Lateral epicondylitis, commonly known as tennis elbow, is a painful overuse injury affecting the tendons on the outside of the elbow. Bracing is a frequently recommended conservative tool used to manage symptoms and allow individuals to remain active while the tendon recovers.
Understanding Lateral Epicondylitis
Lateral epicondylitis is a degenerative condition, referred to as tendinosis, rather than an inflammatory one. It involves the common extensor tendon, primarily affecting the Extensor Carpi Radialis Brevis (ECRB) muscle where it attaches to the lateral epicondyle of the humerus. Repetitive motions, especially those involving gripping and wrist extension, cause chronic stress on this tendon, leading to microscopic tears and a breakdown of the collagen structure. This degeneration at the bone-tendon junction is the source of the persistent pain and tenderness felt on the outside of the elbow.
The Mechanism of Support
The primary function of a brace is to reduce the mechanical tension transmitted to the damaged tendon insertion site. Counterforce braces achieve this through pressure redirection, often called “unloading.” The strap is positioned a few centimeters below the painful lateral epicondyle, directly over the largest part of the forearm extensor muscle belly. When the wrist extensor muscles contract, the brace applies targeted compression, distributing the force over a wider area of the forearm.
This compression effectively creates a new, temporary anchor point for the muscle, altering the angle of pull on the tendon. The brace also provides a secondary benefit by dampening the shock and vibration that occur during forceful activities like gripping or lifting. This compressive restraint helps reduce the overall magnitude of force the muscle can generate, preventing further micro-trauma.
Classifying Elbow Supports
Counterforce Straps
The most common support type is the counterforce strap, a simple, non-elastic band designed for targeted compression. These straps often include a gel or air pad to focus pressure precisely on the muscle belly below the elbow. They are the preferred option for individuals experiencing acute pain during specific activities, as they excel at the pressure redirection mechanism.
Elbow Sleeves
Another option is the elbow sleeve, which provides uniform compression and warmth across the entire joint. These sleeves help manage generalized aching or mild soreness, but they offer less targeted unloading than a strap. Sleeves are more suitable for chronic conditions or when generalized joint support is needed.
Wrist Braces or Splints
For more severe cases, a physician may recommend a wrist brace or splint designed to immobilize the wrist and hand. By restricting wrist movement, these supports force the forearm extensor muscles into a state of rest. This complete muscle rest is typically reserved for instances where pain is constant or when initial conservative measures have failed.
Integrating Bracing into a Recovery Plan
Bracing is an effective tool for managing symptoms, but it is not a standalone treatment for the underlying tendon injury. The brace should be worn during activities known to provoke pain, such as work tasks, sports, or repetitive household chores. Wearing the brace at rest or while sleeping is generally unnecessary unless constant pain significantly disrupts sleep patterns. For lasting recovery, bracing must be combined with a structured physical therapy program that includes specific movements.
Gentle stretching and progressive strengthening exercises, particularly eccentric exercises, are important for rebuilding tendon tolerance. Icing the area after activity can also help manage discomfort. Most cases resolve with non-operative treatment, though recovery can take several weeks to many months. If pain worsens or symptoms persist despite consistent bracing and exercise for six weeks, seeking professional evaluation is advised.