How to Wear a Tennis Elbow Brace Properly to Maximize the Benefits
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When you have Tennis Elbow, or lateral epicondylitis, the pain and discomfort can make everyday activities challenging. Tennis Elbow not only causes pain, but also reduces your grip strength, affecting your ability to do simple things like turning a door knob, using a hand tool, or holding your morning coffee.
One of the most effective ways to manage Tennis Elbow pain and improve your grip strength is by to use a Tennis Elbow Brace. Wearing it correctly is key to getting the relief you need - and it’s surprisingly hard to put a Tennis Elbow Brace on in a way that actually helps.
In this blog post, we’ll explain how a Tennis Elbow brace works, the correct way to wear one, how tight it should be, and what to do if your brace makes your pain worse. By the end of this article, you’ll have a clear understanding of how best to use a Tennis Elbow brace, so that you can manage your pain effectively and even start getting therapeutic benefits from your brace.
Tennis Elbow is caused by overuse and strain on a tendon in your forearm, called the extensor carpi radialis brevis (ECRB) tendon. This tendon is responsible for extending your wrist and stabilizing your forearm. When it’s overworked, small tears can develop, leading to inflammation and pain.
Most Tennis Elbow braces are designed to apply circumferential pressure around your forearm. This surface-level pressure can help distract your pain sensation, providing temporary relief.
However, these standard braces fall short because they don’t address the root cause of the condition—they merely mask the symptoms.
The most effective Tennis Elbow braces go beyond simple pressure application. They are designed to attenuate the ECRB tendon with a directional force. It’s applied around your arm, so that the tendon is pushed away from your body. When you perform actions like gripping, lifting, or twisting, these attenuating braces disperse the load away from the affected tendon. Instead of the ECRB tendon bearing all the strain, the brace and surrounding tissues take on some of the load. This reduces the stress on the tendon, alleviates pain, and increases your ability to grip without discomfort.
You can see that choosing the right type of brace for Tennis Elbow is half the battle. Attenuating brace is the only kind that can change the load and treat the root cause of Tennis Elbow. For things to look for in order to spot an attenuating brace, take a look at our guide on how to choose the best Tennis Elbow brace.
Once you’ve picked the right Tennis Elbow brace - the attenuating kind - let’s figure out how to wear a Tennis Elbow brace.
It’s easy to put on a Tennis Elbow brace, but it’s even easier to wear it wrong. We’ll use our attenuating Tennis Elbow Brace to illustrate the process.
Watch the video, or scroll down to the step-by-step guide to ensure you’re wearing your brace properly and reaping its full benefits:
Start by identifying where your ECRB tendon is. To do this, place your hand on the opposite shoulder so that your affected arm forms a V in front of you. Flick your middle finger up and down, and observe the area of your forearm near your elbow. You’ll notice a spot between the two forearm muscles that flicker with your finger movement—that’s your ECRB tendon. To be extra-sure, you can also place a finger of your other hand there, and feel the palpitations.
Once you’ve located the ECRB tendon, place the brace’s nodule directly against it. The nodule is the part of the brace that applies targeted pressure to the tendon, which is crucial for relieving pain and unloading the tendon.
After positioning the nodule on the ECRB tendon, tighten the brace using the counterforce strap. Make sure it’s snug but not overly tight. Secure the strap in place to ensure the brace doesn’t move during activities.
Finally, check that your brace is in the correct position. Fold your arm into the same V shape you used to locate the ECRB tendon, and move your middle finger up and down. If the brace is properly positioned, you should feel the nodule pressing against the tendon and experience a noticeable reduction in pain.
One common misconception is that tighter braces are more effective. However, the goal of a Tennis Elbow brace isn’t generalized compression, so it doesn’t need to be excessively tight. The point of an attenuating elbow brace is to apply a directional force on the ECRB tendon to modify the load, so make it just tight enough to create that directional force.
In fact, a brace that’s too tight can restrict blood flow, cause discomfort, or even lead to numbness in your arm or hand. That’s not what we are looking for!
A good rule of thumb is to aim for a tightness level similar to how a blood pressure cuff feels—firm but not constrictive. We often recommend an “8 out of 10” tightness level, where 10 is the tightest you could comfortably tolerate.
If you find that your brace feels too tight or too loose, don’t hesitate to adjust it. You might need to make adjustments throughout the day, as you perform different activities, too. The right fit is essential for the brace to do its job effectively.
While a Tennis Elbow brace is helpful, there are situations where it can make your pain worse. If this happens, it’s important to reassess your condition and the way you’re using the brace.
One possible reason your Tennis Elbow brace might worsen pain is if you have a condition called Radial Tunnel Syndrome (RTS). RTS occurs when the radial nerve is compressed or trapped in the radial tunnel, a narrow space in your elbow. A Tennis Elbow brace can exacerbate this condition by making the tunnel even tighter, leading to increased pain.
RTS pain often feels different from Tennis Elbow pain. It’s typically characterized by tingling, numbness, or a “pins and needles” sensation. If you experience this kind of pain while wearing a brace, it’s a sign that you might be dealing with RTS rather than—or in addition to—Tennis Elbow. In this case, it’s best to consult a doctor for a proper diagnosis and treatment plan.
Another reason your brace might be making things worse is if you have another elbow condition with, or instead of, Tennis Elbow. Conditions like Golfer’s Elbow (medial epicondylitis), Bursitis, or joint problems can all cause elbow pain, and wearing a Tennis Elbow brace this way might not be appropriate for these conditions.
For example, if you have Golfer’s Elbow, which affects the inside of your elbow rather than the outside, you’ll need to wear the brace differently. It’s crucial to get a proper diagnosis and, if necessary, adjust how you use the brace. If you are unsure, take the Tennis Elbow test called Maudsley’s Test.
Impact on Daily Activities: Tennis Elbow can significantly affect daily activities by reducing grip strength and causing pain, making tasks like turning a doorknob or holding a cup challenging.
Benefits of a Properly Fitted Brace: Using a properly fitted Tennis Elbow brace can help manage pain and improve grip strength by applying circumferential pressure and attenuating the strain on the affected tendon.
Importance of Correct Brace Placement: Correct placement and tightness of the brace are essential; it should be snug but not overly tight, aiming for a firm fit similar to a blood pressure cuff.
Signs Your Brace May Be Worsening Pain: If the brace worsens pain, it could indicate other conditions like Radial Tunnel Syndrome or Golfer’s Elbow, and a proper diagnosis is needed.
Signs Your Brace May Be Worsening Pain: If the brace worsens pain, it could indicate other conditions like Radial Tunnel Syndrome or Golfer’s Elbow, and a proper diagnosis is needed.
Alleviate was founded by a patient-and-clinician duo to bring the effective chronic pain treatment from physical therapy offices to everyone's home. With our Tennis Elbow System (which comes with the Tennis Elbow Brace, Elbow Massager, Guided Recovery Program in the Alleviate App, and our popular Recovery Balm), you can use the Alleviate Method to recover from Tennis Elbow at home.
Luke Ferdinands, Physical Therapist & Co-Founder
A New Zealand-trained physical therapist with over 20 years of experience, Luke developed the Alleviate Method to bring the gold standard of physical therapy care to everyone's home. Luke leads the development of physical tools and digital physical therapy content, focusing on driving clinical outcomes for people with chronic musculoskeletal pain conditions like Tennis Elbow, Plantar Fasciitis, Runner's Knee, and more.
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