Orthotics and Bracing for Tennis Elbow: Effectiveness and Considerations

Introduction to Tennis Elbow and Orthotic Support:

Tennis elbow also known as lateral epicondylitis is a painful condition of the elbow caused by overuse of the forearm muscles responsible for extending your wrist back. While it can certainly be brought on by a groundstroke in tennis, any repetitive wrist motion such as that required in painting, cooking or hammering can cause it. At its worst, it can impact tasks important to everyday life such as holding a glass of water or gripping a toothbrush. The most effective treatment of tennis elbow involves a multifaceted approach which often involves the use of a brace, either at the forearm level or the wrist.

Understanding Tennis Elbow and Its Symptoms:

The pain in tennis elbow is caused by inflammation, swelling and even micro-tearing of the forearm muscles where they attach at the elbow. One muscle in particular, the Extensor Capri Radialis Brevis (ECRB), is implicated in most cases. Symptoms include a painful, burning or aching sensation at the outside part of the elbow that may radiate into the forearm. It is aggravated by repetitive extension of the wrist and gripping. The earlier you diagnose the problem the easier it will be to manage symptoms, prevent further damage and return to activity.

Orthotic Treatment Options for Tennis Elbow:

There are two main forms of orthotic bracing to help combat tennis elbow. The first is a Counterforce Brace or what is more commonly called a Tennis Elbow Strap. This works to redistribute forces so there is less strain at the elbow itself. As this brace is less restrictive you can still use it while playing tennis, working, and even cooking. They have also been shown to reduce pain and dysfunction, especially during the initial phase following the onset of symptoms. Alternatively, a simple Wrist Splint can also be used. By supporting your wrist in a neutral position and preventing extension, it forces your muscles to rest, which can result in faster pain relief.

Effectiveness of Orthotics in Tennis Elbow Management:

The evidence for effectiveness of bracing in management of tennis elbow is mixed. There are studies that show significant reduction in pain as well as improvements in grip strength with braces. Other studies have shown no significant difference compared to placebo or control groups. Effectiveness of bracing is likely dependent on many factors including symptom severity, individual biomechanics and compliance with bracing protocols.

Considerations for Optimal Orthotic Usage:

Proper fit and appropriate positioning are imperative to successful use of any orthotic. The counterforce straps specifically, if not applying enough tension in the correct position, may lose its efficacy. For either brace to be effective, they need to be worn routinely and particularly during activities known to aggravate the elbow.

Integrating Orthotics with Rehabilitation:

Bracing is often complemented by other forms of treatment, including physical therapy and rehabilitation exercises. Stretching the wrist with the elbow extended as well as using light weights to strengthen the muscles that both flex and extend the wrist are a critical part to an at home program for tennis elbow management and prevention.

Physical therapy is a crucial component in the management of musculoskeletal pain, and tennis elbow is no exception. Physical therapy can help address flexibility issues, strength imbalances and work to achieve proper biomechanics. Therapists can also incorporate special tools and techniques to encourage proper healing of the tendon.  

Additionally, your provider may recommend other management strategies including the use of anti-inflammatory medications, corticosteroid injections, platelet rich plasma injections and ergonomic modifications. 

Prevention Strategies and Lifestyle Adjustments:

Proper mechanics are key to preventing any overuse injuries. Making small adjustments, like widening the grip of the racket or loosening the string tension, are quick adjustments that can make a big difference. Prior to beginning any sport or repetitive activity, a proper warm up followed by stretching the wrist flexors and extensors can help reduce the risk of injury.

Conclusion and Recommendations for Further Exploration:

Tennis elbow can be a debilitating condition that impacts daily activities as well as athletic performance. When used in conjunction with a comprehensive program, bracing can be an effective way to decrease pain and dysfunction. Consultation with a provider at Rothman can help tailor an individualized treatment plan to decrease pain, maximize function and promote healing. If you’re ready to address the pain being caused by Tennis Elbow, make an appointment today.