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Elbow
Braces
To think that putting
a band around the
elbow could do anything to help a physical condition is
ludicrous. Wearing a brace actually has the potential to harm the injured
area due to the compression exerted by the brace and by changing the
biomechanics of motion from the compressive force.
Because most
orthopedists believe that most elbow pain is due to injury at the muscle that
attaches to the medial epicondyle, and since their treatments of
RICE treatment
(rest, ice, compression, and elevation) are not working, they then proceed
with
NSAIDS. When those do not work, they give
cortisone
shots. When these fail to relieve the pain, they recommend surgical scraping
of the bone. This is usually where the patients draw the line. So they came up
with another treatment, called the counterforce brace. The theory behind this
brace is that a band of elastic pliable plastic material is fastened around
the elbow for the purpose of dispersing the forces to the elbow, so less force
is felt at the medial epicondyle. This is another example of a myth that has
been perpetuated in sports medicine because everyone believes that it works.
The elbow braces do not increase strength. They do not do anything to help the
athlete repair the area. Even if they did decrease the force on the medial
epicondyle, this is a kind of immobility, which is the worst thing you can do
to a
ligament
or
tendon
that is trying to heal.
In 1998, Jennifer
Wuori and associates, at the University of Western Ontario, decided to
scientifically study what these braces do. The authors concluded, "We
examined the effectiveness of bracing on measures of pain-free grip strength
and pain in individuals with
lateral epicondylitis. There was no benefit
associated with the use of a counter-force
tennis elbow brace or an Airprene
elbow support when compared to no brace or a placebo brace. Our study provides
clinicians with evidence on which to base their judgment of the immediate
effectiveness of these two braces with respect to pain-free grip strength and
pain. The merits of elbow bracing, as a treatment technique used over time and
tested using function-specific measures, warrant further investigation."
(Wuori, J. Strength and pain measures associated with lateral epicondylitis
bracing. Archives of Physical Medicine and Rehabilitation. 1998; 79:832-837).
They never come out and say it, do they? The three words that we need to hear
more "It doesn't work!". Elbow bracing does not work.
It does not help pain, and it certainly does not increase the muscle strength
in the arm. In other words, it does nothing to stimulate the repair of the
painful area. There is only one treatment that does that,
Prolotherapy.
Research Using
Electromyography
Dr. Mark Glazebrook
and associates, in Nova Scotia, Canada, performed an excellent study on a
different part (the medial side) of the elbow. They tested
golfers with medial epicondylitis, using electromyography. This involves putting an electrode into
the elbow and measuring the electrical activity in it while the actual muscle
is tested. The study examined whether bracing or changing grip size (of the
golf club) would improve the elbow pain or medial epicondylitis. Sixteen
golfers were tested. The golfers were hooked up to the machine and measured
during the golf swing. They each wore different braces and tried different
grip sizes. The electric activity of the muscles was measured each time. The
researchers' conclusion was as expected, "When forearm brace and
oversized grips were imposed on symptomatic subjects, there was no significant
difference in mean electromyographic magnitude or muscle activation pattern
during the golf swing. Thus, the method of symptomatic relief of the
intervention strategies tested is still in question." What they, again,
failed to say is "It doesn't work!" But at least they
said, "It is still in question."
Athletes feel better
wearing a brace because they think it is doing something for them. Psychology
plays a major role in sports. This is no exception. The brace may not be doing
anything physically for the athletes, but it helps them psychologically. Any
athlete with elbow pain wants to find the answer for curing the pain. The
painful area needs to be stimulated to grow and repair. The best way to do
this is with Prolotherapy.
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