Should you wear a brace as a treatment for your Tennis Elbow? What's the best kind?
Although they're recommended everywhere you turn, there are solid reasons why supports like braces, splints and wraps are a bad idea for treating Tennis Elbow, and why the best brace, splint or support may be none at all!
Yes, it’s true that most of the “authorities,” medical websites and various blogs do recommend that you wear some kind of support for a few weeks to help "rest, protect and heal your Tennis Elbow"
At first glance it certainly seems like the right thing to do, but on closer inspection there are several reasons why those supports are not the way to help Tennis Elbow heal, (in most cases) and why they can actually hurt you instead.
Slideshow: Tennis Elbow Treatment - How Braces Can Slow Your Recovery
This slideshow will give the key points on why braces are not a good way to treat your Tennis Elbow injury - By: Allen Willette
Exceptions: When To Wear A “Support” On Your Elbow
The exception being while you’re playing Tennis, golf or some other sport that involves dynamic, forceful activity, because you’ve decided to keep playing in spite of your injury.
In that case, it makes sense to wear a support as protection
Okay, but what about the rest of the time?
What about while walking around, sitting at home, sleeping or while you’re working?
No. It’s definitively not a good idea, and here’s why.
Why Immobilization Doesn’t Help Tennis Elbow Heal
First of all, Tennis Elbow, (along with most other forms of "Tendonitis") is usually not the kind of injury that benefits from being bound up with some kind of restrictive "support" for days or weeks.
In other words, "supports" don't actually support the healing of this kind of tendon injury! Although it may feel better temporarily!
So, in case you’ve been wearing some kind of brace and have already noticed that it feels a little better – remember the key question to ask yourself:
Does that mean it’s actually healing?
It’s a little deceptive because having less pain and feeling better is one of the ways we can tell that an injury is healing and getting better.
All these so-called treatments do is trick you by easing and postponing your pain for a little while
So, why then doesn’t bracing or supporting your muscles, tendons or your entire elbow help your Tennis Elbow heal?
If you broke your arm, then you’d have to put in a cast while the bone heals – There’s no question about that!
If you sprain your ankle badly then you’d have to wrap it for a while – No argument there.
But Tennis Elbow has almost nothing in common with a broken bone, and usually very little in common with a sprain.
Tennis Elbow is not a sprain or a strain (usually) – By that I mean there is usually no major tear (strain) in the muscle or tendon that needs to be protected from movement, in which case a brace or support probably would be needed at first.
(And an MRI should show any significant tear.)
But What About The Possibility of a Smaller Tear?
A lot of Tennis Elbow sufferers really worry about that – often because the pain is so sharp or relentless.
Well, that’s always possible, but unfortunately the severity of the pain and its persistence often has little to do with it.
In other words, just because it hurts like hell for weeks or months doesn’t mean there’s a tear – large or small – Often there isn’t.
However, for arguments sake, even if there is a small tear, from my understanding and what the leading-edge sports medicine approach seems to favor, is to either keep it free and mobile - or brace it for a very short time after the injury, and then start moving it again as soon as possible
We’re talking about mere days of bracing (in the case of a small tear) followed as soon as possible by gentle movement rather than weeks of bracing and immobilization.
But let’s get right back to the typical case of Tennis Elbow now.
Tennis Elbow is a tendon injury, and most of the time the injured tendons are NOT badly torn in one big, traumatic event – They’re damaged gradually.
The Key Issue And Biggest Risk To Injured Tendons
And the key problem is that Tendons heal much more slowly, in part because they have a much smaller blood supply
So slowly, in fact, the biggest risk with tendons is that they don’t heal at all – and that they gradually break down instead – (Technically this is called Tendinosis, by the way.)
And that’s what’s really going on more often than not in the typical case of Tennis Elbow: Gradual breakdown, stagnation and degeneration. (Regardless of whether there was a tear or not.)
This is really important, but without going into the technical detail it takes to properly explain this degeneration thing…
The key thing to always remember is the fact that Tendons heal slowly – once again, mostly because they have much less of a blood supply.
And the last thing you want to do is to reduce that circulation and blood supply to your tendons even more as they’re trying to heal.
How Supports Reduce Circulation And Slow Tendon Healing
Unfortunately that’s exactly what wearing a brace, splint, band, strap or any other kind of so-called support does; it tends to reduce the circulation in the area you’re wearing it around.
It does that in two ways:
- First, indirectly, by restricting the movement of your muscles, tendons and elbow joint. Less movement = Less circulation, because muscle movement is essential for good blood (and lymph) flow.
- And second, by directly compressing the tissues and blood vessels in that area. And, yes, even if it’s not that tight. Naturally, the tighter and more restrictive it is, and the longer you wear it the worse it is.
Supports Can Also Lead To More Scar Tissue
The other big downside with supports is that the compression and reduced mobility tends to encourage sticky scar tissue, which further binds and restricts your muscles and tendons.
I’m sure you will agree losing your flexibility to a bunch of nasty scar tissue and having your healing process stall are the last things you want!
Muscles and tendons actually need gentle movement and mobility to heal – (except right after a major tear, which I’ve already mentioned is rarely the case with Tennis Elbow).
Gentle movement during most if not all of the healing process helps the repair process and helps to prevent excessive Scar Tissue build up.
Once Again, The Only Times To Use A Brace or “Support”
In conclusion, most of the time it only makes sense to wear a brace or support:
- If you’re sure you’ve suffered a significant tear
- Or when you’re on the tennis court or golf course or engaging in some kind of short-term forceful activity, like hammering nails or digging in your garden.
To protect your injury somewhat from the risk of further damage.
Best to abandon completely the idea that using a support for days, weeks or months is going to help your Tennis Elbow heal.
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