January 23, 2021
If you’re experiencing pain on the outside of your elbow you may have tennis elbow. If the pain is on the inside of the elbow, it may be golfers’ elbow. Either way, you may be able to use a counterforce elbow brace to treat this type of elbow pain.
Patients often ask about a Tennis Elbow Brace or a Golfers Elbow Brace. Tennis elbow or lateral epicondylitis and golfers elbow or medial epicondylitis are common conditions that occur due to repetitive overuse of the elbow. In this video, Sports Medicine Physician and Elbow Specialist, Dr. J. Michael Bennett describes the anatomy of golfers elbow and tennis elbow and talks about how to use a counterforce elbow brace as a tennis elbow brace or a golfers’ elbow brace to treat the conditions. Of course, you should consult with your own physician before beginning any treatments.
Here’s Dr. J. Michael Bennett in a Whiteboard Series video on the use of a counterforce elbow brace.
This is a summary of Dr. Bennett’s video:
Hello and welcome. My name is Doctor J. Michael Bennett. I’m an Orthopedic Sports Medicine Physician. I specialize in injuries of the shoulder, elbow, and knee. Welcome to the Whiteboard Series. Today, we’re going to talk a little bit about lateral and medial epicondylitis, also known as tennis elbow and golfer’s elbow. I just want to go over what exactly it is and the appropriate way to use a counter-force brace or the type of elbow brace that you would need for any of those tendinitis.
So, basically tennis elbow and golfer’s elbow occurs from repetitive use of the wrist or the elbow. If you’re looking at an elbow, right here, the bony anatomy, the lateral side, which is the outside area; this is where the common extensors that lift the wrist insert right here at the bone. So the muscles come up and insert right here to the lateral epicondyle. The medial side, which is the inside of the elbow; the flexors which allow you to flex the wrist insert right here at the medial bone.
So what happens is with repetitive, forceful activities you irritate both of those insertion sites. Depending on your swing and what type of sport you’re playing is going to determine whether or not you’re going to have a medial epicondylitis on the inside or lateral epicondylitis on the outside. It’s usually due to repetitive, forceful flexing or repetitive forceful extension.
I’ve seen medial epicondylitis or golfer’s elbow in tennis players as well usually if they’re going through with a forehand. We’ll see more tennis elbow when they’re going through with the backhands. So, that’s using more extensors and when they’re going with the forehand that’s using more flexors. Golfers, typically in their swing, when they’re coming through they’re flexing their wrists sometimes and that irritates this inside aspect of the elbow. When it does become irritated, you get an inflammation. If it’s a long period of time, if it’s chronic, sometimes you can even get partial tears of this tendon.
Many people have partial tears of this tendon and nine times out of ten this can be treated conservatively with conservative measures and non- operative measures. One of those measures is to use appropriate bracing and the brace that we typically would recommend for these type of tendonitis’s is a counter-force brace.
This is a counter-force brace. All that this is, is a circumferential elbow brace made of neoprene that actually gives you a little bit of tension across the irritated area. The way you use a counter-force brace is you find the area that’s painful, if it’s the outside of the elbow or the inside of the elbow. Approximately one thumbs breadth below where it hurts you’re going to slide the brace. You’re going to slide it all the way up one finger breadth or one thumbs’ breadth below where it’s irritated and then you’re going to wear it snuggly.
You use the elbow brace throughout the day, during your regular activities. Use it for a couple of weeks to see if you have an improvement in your symptoms. If it does help then that may be all you need to do; in addition to maybe taking an anti-inflammatory.
Now one thing that’s key is make sure you don’t have this too tight. If you have it too tight where you actually feel numbness or tingling in your hands or you see some discoloration that means it’s too tight and you want to loosen it up a little bit. This is supposed to be comfortable. Just be aware of what you’re doing repetitively during the day; make sure you’re not repetitively using that wrist, or lifting that wrist, or flexing that wrist.
Occasionally, you may want to pick up a wrist splint as well. That also helps immobilize the wrist and keeps you from using that wrist over and over again and irritating either side of those tendons. If you fail conservative measures, then definitely, I would highly recommend that you be evaluated by an orthopedic specialist; preferably someone who specializes in shoulders, elbows, and knees and has experience in dealing with this type of problem.
The good news is that this is a very common problem and most general orthopedists are familiar with treating this type of pathology. So, if you have any further questions, feel free to visit my web site at orthopedicsportsdoctor.com or jmichaelbennett.com as well. Thank you very much for this session of the White Board series.
By Dr. J. Michael Bennett