29 October 2012

Review: Armaid Elbow massage device

Richard from TCA asked if I wanted to try a new elbow injury treatment device that TCA are now retailing in the UK called the Armaid. TCA have started retailing it after seeing some impressive results on chronic golfer’s elbow. I must say, it’s a cleverly designed piece of kit and performs it’s task extremely well. But does it work? The answer, it seems, is ‘sort of’. Let’s go through some details.

How the Armaid works is pretty simple. If you want to see the details, watch the video below. Basically it provides an easy and effective was to give the flexor or extensor tendons and muscles of the forearm a good massage of various intensities. It’s very easy to use and control. Administering a good session of massage either as a therapist or by yourself is actually quite a difficult thing to do. It’s pretty hard on the thumbs, wrists, and elbows of the arm actually applying the treatment. So it can actually cause injuries as well as help them! Apart from that, your massaging arm gets tired before you’ve done enough.

So the first thing to say is that if I did want to perform regular massage on elbow epicondylitis, I’d definitely get one of these and use it.

This leads to the broader question of whether massage is actually useful for healing these injuries. That is less simple to answer. To attack the question, it’s first necessary to be clear that injury treatments fall into 2 broad categories; those that only reduce symptoms by reducing pain signals and those that reduce symptoms by actually altering the health of the affected tissue.

Obviously the latter is more effective in the long term and the more desirable type of treatment. At the moment, it seems like eccentric exercise therapy together with various other interventions (postural, training, technique, tactics) are effective in most cases for eliminating golfers and tennis elbow. Most people fail to recover because they don’t do the eccentrics, don’t do them properly and don’t make the necessary changes in their climbing to remove the underlying causes. So the condition becomes chronic.

It has been suggested that massage of various types can also be a useful treatment, either by directly increasing nutrient delivery to the degenerated tendons, breaking up disorganised scar tissue or adhesions, or by an analgesic effect. Deep friction massage is one particular massage technique that is aimed at breaking up adhesions in the tendon itself. It's not really known if it has any real effects beyond short term pain relief. DFM uses aggressive massage across the fibres rather than in line with them. I'm not sure if the Armaid could be used effectively for DFM?

Pain signals by various types of massage might be reduced in several ways such as breaking up the ‘neovessels’ packed with pain receptors that grow in diseased tendons, providing a ‘counter irritant’ that down-regulates pain sensation by the brain, or by releasing painful trigger points in the muscle belly. There is evidence that all of these aspects of massage help the injury feel less painful.

Analgesic effects are nice, but may not actually help the tendon heal directly. So there is an argument for not wasting your time on these and focusing on the treatments that will improve the strength of the tendon tissue. And this is where the rub of the debate is. Massage may not improve tissue health directly, but the pain relief may be worth it if it allows you to complete the therapeutic exercises that do.

So, I would use try this device if I had bad enough elbows that I was unable to complete a rigorous program of daily eccentrics (priority number 1), and do some climbing too. To use it as a pain reliever to just keep climbing and not address the underlying causes and tissue damage would be a very risky strategy. It’s true that pain relief allowing climbing to resume does sometimes allow spontaneous healing. I’d say this is more likely if the original condition was caused by a sudden increase in loading such as resuming climbing after a bit of time off. However, tendinosis of the elbows tends has a habit of being way more tenacious than that. Don’t underestimate it.

If you feel sure that elbow massage could be useful for you, you could try one of these. It’s most likely to be useful for particularly bad and chronic cases that are reluctant to respond to diligently applied eccentrics and technique changes.

You’ll find the Armaid for sale in the TCA shop here.


Ross said...

I remember seeing this and thinking that the flexing required to squeeze the device together would probably counteract any good it does.

Better off having the 3 sessions with the therapist to get some decent antagonistic exercises and an accurate diagnosis. Just my opinion though!

Dave MacLeod said...

I'm not I get what you mean about the 'flexing required'. It takes very little effort to use.

peter whitehead said...

Triger point theropy is what cured my Tennis and Golfers elbow but all i used was a small hard ball and it worked very well.

Ross said...

Fair enough, I did say 'probably' as I've never used the device. I was just assuming that you'd have to squeeze fairly hard to get a worth-while effect.

I've always followed this program when my elbows have started to give me issues; http://www.athlon.com.au/articles/r&i_dodgyelbow.pdf

dave frost said...

I really don't like this sort of product. Mainly because it can be used by people who have self diagnosed (incorrectly). There's a good chance the most peoples elbow problems are probably related to shoulder stability issues, and in that case, this product is going to be a complete waste.

Andrew Patterson said...

I've owned and used this product for about 5 months now. Verdict? Mostly quite good, and I seemed to recover from my elbow issues. Part of my recovery could have been due to the "if-you-buy-it-you-use-it" mentality. To wit: the mere fact that I spent money to purchase this product motivated me to pay attention to my elbow pain. This raises a point about the psychology of rehabilitation, and the motivations/strategies we take to achieve rehabilitation.