Tennis elbow, medically known as lateral epicondylitis, is a common overuse injury that causes pain on the outside of the elbow. This discomfort occurs when the tendons connecting the forearm muscles to the outside of the elbow bone (lateral epicondyle) become strained and irritated, often due to repetitive wrist and arm motions. Activities like gripping, twisting, or extending the wrist repeatedly can lead to micro-tears and inflammation in the common extensor tendon. Many people consider a sling for support, believing that immobilization will promote healing. Understanding the nature of this tendon injury is important for choosing the correct support device and beginning an effective recovery plan.
Why Slings Are Not Recommended for Tennis Elbow
A sling primarily functions to hold the arm in a fixed position, which is a method best suited for acute trauma like fractures or dislocations. For a tendon overuse condition like lateral epicondylitis, prolonged immobilization is counterproductive to the healing process. Tendons require controlled movement and appropriate loading to encourage blood flow and promote tissue repair. Restricting all movement with a sling impedes necessary circulation and may lead to muscle atrophy and joint stiffness, potentially lengthening the recovery time.
Immobilization prevents the forearm muscles from engaging in gentle, controlled movements that help strengthen the tendon and improve its tolerance to stress. While a sling might offer temporary pain relief by completely preventing arm usage, it fails to address the underlying issue of tendon strain and weakness. The goal of treatment is not to stop all movement, but to manage the strain and gradually restore the tendon’s capacity for load. In very severe, acute cases of pain, a doctor might recommend a brief period of splinting for a few days, but this is a rare exception.
Recommended Support Devices and Their Function
Counterforce Elbow Strap
The preferred support device for managing the symptoms of lateral epicondylitis is the counterforce elbow strap, also known as a tennis elbow brace. This device is fundamentally different from a sling because it does not immobilize the entire arm or elbow joint. Instead, the counterforce brace is a strap that wraps snugly around the forearm, typically placed one to two inches below the painful bony prominence on the outside of the elbow.
The mechanical function of the counterforce strap is to create an alternative point of origin for the extensor muscles. By applying targeted compression to the muscle belly of the forearm, the strap redirects the forces that would normally pull directly on the inflamed tendon insertion at the elbow. This mechanism reduces the tensile load on the irritated tendon, allowing the tendon to rest while still permitting necessary arm movement. The result is a reduction in pain during activities that involve gripping or lifting.
Other Support Options
Another option is a compression sleeve, which provides a more generalized, uniform pressure across the entire elbow joint. Sleeves offer mild support, help manage swelling, and can increase proprioception (the body’s awareness of the joint’s position). While helpful for managing mild, generalized aching, the sleeve does not provide the targeted, load-relieving mechanism of the counterforce strap. A wrist-stabilizing brace is sometimes used alongside other treatments to limit wrist extension, as this position directly stresses the injured extensor tendons at the elbow.
A Holistic Approach to Recovery
Using a supportive device like a counterforce brace is only one part of a comprehensive recovery plan for tennis elbow. True healing requires addressing the inflammation and the underlying causes of the tendon overload. Initially, managing pain involves a period of relative rest, which means modifying or avoiding the specific activities that cause the pain to flare up. Applying ice to the outer elbow for 15 to 20 minutes several times a day can help reduce inflammation and provide temporary pain relief.
The cornerstone of long-term recovery involves a structured physical therapy program focused on stretching and strengthening the forearm muscles. Gentle stretches for the wrist flexors and extensors improve flexibility and help break down any early scar tissue. Strengthening should progress to include eccentric exercises, where the muscle lengthens while resisting a force. This specific type of loading is particularly effective for improving tendon strength and resilience.
Activity modification is also important and includes evaluating technique in sports or work tasks, and ensuring proper equipment. While many people recover with conservative management, consult a medical professional if pain persists beyond six to eight weeks, significantly worsens, or if you experience symptoms like numbness or tingling. A healthcare provider can offer a definitive diagnosis and may recommend additional treatments, such as oral anti-inflammatory medications or targeted injections.