We discuss the various types of tennis elbow brace and their pros and cons. Not everyone with tennis elbow will benefit from wearing a brace, so we’ll look at when and why a brace or tennis elbow strap may be useful. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call.
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It’s worth noting that braces should not be used as a standalone treatment for tennis elbow. Research shows that you get better long-term results when you combine a brace with other treatments. Here's our detailed discussion of the best, evidence-based treatments for tennis elbow.
Tennis elbow wrist braces (splints)
How a wrist splint might help for tennis elbow
It might seem a bit weird that a brace around your wrist can help for your elbow pain. Here’s how it works.
The muscles involved in tennis elbow are the ones that bend your wrist back (into extension). For your tennis elbow to settle down and recover, you must temporarily reduce the amount of work those muscles (the wrist extensors) and the tendons that connect them to your elbow do. The problem is that it can be super difficult to properly rest your hand, because we tend to use it without thinking about it.
Wearing a wrist splint that stops you bending your wrist back forces you to rest those muscles, which in turns reduces the strain on the injured tendons, allowing them to recover.
Are wrist splints effective?
Yes, research shows that wrist splints can help to alleviate tennis elbow pain. There’s also a suggestion that a wrist splint may reduce pain quicker than a counterforce strap (see below), but they seem to have similar results after about six weeks. One study found that wrist splints worked better in people over the age of 45; the reasons for this are still unclear.
Wrist braces are most useful for people who have really painful or stubborn cases of tennis elbow.
👍 Pros:
They are particularly good at forcing you to rest and settling down your pain.
They also make other people aware you have an injury, so they tend to be more considerate.
👎 Cons:
Because these braces limit your movement, you may lose a bit of strength. However, you can always restore your strength through rehab exercises. So, this should not be a deal breaker.
Some people find them too limiting and restrictive.
How to use them
In the research studies, participants were required to wear their wrist splint:
For six weeks,
for all their daily activities, and
remove it only when they shower, sleep, or do their rehab exercises.
I tend to be less strict with my patients and may tell them to wear it continuously for a couple of weeks, and after that just when they are doing activities where they are likely to overdo things. But my advice varies a lot between patients. Personalities also play a role – some people just can’t help themselves and really need to be forced to rest it.
What to look for in a tennis elbow wrist splint
The wrist splint must:
Limit your wrist extension movement, so it must have metal or rigid plastic rods on the top or the bottom – some of them still allow your wrist to flex (bend downwards).
Support your wrist in slight extension – the braces used in the studies positioned the hand between 5 and 30 degrees extension.
Be secured with Velcro or straps so you can easily adjust it if it feels too tight.
Tennis elbow straps (counterforce braces)
How tennis elbow straps might help
A tennis elbow strap is worn around the muscle bellies of the wrist extensor muscles, about 2 cm (almost an inch) below the elbow crease. The raised pad must be directly over the muscles, NOT the elbow.
When we contract or use our wrist extensor muscles, they pull on their tendons, which attach into the bones at the outer elbow. When you have tennis elbow, those tendons are injured (usually in the area where they attach to the bone), and this pulling force is what increases your pain.
The thinking on how tennis elbow straps work is that, by applying a compression force to the muscles just lower down from where their tendons attach, it shifts the pulling force away from the injured area. This is why these straps are often called counterforce braces.
One study, performed on cadavers, found that counterforce braces could reduce the force on the tendons by 13%-15%, while another found that the wrist extensors were less active when you wear the strap.
Are tennis elbows straps effective?
For some people, a tennis elbow strap can reduce their pain immediately and help them do their daily tasks with less discomfort. However, others may actually experience more pain when wearing them. So, it can be hit and miss.
There is also some evidence that counterforce braces help to preserve grip strength better than wrist splints, and they may be more useful for people under the age of 45.
👍 Pros:
Counterforce braces don’t restrict your movement, so you can carry on with daily tasks as normal.
It should not cause you to lose muscle strength.
They are cheap, so not a big loss if you buy one to test and it doesn’t work.
👎 Cons:
It can make some people’s pain worse – adjusting the position might help, but it may also simply not be the right type of brace for you.
If you have nerve irritation or entrapment together with tennis elbow, stay away from elbow straps, as it will irritate the nerve even more.
How to use them
In my experience, tennis elbow straps work best for people who don’t have a lot of pain when they keep their arm and hand still, whose elbows aren’t super sensitive to being pressed on, and who don’t have nerve irritation.
When it comes to braces, I believe less is more. So, I tend to advise my patients to wear them only when they do tasks that irritate their elbow. In reality, most people start off using them nearly all day long, and then, as their tennis elbow improves, they use them less often.
I would always take them off when you do your rehab exercises, otherwise your exercises may not have the desired effect on the injured area.
What to look for in a tennis elbow strap
It needs to have a strap that you can easily adjust.
It must have a firm, raised area (typically a hard foam strip or bubble) to apply pressure over the wrist extensor muscles.
Tennis elbow sleeve
How tennis elbow sleeves might help
A tennis elbow sleeve keeps your elbow warm, and some people find that this helps for their pain.
The sleeve also stops you from bending your elbow fully – sitting with your elbow bent for extended periods often makes it hurt more.
And finally, it can act as a reminder to take things easy.
Are tennis elbow sleeves effective?
Tennis elbow sleeves have not been researched, and to be honest, it’s not something that I would prescribe for a patient. That said, I’ve had patients who bought them of their own accord and reported that it helped to wear them. So, it might be something to try.
How to use them
There really isn’t a right or wrong way to use these. It should be fine to wear one even when you’re doing your rehab. You might find that it starts to irritate your skin if you wear it too often and/or too long.
What to look for in a tennis elbow sleeve
The main thing is to get the size right.
It should feel like a comforting hug when you have it on – not too tight, nor too loose.
There are ones that combine an elbow sleeve with a compression strap for tennis elbow. However, I wouldn’t go for them, because you can’t be sure that the compression strap will sit in the right place for you.
When to remove your tennis elbow brace immediately
Tennis elbow braces don’t work for everyone and can make things worse in some cases.
The golden rule for wearing a tennis elbow brace is: A brace that is uncomfortable or increases your pain is useless. If adjusting it doesn’t help, ditch it.
You should remove your brace immediately if:
It makes your pain worse and adjusting the position doesn’t help.
It causes tingling, numbness, or weird sensations – those are signs that the brace is irritating a nerve, or it is too tight.
Your hand or forearm turns blue, or swells, or throbs – those are signs that the brace is too tight and restricting your circulation.
Any part of your arm or hand suddenly turns red, or throbs, or swells, or becomes a lot more painful – those are signs that you may have a blood clot; you should consult a doctor as soon as possible.
If any of these symptoms persists for more than a few minutes after removing the brace, consult a doctor.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine or at least 10 years' experience in the field. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.