Best Hinged Elbow Braces
In a recent set of articles, we reviewed a wide range of tennis elbow braces and golfer's elbow braces. While these types of braces are extremely popular, mainly due to the high occurrence of these types of injuries, their designs are drastically different from a hinged elbow brace.
Tennis elbow and golfer's elbow braces are typically designed in a strap form that provides compression to the affected area. However, if you have sustained a severe elbow injury that affects the overall stability of the elbow joint, such as a torn ligament, then you will likely require a higher degree of stabilization.
When you incorporate hinges into a brace design, this is usually to provide some sort of rigid support that prevents external forces from moving your elbow into unhealthy positions. For example, some elbow braces are designed to resist hyperextension, and bilateral hinges can also act to maintain medial and lateral (sides) stability of the elbow joint, which can be desirable after suffering a ligament injury.
To get to the point, we will provide an overview of a couple different styles of hinged elbow braces in this next section. Below this section you can find more information about hinged elbow braces in general, as well as some basic information about elbow anatomy.
Reviews - Best Hinged Elbow Braces
This is considered to be a range of motion (rom)
hinged elbow brace with a primary function of resisting hyperextension. The bilateral hinges not only provide medial and lateral support, but they are design to lock at zero degrees, which can really help your elbow from going into a hyperextended position.
The hinges are supplemented by a X-cross hook-and-loop strap closure system, which further help restrict range of motion (especially rotation), as well as provide stability in the form of compression and a snug fit.
This hinged elbow brace also has thermal capabilities, insulating heat and providing compression at the same time to help alleviate pain and swelling. This can be a bonus, especially if you're still rehabilitating an injury that flares up from minimal to no use.
One other thing to note about the hinges: they are often good for post-operative care, as they can be set to limit extension at 0, 10, 15, 30, and 45 degrees, allowing you to progress through your range of motion as you heal. However, like always, it's highly encouraged that you check with your doctor or physiotherapist about the best way to immobilize, or begin to mobilize, your arm following a severe injury.
There are only two notable disadvantages to this hinged elbow brace. First, the thermal capabilities is a double-edged sword. While the application of heat and compression to the affected area can really help how you feel, it's ventilation is lacking, so your arm may become quite sweaty, which could also lead to more frequent cleaning. Secondly, some individuals find the size runs a little large, but it's not a huge deal if you end up with an improper fit, as you can always exchange for a different size.
Overall, this is a solid all-around hinged elbow brace that has a variety of capabilities. It's nothing fancy, but employs all the features you need for good stability and a limited range of motion. It's one of the cheaper hinged elbow braces out there, so there are a couple subtle issues (see paragraph above), but at the end of the day, it offers good bang-for-your-buck.
The DLX Post-Op Hinged Elbow Brace is an excellent brace for rehabilitation from elbow injuries, including those injuries that required surgery. They haven't dressed it up with a fancy appearance, which in our opinion, is a good thing. This will keep the wearer focused on the pieces that matter, can allow the wearer to better understand how the brace actually functions, and it also makes fitting and adjustments and easier process.
It may look a little clunky, but it's highly adjustable and can be used in many different situations. The elbow can be fully locked at different angles occurring in 15 degree increments, or a specific range of motion can be set if so desired. The hinges are easily adjustable through the use of a button, even while wearing.
It's not just the adjustable hinges that matter, but the adjustable length also serves an excellent purpose of helping provide the best fit and control of movement possible. The adjustable straps simply use Velcro to close, which makes it easy to put on and take off. The brace doesn't have fabric wrapping completely around your arm insulating heat, so if you're just looking for something that provides heat and compression, this isn't it.
Rather, this DLX hinged elbow brace is great for rehabilitating an elbow injury, especially if you need good control of your range of motion, especially a limited range of motion. Besides, the lack of thermal capability will also help keep your arm cool and dry, which a lot of people prefer.
The only notable disadvantage to this elbow brace is that you need to keep an eye on it when you're first using it. Knowing how to adjust the hinges and keep them locked in is very important, and while it's simple to use, it's best to be 100% confident using it, especially before engaging in any type of rehabilitative exercises or activity. Some customers have mentioned it takes a little while for them to optimize the fit perfectly for them, so again, at first just make sure you take care and pay attention when putting on the brace.
Overall, the DLX Post-Op Hinged elbow brace is an excellent brace for post-operative recovery, or recovery from an injury that didn't require surgery. The name of the game here is to limit range of motion in flexion and extension, provide medial and lateral support for resistance of varus/valgus stresses, or completely immobilize the elbow if so desired. It doesn't look overly sleek, but who cares, your health is the only thing that really matters in this case.
This is a really interested hinged elbow brace that combines lots of different features to promote versatility and all-around comfort. For comparisons sake, you could consider this to be similar to the Thermoskin Hinged Elbow Support that we reviewed above, but with some slight improvements. Of course, these improvements come with a price.
This hinged elbow brace is highly adjustable in all accounts. The hinges can be adjusted and locked in order to restrict your arm to a specific range of motion. The extension stops include 0, 10, 20, 30, and 40 degrees. The brace does not ship with flexion stops installed, as this is an optional feature that many people don't require, but nevertheless, you can install them to provide stops at 45, 60, 75, and 90 degrees.
The brace is a slip-on style, which is as simple as it gets, but it still incorporates anterior cross straps with a strap-lock buckle. The material provides some compression, which can help with pain (depending on the source) and also helps control elbow movement, which is great when recovering from injuries that greatly destabilize the elbow, such as a dislocation or ligament tears. Unlike the Thermoskin Hinged Elbow Support, the Breg Hex Adjustable Hinged Elbow Brace uses "Half Airmesh" material to allow for ventilation, while the neoprene still offers compression.
Overall, this is an excellent hinged elbow brace that can be suitable for any stage of injury recovery. It can be locked in one specific position, adjusted to allow a restricted range of motion, or provide a nearly full range of motion while still enhancing control and stability of the elbow joint. The main disadvantage is the cost, as it's a little more expensive than other braces of similar design, but at the end of the day you get what you pay for.
The Orthomen ROM Hinged Elbow Brace is very similar to the DLX Post-Op Hinged Elbow Brace that we reviewed above. While they have extremely similar overall designs and come in at similar price points, there are some subtle differences.
The Orthemn ROM Hinged Elbow Brace comes with a shoulder strap (sling) that helps support and elevate your arm when needed. This is a great feature to have immediately following injury or surgery, and when combined with the fact that the brace can be locked in one position, this leads to a great ability to immobilize the arm if so desired.
The hinges can be adjusted in order to be fixed in one position or set to a specific restricted range of motion. It has an extension limitation from 0-60 degrees and a flexion limitation from 0-120 degrees, each in increments of 15 degrees. The press-and-rotate hinge lock is easy to use and can be adjusted while wearing the brace. Furthermore, the length of the forearm and upper arm portion is adjustable as well.
There are two main disadvantages to this hinged elbow brace. First, if you are right-hand dominant, the straps on the left arm model can be somewhat difficult to do up or adjust. Second, the brace can be a bit small for those with significantly larger arms.
Overall, this is a great hinged elbow brace that can be used to aid in recovery from severe elbow injuries and any associated surgery. While it is definitely comparable to the DLX Post-Op Elbow Brace, we find the DLX to be slightly better in terms of fit and function, but at the same time, it lacks the padded shoulder strap that comes with the Orthomen.
We don't think you can really go wrong with either model, you'll just have to pay attention to the specific features and subtle differences in order to make a decision based on personal preference. Additionally, your physician or physiotherapist are also great resources to help figure out which elbow brace may be best for your specific injury and recovery protocol.
DonJoy Performance Bionic Hinged Elbow Support - Great for UCL (Ulnar Collateral Ligament) Brace
This is a sleek-looking hinged elbow brace from a reputable brand that can potentially be a great brace for many different individuals. The stretch webbing closure system and cross straps are utilized to facilitate an anatomical fit and the neoprene material is perforated to help increase ventilation. The bilateral polycentric hinges have hyperextension stops to provide a level of safety that a normal compression sleeve or tendonitis strap simply cannot do.
The material is made with Anti-Migration technology to help prevent slippage. It also includes some reflective material so it's visible in darker conditions. The brace on a whole isn't overly bulky, so it can be convenient to wear in many different settings.
As great as this hinged elbow brace looks, there is one noticeable flaw: the sizing. Some individuals find it fits great immediately, but there are a significant amount of people who ordered based on their recommended sizing and had to exchange the product. This seems to be more apparent for those with larger forearms. For example, some people order based on their bicep measurements (recommended sizing method by DonJoy), only to find that it's too small for their forearm!
Overall, this is a great all-around hinged elbow brace that offers good value; however, it can be a risky pick in terms of sizing, especially if you have larger forearms. This isn't a big deal if you don't mind exchanging the brace for a different size if necessary, but if you need something that you can count on fitting correctly right out of the box, you may want to consider another option.
Anatomy of the Elbow Joint
The elbow joint complex includes the articulation of three bones: the humerus (arm bone), and the radius and ulna (forearm bones). There are actually three separate joints that combine to form the joint complex, and these include the humeroulnar joint (articulation between the humerus and ulna), the humeroradial joint (articulation between the humerus and radius), and the proximal radioulnar joint (articulation between the radius and ulna at the level of the elbow).
For the sake of simplicity, one can think of the elbow joint as the upper body's version of the knee joint. While articulating bones often fit together like a piece of a puzzle, there are some incongruities at the elbow joint, and way more incongruities (or unstable portions) at the knee joint.
So where does the elbow joint receive its support from? After all, we place a lot of stress on our joints everyday, especially if you're an athlete or someone working in a very physical profession. The two main factors here are muscles and ligaments.
In addition to providing movement, muscles act as dynamic stabilizers for joints. For example, at the elbow joint, the biceps muscle runs down the humerus, crosses the elbow joint, and inserts into the forearm. When it contracts, it will pull the forearm up towards the shoulder, which is also called elbow flexion. Muscles can contract while shortening, they can stay the same length and contract, or they can contract while the muscle is being forcibly lengthened. In any case, contraction of muscles around the elbow joint can provide further stability.
Ligaments are different from muscles in that they are passive structures. This means you cannot actively contract ligaments. Instead, they work like really stiff elastic bands connecting one bone to another, usually across a joint. There are many ligaments in the elbow joint complex, including the ulnar/medial collateral ligament, the radial/lateral collateral ligament, and the annular ligament.
Ligaments are often damaged or torn in sports and accidents. This happens when some sort of external force makes the respective joint move into a position it normally doesn't move into. For example, hyperextension of the elbow can cause ligament tears and significant damage to the overall elbow joint.
Video Tutorial - Anatomy of the Elbow Joint
When studying anatomy, I usually find it helpful to read a little bit about it first before viewing any images or videos. For example, the text above gives you a brief idea of what structures are involved in the elbow joint and how they work. If you learn from a video right away, there's nothing wrong with that, but it can be difficult to keep up on the terminology, the points they are trying to make, and follow along with the visuals all at once. After I do a quick little bit of research, I find I'm way more ready to learn from a video and get into the meat of the concepts.
If you are interested in supplementing your knowledge of the elbow joint, we find the following video to be a nice demonstration of the elbow joint anatomy. This one focuses on the bones and ligaments, and it's quite nice because they interact with the elbow joint as they explain, showing and removing structures to make the concepts clear.
This next tutorial is a a little different in that it focuses primarily on the muscles and the nerves that cross the elbow joint. This may give you a better idea of the the elbow joint actually moves and functions, and what nerves supply sensation to the elbow. Many people find that detailed aspects of musculature are a little complicated, but in this case, we simply encourage you to focus on the big ideas and general concepts.
How Do Elbow Braces Provide Stability?
Braces are designed to mimic and reinforce our existing anatomy. We don't all wear braces 100% of the time around all of our joints because, usually, our normal anatomy can withstand the day-to-day forces that are exerted on our body.
However, when things start to change, for example with injury, added weight, or we're changing our environment all together such as playing a sport, then it becomes more likely that our joints are more susceptible to damage.
Let's take the case of the elbow joint, given that's the point of this article. If someone falls on an outstretched arm and dislocates their elbow, chances are that there will be severe damage to the ligaments surrounding the elbow as well, in addition to the joint capsule itself. So let's someone partially dislocated their elbow (maybe it dislocated and popped back into place) and also suffered a torn ulnar/medial collateral ligament (UCL). If the UCL is completely torn, or damaged tot he point where it is extremely fragile and slack, the hinges on a hinged elbow brace will help reinforce that area. Hinges typically resist hyperextension, just like the UCL, and they also provide rigid support on the sides of the elbow to help resist any varus or valgus forces that could also damage the ligament.
Moreover, if you just came out of surgery or are in the initial stages of rehabilitating a severe elbow injury, you may be instructed to immobilize your elbow completely before progressing to any type of movement. Hinged elbow braces are great for this purpose, as many of them can be locked into a specific position, helping to protect your elbow and provide a good setting for healing, while not having to worry about accidentally moving it and causing further damage.
Do All Elbow Braces Provide the Same Level of Support?
Definitely not! Hinged elbow braces typically provide the most support. They usually combine compression, all-around padding, and lockable hinges that can also be set in a way that you are free to move, but within a specific range of motion. The hinges act almost like emergency stops, ensuring you won't put the elbow joint into a position that is unhealthy for it.
Hinged elbow braces also often incorporate a crossing strapping system on the front/anterior portion of the elbow, which further helps to resist hyperextension, but also allows for better control of elbow flexion and extension, which could be desirable when you first start moving your arm around again after an injury or surgery.
Other braces you may see or more like straps or sleeves. Straps are often used for conditions like golfers elbow or tennis elbow, whereby the tendons and surrounding structures become irritated and inflamed by repetitive movement over the lateral or medial epicondyle of the humerus. These straps help provide targeted compression to reduce pain and inflammation, especially during activity, but provide no additional support or stability beyond what your normal anatomy already provides.
Lastly, elbow compression sleeves are also highly popular among the general population and athletes alike. These work in a similar manner to the straps by providing compression for relief of pain and inflammation, but the compression is more general and widespread. These compression sleeves usually offer a tiny bit of additional support simply due to their overall compression and elastic material, but it's definitely not even close to the level of support a hinged elbow brace would provide. Lots of people like compression sleeves because they can be easily worn under clothes, they're cheap, they're often stylish, and they do help provide some relief of general pain and inflammation from chronic injuries or overuse.
Common Injuries of the Elbow Joint
The ulnar collateral ligament (UCL), also known as the medial collateral ligament, is the ligament that runs across the elbow joint on the inside side of the arm. It actually has three separate bands, all of which resist movement in different directions, although there is quite a bit of overlap. It's a fairly strong ligament, but is commonly ruptured during falls that dislocate the elbow, and it is one of the most common injuries for baseball players, especially pitchers.
A sprain can have several levels of severity. Usually, these levels of severity, or classifications, are ranked by how much of the ligament is suspected to be torn. For example, the least severe UCL sprain could leave it completely intact, but it stretched enough to cause a little bit of damage or irritation, making it a little more susceptible to further injury, whereas the most severe sprain would be a complete rupture.
Grades of UCL Sprains
Grade 1: UCL is stretched, but not torn.
Grade 2: UCL is partially torn, but still technically intact. There are varying degrees of Grade 2 UCL sprains.
Grade 3: Complete tear/rupture of the UCL. Surgery or reconstruction is most likely required.
Video Commentary of UCL Sprains
Below is a video of Dr. David Geier, Orthopedic Surgeon and Sports Medicine Specialist, describing various aspects of a UCL injury. He answers some common questions people have, such as "Do you need surgery for a UCL injury?", as well as provides what he believes to be some useful general information. We definitely found this video helpful, hopefully you will, too!
Bursitis is quite common in the elbow as well as the shoulder. Bursae are fluid-filled sacs that usually help reduce friction between structures that have to move along each other. There are 4 main bursae in the elbow joint. The first three we list are all considered to be olecranon bursae, as they are located around the olecranon on the back of the elbow joint. The last bursa in the list is found on the front of the elbow joint.
Subcutaneous Bursa: This bursa sac is located in the subcutaneous tissue (fat just under the skin) over the olecranon, which is the bony prominence we all commonly know as the elbow. This bursa is commonly inflamed in people with occupations that require a lot of leaning on the elbows and forearms. It is sometimes referred to as the olecranon bursa, which makes sense given its location, but technically, the term "olecranon bursa" should also incorporate the next two bursa as well.
Subtendinous Bursa: Located between the triceps tendon and the olecranon, this bursa is responsible for reducing friction as the triceps tendon moves over the back of the elbow.
Intratendinous Bursa: Located within the tendon of the triceps, this bursa actually isn't present in all individuals.
Bicipitoradial Bursa: Also known as the biceps bursa, it is located between the biceps tendon and the anterior (front) portion of the radial tuberosity. This helps reduce friction as the biceps tendon moves over that bony prominence.
Bursitis can result from trauma, but often times it develops over a long period of time, even months to years. Given they provide assistance in repetitive movements, these are generally also the movements that cause damage over time. Additionally, infection or pre-existing conditions like arthritis or gout can also increase the risk of elbow bursitis.
So how do you know if you have bursitis? Anything to do with a diagnosis should always be left for your doctor or other health professional, but one common sign of bursitis is significant swelling. The swelling can increase to the point where it hurts, especially if you press on the affected area. If you leave it too long, an infection can occur, which will cause warmth and redness in the skin. If you experience this, we recommend you see a doctor as soon as possible, as a spread of infection can lead to even more dangerous problems.
There are lots of different treatments for bursitis. The easiest or lowest level of treatment is simply stopping activity and letting it heal. Another common treatment if the bursa is swollen is to physically drain the bursa of its fluid, which can usually be done in the physician's office. If they suspect infection, they can send off the fluid for lab tests to learn more. Lastly, surgery to remove the bursa altogether can be another treatment, but this is usually reserved to the most serious cases, which often (but not always) involve infection.
Tennis and Golfer's Elbow
We won't get too much into these conditions in this article, as we already discussed them in previous articles (see first paragraph of this article for links). Briefly, these are common conditions that involve tendons of the arm constantly rubbing over the medial and lateral epicondyles of the humerus. They are generally overuse conditions that are treated with targeted compression, anti-inflammatory drugs, or in some serious cases, surgery.
One thing we want to point out is the difference between strain and sprain. A strain involves tears or damage to a muscle, while a sprain refers to a ligament.
Muscle strains of varying degrees are quite common. They are arguably the most common in the legs, especially the hamstring muscles which cross both the hip and knee joints. At the elbow, a biceps strain is probably the most common, but it really depends. For example, a rider in a rodeo may be essentially straps in at the hand, and with the extreme forces and jarring movements caused by riding the bull, the bicep may be taking on more than it can handle, resulting in a biceps strain.
Treatment for muscle strains varies according to severity and where the injury is. Pain, especially with movement, is the main indicator of a muscle strain that isn't a complete tear. If there is a full rupture of the muscle, you may actually see it ball up somewhere along its path. With a full tear, performing a normal movement is usually impossible.
For visualization sake, let's take the calf muscle in your lower leg. If you fully rupture your Achilles tendon on the back of your leg, you likely won't be able to point your toes out, at least not very well. If you then lay on your belly relax, when the doctor squeezes your bad calf muscle, nothing will happen. But when they squeeze your calf muscle on the good leg, your foot will pop up.
Therefore, treatment can range from surgery and/or complete immobilization for severe strains, to simply avoiding activity for a while as it heals. Again, as with any injury, its best not to self-diagnose strains, and instead have a doctor or physiotherapist investigate the matter.
Hinged elbow braces are extremely useful medical devices that can help with injury prevention and treatment. They act to replicate and strengthen our own structural anatomy, as well as prevent particular movements while the injury heals.
Hinged elbow braces provide by far the most protection and stability out of all elbow braces, but elbow compression sleeves and straps also have their purpose. Elbow injuries are very common, especially in sports that involve lots of throwing or upper body mechanics, so these athletes may benefit most from learning more about what's available in terms of bracing products.