advantage of these braces is also their disadvantage. The small compression area does not allow you to relieve the muscles well and change their pulling angle. Also, you cannot use them if you have injured your shoulder triceps.
Perhaps these fixators will work for you with a small area of tendon inflammation. Yes, it is worth noting that they are short-lived. But it is compensated for by the pleasant price.
An interesting bonus. If you put the product in the freezer for a couple of hours, the gel pad cools down the injured area.
The 3 most popular products on Amazon from this group (2021):
- Made of durable neoprene. This material holds the gel pad well during movement and creates uniform, 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 secure fixation
- Design does not allow use in medial epicondylitis
- Although good air permeability, some users have reported sweating of the retention area
- 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
- There are two pieces in the standard package.
- Small buckle area. With a lot of force, the clasp may not hold and the fixation will weaken. Constant re-taping of the strap leads to 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 with classic clothing style
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 their spectacular appearance. Such a thing will make you look like an alpha athlete on the court or golf course.
Despite the sufficient number of fans, such breaches 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 the retainer is made of, but this disadvantage ruins 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 (a durable polymer material). In our opinion, it has more disadvantages compared to the narrow closure. The quality of its work depends on the right size. If you can find the perfect size, you will be satisfied.
- The ankle brace has a knitted 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
- The product won’t stretch or unbuckle during play, as there are no locking straps on it
- If sized incorrectly, compression may be strong or insufficient. In the first case, the elbow pad restricts movement. In the second, 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
A product of spandex and nylon, it differs slightly in appearance from the previous product. However, it retains all its advantages and disadvantages. We should also mention that the seller guarantees a 100% refund if necessary.
We went a little bit away from the Amazon ratings to give this type of brace a chance. In our opinion, the idea of elbow sleeves is a good one 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 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. Thus, pain management becomes 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. Despite the 6 standard sizes, sometimes it is difficult to find the right one.
III. Combinations of sizes I and II
Some manufacturers try to take the best from the competition and make a combination of variants I and II. Sometimes they turn out to be effective solutions.
Here’s what the customer ratings on amazon say about it:
This brace, sewn from neoprene, is among the top three most popular on Amazon in this group. It has a large locking 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 comfortable 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 about how these types of fasteners don’t last very long.
The Vive Elbow Brace is made of nylon. It has soft padding in the elbow area and relieves pressure for 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 uncomfortable.
- Versatile design. This brace is suitable for right and left elbows
- Large locking 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 flexion in 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 about how this type of fastener is short-lived
The main feature of this brace is the presence of metal inserts (ribs). You will loosen your elbow a lot with this brace because the inserts create 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.
Causes 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 parts of the muscle become 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 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 can 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 a doctor find one.
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 damaged tissues to heal. The ideal option is to change the sport. If you do not 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 strengthen the forearm extensor muscles.
In a conversation with the doctor, ask to prescribe anti-inflammatory drugs (NSAID). They are 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.
In neglected cases, surgical treatment is resorted to. Its task is to change the vector of load on the muscles. 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 normal muscle function.
We told you about the most popular braces on amazon in the first half of 2021. It may seem like an inexpensive brace will solve a lot of 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.
Orthotic 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 presentation of load-induced tendinopathy
- Pattanittum P, Turner T, Green S, Buchbinder R. Non-steroidal anti-inflammatory drugs (NSAIDs) for treating lateral elbow