GB2294881A

GB2294881A - Elbow orthosis

Info

Publication number: GB2294881A
Application number: GB9421224A
Authority: GB
Inventors: Jacqui Helen Mullins
Original assignee: Individual
Current assignee: Individual
Priority date: 1994-10-21
Filing date: 1994-10-21
Publication date: 1996-05-15
Anticipated expiration: 2014-10-21
Also published as: GB2294881B; GB9421224D0

Abstract

The orthosis comprises a pad 12 of sufficient size to fit distally to the lateral or medial epicondyle of the wearer, without at the same time encompassing the arm of the wearer, and two or more straps 20, 22 attached to the pad. The straps are of sufficient length to be wrapped around the arm and have hook and loop means at their remote ends 24, 26 for releasable attachment to at least one of the straps and/or the pad. The straps may be wrapped around the arm on either side of the elbow to provide compression to both the insertion of the forearm extensors and flexors and the origin of the wrist extensors and flexors. The orthosis is useful in the treatment of tennis elbow, medial epicondylitis or triceps strain. <IMAGE>

Description

ELBOW ORTHOSIS The present invention relates to an Elbow Orthosis which is particularly suited to the treatment of tennis elbow (lateral epicondylitis) and golfer's or thrower's elbow (medial epicondylitis).

As is well known, muscles are attached to bones at the periosteum by means of tendons in one of two types of attachment, known respectively as the origin and the insertion. In addition to providing muscle with a firm attachment, tendons also transmit to the bone the forces generated during muscle contraction. In order to perform these functions effectively, tendons consist of white fibrous connective tissue containing parallel bundles of collagen fibres. This enables them to retain flexibility but resist stretching when a pulling force is applied.

Fibrocartilage is present and gives added strength in those areas where tendons merge with bone.

Epicondylitis is inflammation of the origins of tendons where they insert into condyles of bones, such as, for example, the epicondyles of the humerus, radius and ulna. Epicondylitis is called tennis elbow when the lateral epicondylar area is involved and although this is common amongst tennis players, it is seen in golfer's and many other racket sports. It is also very common in certain manual occupations and other leisure activities.

Generally speaking tennis elbow is an over use injury at the site where the muscles in the forearm which extend the wrist are attached at the elbow. Pain and tenderness is felt over the outside (or lateral side) of the elbow near a small bony protruberance which can be felt there.

Excessive and repetitive movements at the wrist such as gripping, twisting and un-twisting or backhand shots in tennis, squash or badminton cause stretching and strain of this tendon and straightening or extending the wrist against resistance will bring on the pain at the elbow.

In racket sports (particularly tennis) a faulty backhand technique may bring on and aggrevate this problem. In tennis this occurs when a player predominantly uses a wrist action rather than using a firm wrist and the whole trunk, arm and shoulder to hit the ball. If the racket is too heavy or the grip too big or small then this may also lead to problems. Heavy balls, fast court surfaces such as grass and a tightly strung racket are all factors that increase the load of inpact on the wrist.

When epicondylitis effects the medial epicondylar area the condition is known as golfer's or thrower's elbow and arises where there is excessive strain or stretching of the flexor muscles of the forearm. These muscles bend the wrist palm downwards and provide finger grip. Rapid, forceful bending of the wrist with a closed grip can bring this on, particularly where the forearm is turned inwards at the same time. This movement occurs in javelin throwers, golfers (particularly those with a faulty bottom handed technique), baseball pitchers, cricket bowlers and in tennis players with a fast service or exaggerated top spin.

To date, the exact pathophysiology of epicondylitis has not been clearly established. What is known however is that repetitive motions and over use contribute to microtraumatic changes in the affected tendons, causing microscopic tears, bleeding, oedema and pain. In addition to the microscopic tendon tears, pathologic signs include avascularity of the tendon and calcification at the tendon origin. Scar tissue is formed from the avascularity and microtrauma. In some cases the tendon ruptures as a result of the degenerative changes. Ischemia from the avascularity may account for the pain.

Another cause of pain is the inevitable swelling in the epicondyle region. The distension of the tissues not only applies pressure to the nerve endings making the injury more painful, but also limits the amount of movement possible at the joint. Clearly, the less swelling that occurs and the sooner that it is dispersed the better.

In the past in order to discourage swelling conventional bandages have been wound around the arm.

More recently, tubular elasticated bandages have also been used to apply compression to the effected region. It has been found however, that these bandages, which typically extend at least 5cm either side of the elbow, are uncomfortable if worn for prolonged periods and themselves serve to restrict movement at the joint. It is therefore an object of the present invention to provide an elbow orthosis which, whilst assisting in the treatment of epicondylitis, is both comfortable to wear and does not overly restrict movement.

According to the present invention there is provided an elbow orthosis comprising a pad of sufficient size to fit distally to the lateral epicondyle or the medial epicondyle of the wearer of the orthosis without at the same time encompassing the arm of the wearer and two or more straps attached to the pad, the straps being of sufficient length to be wrapped around the arm of the wearer and provided at an end remote from the pad with means for releaseable attachment to at least one of the straps and/or the pad.

Advantageously, at least one of the straps may be adapted to be wrapped around the arm above the elbow and another of the straps may be adapted to be wrapped around the arm below the elbow. Preferably the straps may be adapted to provide compression to both the insertion of the forearm extensors and flexors and the origin of the wrist flexors and extensors.

Advantageously, the orthosis may be provided with two straps which diverge from each other as they extend away from the pad.

Advantageously, the straps may be attached to the pad solely along one edge of the pad. Preferably the edge of the pad to which the straps are attached may, in use, extend generally longitudinally of the arm, the straps being attached separately to the pad along said edge in side by side relationship. Preferably, the straps may extend from the edge of the pad to which they are attached in such a way as to overlie the pad before extending away therefrom.

Advantageously, the means for releaseable attachment may comprise hook and loop attachment means.

An embodiment of the present invention will now be described by way of example with reference to the accompanying drawings in which: Figure 1 is a diagram illustrating the bones of the elbow joint; Figure 2 is an anterior view of the muscles that move the wrist and fingers; Figure 3 is a posterior view of the muscles that move the wrist and fingers; Figure 4 is a schematic view of an elbow orthosis embodying the present invention; Figure 5 is a schematic view of the elbow orthosis of Figure 4 viewed from below.

Figure 6 is an anterior view of the elbow orthosis of Figure 4 as worn by a wearer; and Figure 7 is a posterior view of the elbow orthosis of Figure 4 as worn by a wearer.

Referring to Figure 4, there is shown an elbow orthosis 10 comprising a generally rectangular pad 12 defined by respective pairs of opposite edges 14,16 and 18,19. The rectangular pad 12 is adapted such that in use it is orientated with the two longer edges 14,16 extending generally longitudinally of the arm and is so sized as to fit distally to the lateral epicondyle or the medial epicondyle of the wearer of the orthosis without at the same time encompassing the arm of the wearer.

Accordingly, the longer edges of the pad 12 may have a length of between Scm and 15cm while the shorter sides of the pad may have a length in the range between 3cm and 10cm. Preferably, the pad 12 is so sized as to have a longer side of approximately 9cm and a shorter side of approximately 4.5cm.

Two straps 20 and 22 are separately attached to the pad 12 in side by side relationship at one of the longer edges 14. The straps 20,22 may be attached to the pad 12 in any convenient manner such as by glueing or being stitched. The straps 20,22 extend from their respective points of attachment in such a way as to overlie the pad before then extending away from the pad and terminating in a respective end portion 24 or 26. As is clearly shown, the straps 20,22 diverge as they extend away from the pad 12 in such a way that they define a V shape having its apex located at their respective points of attachment.

The straps 20 and 22 have a length which is sufficient to enable them to be wrapped around the arm of the wearer of the orthosis and may therefore have a typical length of between 10cm and 40cm.

The end portions 24 and 26 are each provided with a suitable means by which they may be releasably attached to the opposite ends of the straps or to the pad once the straps have been wrapped around the arm of the wearer. In the example shown this attachment means it is provided by a hook and loop arrangement, a hooked region 28 being located at a proximal end of each strap on an upper surface remote from the pad 12 and a looped region 30 being located at a distal end of the straps on a suitable under surface. It will be apparent however that any other suitable releasable attachment means may also be used.

The orthosis 10 may be formed of any convenient material having the necessary comfort and wear resistant properties such as neoprene. The rectangular pad 12 may be padded for extra comfort or may be adapted to provide increased heat retention to the region that it overlies.

In use the orthosis may serve in the treatment of either tennis elbow (lateral epicondylitis) or golfer's or thrower's elbow (medial epicondylitis). In either case the pad 12 is positioned over the appropriate epicondyle region and orientated so that its two longer edges extend longitudinally of the arm of the wearer. The straps are then wrapped around the arm in such a way as to enable each of the looped regions 30 to engage their corresponding and respective hooked region 28.

If it is desired to apply additional compression to the epicondyle region the two straps 20,22 may be crossed so that the looped region of one strap 30 engages the corresponding hooked region 28 of the other.

Alternatively the straps 20, 22 may be of increased length thereby enabling them to be wrapped more than once around the arm.

Because the two straps 20,22 diverge as they extend away from the pad 12, when worn by a wearer one of the straps is wrapped around the arm at a point above the elbow while the other is wrapped around the arm at a point below the elbow leaving the elbow itself uncovered. This increases the comfort experienced by the wearer and facilitates the optimal movement of the joint.

Furthermore, because the straps are wrapped around the arm either side of the elbow, the orthosis is able to provide compression to the insertion of the forearm extensors and flexors as well as to the origin of the wrist flexors and extensors. This in turn enables the orthosis to find use in the treatment of triceps strain which may occur when there is a strain or rupture of the triceps tendon responsible for straightening the elbow.

Additional comfort is ensured by providing that the rectangular pad 12 is no larger than is necessary to overlie the lateral epicondyle to provide compression to the common extensor origin or to overlie the medial epicondyle and provide compression to the common flexor origin. Further comfort is also provided in the manner of attachment of the straps 20,22 to the rectangular pad 12 since by ensuring that each strap is joined separately to the pad either strap may be moved independantly of the other to provide maximum comfort.

By providing a hook and loop means for the releasable attachment of the straps 20,22 it will be apparent that the compression applied by the orthosis may be adjusted from time to time by an individual wearer and that the same orthosis may be worn by several individuals each having differently developed arm muscles.

Claims

CLAIMS:

1. An elbow orthosis comprising a pad of sufficient size to fit distally to the lateral epicondyle or the medial epicondyle of a wearer of the orthosis without at the same time encompassing the arm of the wearer and two or more straps attached to the pad, the straps being of sufficient length to be wrapped around the arm of the wearer and provided at an end remote from the pad with means for releaseable attachment to at least one of straps and/or the pad.

2. An elbow orthosis in accordance with claim 1, wherein at least one of the straps is adapted to be wrapped around the arm above the elbow and another of the straps is adapted to be wrapped around the arm below the elbow.

3. An elbow orthosis in accordance with claim 1 or claim 2, wherein the straps are adapted to provide compression to both the insertion of the forearm extensors and flexors and the origin of the wrist flexors and extensors.

4. An elbow orthosis in accordance with any preceding claim, wherein the orthosis is provided with two straps which diverge from each other as they extend away from the pad.

5. An elbow orthosis in accordance with any preceding claim, wherein the straps are attached to the pad solely along one edge of the pad.

6. An elbow orthosis in accordance with claim 5, wherein the edge of the pad to which the straps are attached extends, when in use, generally longitudinally of the arm, the straps being attached separately to the pad along said edge in side by side relationship.

7. An elbow orthosis in accordance with claim 5 or claim 6, wherein the straps extend from the edge of the pad to which they are attached in such a way as to overlie the pad before extending away therefrom.

8. An elbow orthosis, wherein said means for releaseable attachment comprise hook and loop attachment means.

9. An elbow orthosis substantially as herein described with reference to Figures 4 to 7 of the accompanying drawings.