CA2713694A1 - Tennis elbow wrist brace - Google Patents

Abstract

Tennis elbow, or lateral epicondylitis, is an orthopaedic condition in which the wrist extensor muscles are over-worked leading to a tendinopathy of the common wrist extensor tendon originating on the lateral epicondyle of the humerus. There are many factors that can lead to excessive workload for the extensor muscle group.
Neck, shoulder, elbow, and wrist biomechanical impairments may contribute.
Lower cervical nerve root facilitation is often important. Muscle strength and flexibility imbalances may contribute, as well. Also ergonomics, technique and repetitive tasks are important factors. Regardless, all contributing factors lead to the wrist extensor muscle group becoming overworked. All contributing factors should be addressed.
Some factors must be treated by a skilled therapist. Whereas other factors such as activity modification, exercise and bracing are managed by the patient. This invention, which can be self-applied by the patient, is a brace with elastic properties that acts on the forearm to assist the muscle action of the over-worked wrist extensor muscles.

Description

Patent Application Specification This invention is a wrist brace that assists the action of the wrist extensor muscles for the treatment of tennis elbow.

Commonly, tennis elbow is treated with a brace that wraps circumferentially around the forearm, just distal to the elbow, putting pressure on the common extensor tendon. This may provide some relief proximal to the brace. However, it is often uncomfortable in cases where the pain site is compressed by the brace. Also, this common type of tennis elbow brace does not assist the muscle action of the over-worked wrist extensors. A less common treatment that does assist the wrist extensor muscle action is elastic taping. Highly elastic tape can be used in the treatment of tennis elbow, such that the tape is placed on the dorsal aspect of the hand and forearm. One of the reported effects of elastic taping is a small amount of mechanical assistance to the wrist extensor muscles. This treatment may be inconvenient for several reasons. Some patients have allergic reactions to adhesives found in tape. Additionally, the tape requires a clean surface. This limits its usefulness in many work environments where a person's hands get soiled. In environments where regular hand washing is a necessity, the tape would not adhere properly, nor would it allow sufficient hand washing for some sterile environments.
Additionally, the tape does not adhere adequately over hair, requiring shaving before application. The tape is not easily applied and removed frequently throughout the day. Normally, tape is left in place for days, until a subsequent visit with a therapist.
Regular taping can become quite expensive, especially if a therapist is required for application. Lastly, many patients with tennis elbow only need mechanical assistance for the wrist extensors for short periods of painful activity. Not all activities are painful. Constant mechanical assistance could weaken the muscles over time. So, mechanical assistance should be removed for painfree activities.
These disadvantages can be overcome by creating an elastic brace that draws the wrist into a plane of extension by securing around the metacarpophalangeal joints of the hand and proximally securing around the forearm, assisting the wrist extensor muscle action. The brace does not have an adhesive and can be made of hypoallergenic materials. It can be applied to the extremity despite hair, moisture, and cleanliness of the surface. It can be applied independently by the patient without the assistance of a therapist. The expense in purchasing the brace is significantly less than repetitive taping. Therapeutically, the brace can be applied and removed easily many times throughout the day for proper hygiene and to limit the de-conditioning of the extensor muscle group by only wearing the brace for known painful activities, removing the brace for easier tasks and to perform regular stretches and strengthening. Lastly, the brace can provide greater mechanical assistance than elastic taping.

In drawings which illustrate embodiments of the invention, Figure 1 is a palmar aspect view of the brace applied to a hand. Figure 2 is a radial and slightly dorsal aspect view of the brace applied to a hand. Figure 3 is a palmar view of the brace not applied to a hand.

The brace is constructed of a length of neoprene, having any suitable length, width, and thickness for a given patient, either customized for an individual or having generic proportions for a patient demographic. Ideally, the neoprene has a nylon fabric on one surface for comfort against the skin and moisture wicking, and a loop Patent Application fabric on the other surface, to which the hook portion of hook-and-loop material would secure. The length of neoprene is cut narrowest at its center where it will contact the palmar aspect of the fingers proximally when applied. At either end of the brace, a small length of hook material is secured to the loop surface of the brace, extending out a sufficient length from the ends of the brace. This hook material will ultimately secure the brace proximally around the forearm, when applied. The length of neoprene is crossed over itself to create a hole through which the fingers will insert during application. In crossing the length of neoprene, the palmar nylon surface remains entirely facing anteriorly and the loop surface remains entirely facing posteriorly. Where the neoprene crosses, it should be fixed securely by any appropriate means (e.g. stitching with thread, a rivet, or a button). Once crossed over itself to create the hole through which the fingers pass, the narrowest portion of the brace that articulates with the fingers sits up partway into the transverse plane.
This allows for best articulation with the fingers.

The brace can be applied to either hand. However, it must be applied with the palmar aspect of the brace facing anteriorly when the arm is held in anatomical position. Ideal application of the brace would have the wearer insert digits 2 and 3 fully through the hole in the brace, such that the brace can pull tightly at the proximal, palmar aspect of the proximal phalanges of those digits. Although, several other applications are possible including the insertion of just one finger through the hole, the insertion of three fingers through the hole, or the insertion of all four fingers through the hole, the two-finger application is most beneficial for preventing constriction of blood flow to the digits and for optimizing the line of pull of the extension force vector created by the brace. Once the fingers are inserted through the hole, the wrist should be actively extended by the wearer while one end of the brace is pulled tightly and wrapped in either direction around the wrist.
Preferably, the first end will wrap around the wrist crossing over the other end-piece of the brace. The first end is secured by the hook material at its end, fixing to the loop material on the dorsal aspect of the neoprene. Once the first end is secured, the other end is pulled tightly and wrapped in the opposite direction around the wrist, preferably securing around the forearm just proximal to the other secured end.
Once both ends are secure, each end can be adjusted for tightness to suit comfort and the desired therapeutic extension force.

Suggested best use of the brace would be to wear it for painful activities only.
Wearing the brace for short-term symptom relief prevents pressure soreness where the brace pulls on the fingers. It also allows time for normal (non-braced) neuromuscular experiences. Furthermore, wearing the brace for short periods, prevents muscular deconditioning of the wrist extensor muscle group that will ultimately require strengthening in most cases. The brace should give immediate symptom relief from mechanical pain when applied. Tension of the brace when applied should be at the lowest tension that provides symptom relief.

Claims (15)

1. A medico-therapeutic brace for the treatment of lateral epicondylitis and similar muscle injuries and tendinopathies of the muscle groups acting on the wrist that uses elastic force to assist muscle action.

2. An article as defined by claim 1, in which the elastic force is derived from neoprene or a similarly elastic material.

3. An article as defined by claims 1 and 2, in which the neoprene is covered on one surface by a nylon fabric, or a fabric having similar qualities of comfort against the skin and reduction of moisture accumulation between the neoprene and the skin.

4. An article as defined by claims 1,2, and 3, in which the neoprene is covered on the other surface by a loop fabric having the necessary qualities for the hook portion of a hook and loop material to secure, or by a material to which the loop portion of a hook and loop material can be sewn.

5. An article as defined by claims 1,2,3, and 4, in which the elastic material is a shape sufficient to secure distally around the hand, or one or multiple fingers, and proximally around the forearm.

6. An article as defined by claims 1,2,3,4, and 5, in which the shape of the elastic material is elongated such that it has two ends and a middle section.

7. An article as defined by claims 1,2,3,4,5, and 6, in which the elastic material is any length and width sufficient to secure around the hand and forearm of the person wearing it.

8. An article as defined by claims 1,2,3,4,5,6, and 7, in which the length of elastic material is crossed over itself at some point between its two ends and fixed by sewing with thread, attaching a button or rivet, or any other suitable method of fixing the elastic material at the point where it crosses.

9. An article as defined by claims 1,2,3,4,5,6,7, and 8, in which crossing the length of elastic material over itself creates a hole through which the hand or fingers will pass to secure the article distally around the finger, or fingers, or hand.

10. An article as defined by claims 1,2,3,4,5,6,7,8, and 9, in which the length of elastic material may be cut straight or have any degree of angulation suitable to optimize articulation around the finger, or fingers, or hand of the person wearing it.

11. An article as defined by claims 1,2,3,4,5,6,7,8,9, and 10, in which the middle section narrows sufficiently at a point along its length to better fit around the fingers of the person wearing it.

12. An article as defined by claims 1,2,3,4,5,6,7,8,9,10, and 11, in which each end of the shape of elastic material wraps circumferentially around the forearm in opposite directions.

13. An article as defined by claims 1,2,3,4,5,6,7,8,9,10,11, and 12, in which each end of the shape of elastic material is secured proximally around the forearm using hook and loop material or hook material alone.

14. An article as defined by claims 1,2,3,4,5,6,7,8,9,10,11,12, and 13, in which each end of the shape of elastic material is secured proximally around the forearm using any button, adhesive, or other material that sufficiently fixes the end around the forearm.

15. An article as defined by claims 1,2,3,4,5,6,7,8,9,10,11,12,13, and 14, that when applied to the upper extremity causes a force on the wrist that biases the wrist toward any plane of extension.