Lateral epicondylitis, commonly known as tennis elbow, is an overuse injury resulting from repetitive strain on the forearm muscles and their tendons attaching to the outer elbow, affecting anyone who performs repeated gripping, lifting, or twisting motions. Supportive bracing is a common, non-invasive strategy used to reduce pain and allow individuals to remain active while the tendon heals.
Understanding How Braces Alleviate Pain
Braces do not directly heal the tendon but alter the forces that cause pain, providing temporary relief during activity. The primary biomechanical function is counterforce, which redirects strain away from the injured area. This is achieved by applying firm, targeted compression to the forearm muscle belly, typically an inch or two below the elbow joint.
This compression creates a secondary anchor point for forearm muscles, such as the extensor carpi radialis brevis (ECRB). When the muscle contracts, the brace absorbs and disperses a portion of the tensile force before it reaches the tendon’s attachment point on the lateral epicondyle. Studies suggest a correctly positioned counterforce brace can reduce the tendon load by approximately 13 to 30%, allowing the inflamed tissue to rest while the arm is in motion.
The brace acts as a mechanical offload, interrupting the cycle of pain and irritation and giving the tendon a chance to recover. However, it does not cure the underlying pathology. For long-term recovery, bracing must be used in combination with other treatments, such as physical therapy and modifications to the activities that caused the injury.
Identifying the Right Support for Your Needs
Individuals typically choose between two main categories of external support: the counterforce strap and the compression sleeve. The counterforce strap, often called an elbow band, is a targeted device that wraps around the forearm muscle just below the elbow. This strap uses high compression to mechanically redirect force away from the tendon insertion. It is best suited for individuals experiencing sharp, localized pain during activities like gripping or lifting, where maximum tendon offloading is desired.
Alternatively, the compression sleeve provides diffused support, covering the entire elbow joint and a portion of the arm. This sleeve offers general compression, which helps manage mild swelling and improve circulation. It also increases proprioception—the body’s awareness of joint position—encouraging safer arm movement. The sleeve provides general comfort and mild support for widespread aching or stiffness, unlike the localized force redirection of the strap.
Guidelines for Effective Brace Use
Proper fit and placement are necessary for a brace to be effective and prevent further irritation. For a counterforce strap, the device should be positioned on the thickest part of the forearm muscle, about one to two inches below the bony prominence on the outside of the elbow. The compression pad must rest directly over the extensor muscle belly, not on the elbow joint, to establish the new anchor point for force absorption.
The tightness requires a balance: it must be snug enough for compression but never so tight that it causes numbness, tingling, or cuts off circulation in the hand or forearm. A practical test is ensuring you can still slide one finger comfortably underneath the strap. If the brace causes increased pain, swelling, or impaired circulation, it is too tight and must be immediately adjusted.
The duration of wear should be strategic, as the brace is intended to be an aid during times of mechanical stress, not constant support. It is most beneficial to wear the brace during activities that trigger pain, such as work tasks, sports, or heavy lifting. Wearing the brace constantly, especially overnight, is not recommended, as the muscle needs to work without support to rebuild strength. Long-term recovery is achieved by combining intermittent bracing with a structured physical therapy program focused on stretching and progressive strengthening.