Elbow Braces
Ross Hauser, M.D. Marion Hauser, M.S.,R.D.

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 treatments (rest, ice, compression, and elevation) are not working, they then proceed with NSAIDS. When those do not work, they give cortisone injections. 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.