The condition known as Golfer’s Elbow, or medically as medial epicondylitis, involves pain and inflammation on the inner side of the elbow. This discomfort occurs at the bony prominence where the tendons of the forearm flexor muscles attach to the bone. Repetitive or forceful wrist flexion and gripping activities place excessive strain on these tendons, leading to tiny tears and irritation over time.
The primary purpose of using an elbow brace is to reduce the mechanical strain on the irritated tendons and temporarily alleviate pain during activities that aggravate the condition. By providing external support, bracing aims to modify the forces acting on the elbow joint and its surrounding muscles. Choosing the correct brace depends on the level of support required and the specific nature of the pain being experienced.
Targeted Relief: The Counterforce Strap
The counterforce strap is the most commonly recommended bracing option for targeted relief of medial epicondylitis, often featuring a cushioned pad and a hook-and-loop closure. This device applies concentrated pressure directly to the muscle belly in the forearm, just below the painful tendon attachment. The strap works by creating a new, temporary attachment point for the forearm muscles, shifting where muscle tension is absorbed.
This mechanism effectively changes the angle of pull on the tendon origin at the medial epicondyle. By compressing the muscle, the strap diverts the load away from the inflamed area during gripping or lifting, reducing the overall tensile force on the damaged tendon. Studies suggest this counterforce can reduce tendon strain by an estimated 13 to 15 percent.
The counterforce strap is most beneficial when worn during specific activities that cause pain, such as sports, heavy lifting, or repetitive manual tasks. It functions as a biomechanical tool to lessen the immediate stress on the tendon while the user is active. The straps are typically constructed from materials like neoprene or elastic webbing, often incorporating a firm plastic or gel pad to ensure the pressure is focused and effective. This localized pressure distinctly differentiates the strap from other, broader forms of elbow support.
Broader Support: The Compression Sleeve
An alternative form of support is the compression sleeve, which covers the entire elbow joint and extends slightly up and down the arm. Unlike the strap, the sleeve provides a mild, generalized pressure across the circumference of the joint and surrounding tissues. This circumferential compression can help improve proprioception, which is the body’s sense of the position and movement of the joint, offering a feeling of stability.
The sleeve’s primary mechanism involves increasing warmth in the area, which can promote blood flow and provide comfort. This general increase in circulation may assist in reducing mild swelling that sometimes accompanies tendon irritation. Compression sleeves are generally made from a flexible, breathable knit or neoprene fabric, allowing for a full range of motion while worn.
This type of brace offers support that is less aggressive and less focused than the counterforce strap, making it suitable for different situations. Individuals often choose a compression sleeve for mild, chronic discomfort or to keep the joint warm during non-strenuous daily activities.
Proper Placement and Sizing
For the counterforce strap to be effective, placement is highly specific. The strap should be positioned on the forearm about one to two inches below the painful bony prominence (the medial epicondyle). The pressure pad must rest directly over the bulk of the forearm flexor muscle group, not directly on the joint or the bone itself.
To confirm placement, apply the strap and test an activity that normally causes pain, such as gripping or lifting. If the pain is significantly reduced, the strap is positioned correctly. If pain is not reduced, the pad may need to be adjusted slightly up, down, or rotated around the forearm until the pain-relieving effect is achieved.
Sizing is equally important for both sleeves and straps to ensure they provide benefit without causing harm. The brace should be snug enough to maintain contact and deliver the desired compression or counterforce. However, it must not be so tight that it restricts circulation, which can be checked by monitoring the hand for any signs of numbness, tingling, or skin discoloration.
The goal of bracing is to provide temporary relief, so it should generally be worn only during activities that provoke pain. Physicians and therapists advise against wearing a supportive brace constantly or while sleeping. Over-reliance on a brace can lead to muscle dependence and potentially hinder the strengthening and rehabilitation process necessary for a long-term resolution of the condition.