A tennis elbow brace, technically known as a counterforce brace, is a specialized strap designed to manage the pain associated with lateral epicondylitis, commonly called tennis elbow. This condition involves discomfort and often microtears in the tendons on the outside of the elbow. The primary goal of wearing this brace is to provide immediate relief from pain during activities that involve gripping, lifting, or repetitive wrist movement. Proper positioning of the brace is paramount, as incorrect placement can render the device ineffective or even cause new discomfort.
Understanding the Brace’s Purpose
The effectiveness of a counterforce brace relies on a mechanical principle that redirects the strain on the forearm muscles. Lateral epicondylitis is caused by overuse of the wrist extensor muscles, particularly the extensor carpi radialis brevis, which attach to a bony bump on the outside of the elbow called the lateral epicondyle. Repetitive strain causes tension at this tendon insertion point, leading to pain and inflammation.
The strap works by applying gentle yet firm compression to the muscle belly of the forearm, slightly below the elbow joint. This targeted pressure creates a new, artificial origin point for the muscle, effectively absorbing and spreading the forces generated during muscle contraction. By temporarily shifting the mechanical load away from the injured tendon attachment site, the brace allows the irritated tissue to rest and heal while still permitting movement.
Identifying the Precise Placement Area
Correct placement is the single most important factor for the brace to function as intended. To find the precise spot, a user must first locate the lateral epicondyle, the bony point on the outside of the elbow where the pain is most pronounced. The brace must never be placed directly over this bony area, as it would cause excessive pressure and fail to alleviate the tendon strain.
Instead, the counterforce strap should be positioned on the soft, fleshy part of the forearm, specifically over the extensor muscle group, or “extensor wad.” This location is typically about one to two inches below the elbow crease, which is roughly equivalent to two finger widths down from the painful spot. The strap’s pressure pad, if present, should be centered directly over the bulk of the muscle belly to maximize the force-redirection effect. This ensures the compression is applied to the muscle tissue itself, not the joint or the tendon insertion point.
Step-by-Step Guide to Proper Application
Before applying the brace, the user should ensure the forearm is relaxed or slightly bent, which helps to isolate the muscle bulk correctly. The brace is then slid up the arm until the top edge rests in the precisely identified location, approximately two finger widths below the elbow.
If the brace has a separate pressure pad, this component should be positioned to sit directly over the most prominent part of the forearm muscle on the outside of the arm. The strap is then pulled through the buckle or loop and secured with the fastener, such as a hook-and-loop closure, to initiate compression. The user should ensure the strap lies flat against the skin without twisting or bunching, which could create uneven pressure points.
Assessing Optimal Fit and Comfort
The tension of the brace must be carefully calibrated; it should be snug enough to apply therapeutic pressure but loose enough to avoid compromising blood flow or nerve function. A simple test is the “one-finger rule,” where the user should be able to slide one finger easily underneath the fastened strap. The brace is too loose if it shifts significantly during movement, but it is too tight if it causes immediate tingling, numbness, or a throbbing sensation in the hand or fingers.
These symptoms, particularly tingling, are signs of potential nerve compression, most commonly affecting the radial nerve, and require immediate loosening of the strap. Furthermore, the skin under the brace should be checked periodically; discoloration or blanching indicates excessive constriction and a need for adjustment. The ultimate measure of correct fit is a noticeable reduction in pain when performing activities that previously caused discomfort, such as gripping an object or lifting a weight.