Tennis Elbow Treatment: How Braces Slow Your Healing And Recovery!

Should you wear a brace as a treatment for your Tennis Elbow? What's the best kind?

Although they're recommended everywhere you turn, there are solid reasons why supports like braces, splints and wraps are a bad idea for treating Tennis Elbow, and why the best brace, splint or support may be none at all!

Yes, it’s true that most of the “authorities,” medical websites and various blogs do recommend that you wear some kind of support for a few weeks to help "rest, protect and heal your Tennis Elbow"

At first glance it certainly seems like the right thing to do, but on closer inspection there are several reasons why those supports are not the way to help Tennis Elbow heal, (in most cases) and why they can actually hurt you instead.

Slideshow: Tennis Elbow Treatment - How Braces Can Slow Your Recovery

This slideshow will give the key points on why braces are not a good way to treat your Tennis Elbow injury -

Exceptions: When To Wear A “Support” On Your Elbow

The exception being while you’re playing Tennis, golf or some other sport that involves dynamic, forceful activity, because you’ve decided to keep playing in spite of your injury.

In that case, it makes sense to wear a support as protection

Okay, but what about the rest of the time?

What about while walking around, sitting at home, sleeping or while you’re working?

No. It’s definitively not a good idea, and here’s why.

Why Immobilization Doesn’t Help Tennis Elbow Heal

First of all, Tennis Elbow, (along with most other forms of "Tendonitis") is usually not the kind of injury that benefits from being bound up with some kind of restrictive "support" for days or weeks.

Should you use a brace to treat your Tennis Elbow? (Maybe not!) #TennisElbowTreatment http://tenniselbowclassroom.com

Tennis Elbow Braces [Infographic]

In other words, "supports" don't actually support the healing of this kind of tendon injury! Although it may feel better temporarily! 

So, in case you’ve been wearing some kind of brace and have already noticed that it feels a little better – remember the key question to ask yourself:

Does that mean it’s actually healing?

It’s a little deceptive because having less pain and feeling better is one of the ways we can tell that an injury is healing and getting better.

The problem is that even though there are a lot of things you can do to make your Tennis Elbow feel better, (like icing, resting, anti-inflammatories, painkillers, creams and Cortisone shots.)

All these so-called treatments do is trick you by easing and postponing your pain for a little while

So, why then doesn’t bracing or supporting your muscles, tendons or your entire elbow help your Tennis Elbow heal?

If you broke your arm, then you’d have to put in a cast while the bone heals – There’s no question about that!

If you sprain your ankle badly then you’d have to wrap it for a while – No argument there.

But Tennis Elbow has almost nothing in common with a broken bone, and usually very little in common with a sprain.

Tennis Elbow is not a sprain or a strain (usually) – By that I mean there is usually no major tear (strain) in the muscle or tendon that needs to be protected from movement, in which case a brace or support probably would be needed at first.

(And an MRI should show any significant tear.)

But What About The Possibility of a Smaller Tear?

A lot of Tennis Elbow sufferers really worry about that – often because the pain is so sharp or relentless.

Well, that’s always possible, but unfortunately the severity of the pain and its persistence often has little to do with it.

In other words, just because it hurts like hell for weeks or months doesn’t mean there’s a tear – large or small – Often there isn’t.

However, for arguments sake, even if there is a small tear, from my understanding and what the leading-edge sports medicine approach seems to favor, is to either keep it free and mobile - or brace it for a very short time after the injury, and then start moving it again as soon as possible

We’re talking about mere days of bracing (in the case of a small tear) followed as soon as possible by gentle movement rather than weeks of bracing and immobilization.

But let’s get right back to the typical case of Tennis Elbow now.

Tennis Elbow is a tendon injury, and most of the time the injured tendons are NOT badly torn in one big, traumatic event – They’re damaged gradually.

The Key Issue And Biggest Risk To Injured Tendons

And the key problem is that Tendons heal much more slowly, in part because they have a much smaller blood supply

So slowly, in fact, the biggest risk with tendons is that they don’t heal at all – and that they gradually break down instead – (Technically this is called Tendinosis, by the way.)

And that’s what’s really going on more often than not in the typical case of Tennis Elbow: Gradual breakdown, stagnation and degeneration. (Regardless of whether there was a tear or not.)

This is really important, but without going into the technical detail it takes to properly explain this degeneration thing…

The key thing to always remember is the fact that Tendons heal slowly – once again, mostly because they have much less of a blood supply.

And the last thing you want to do is to reduce that circulation and blood supply to your tendons even more as they’re trying to heal.

How Supports Reduce Circulation And Slow Tendon Healing

Unfortunately that’s exactly what wearing a brace, splint, band, strap or any other kind of so-called support does; it tends to reduce the circulation in the area you’re wearing it around.

It does that in two ways:

  1. First, indirectly, by restricting the movement of your muscles, tendons and elbow joint. Less movement = Less circulation, because muscle movement is essential for good blood (and lymph) flow.
     
  2. And second, by directly compressing the tissues and blood vessels in that area. And, yes, even if it’s not that tight. Naturally, the tighter and more restrictive it is, and the longer you wear it the worse it is.

Supports Can Also Lead To More Scar Tissue

The other big downside with supports is that the compression and reduced mobility tends to encourage sticky scar tissue, which further binds and restricts your muscles and tendons.

I’m sure you will agree losing your flexibility to a bunch of nasty scar tissue and having your healing process stall are the last things you want!

Muscles and tendons actually need gentle movement and mobility to heal – (except right after a major tear, which I’ve already mentioned is rarely the case with Tennis Elbow).

Gentle movement during most if not all of the healing process helps the repair process and helps to prevent excessive Scar Tissue build up.

Once Again, The Only Times To Use A Brace or “Support”

In conclusion, most of the time it only makes sense to wear a brace or support:

  1. If you’re sure you’ve suffered a significant tear
     
  2. Or when you’re on the tennis court or golf course or engaging in some kind of short-term forceful activity, like hammering nails or digging in your garden.

To protect your injury somewhat from the risk of further damage.

Best to abandon completely the idea that using a support for days, weeks or months is going to help your Tennis Elbow heal.

If you’re tired of chasing your Tennis Elbow pain with things like braces, ice and pills  without ever managing to heal it – Take a look at the Gold Membership Program and learn how to help yourself make a full recovery and finally heal...

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15 Responses to “Tennis Elbow Treatment: How Braces Slow Your Healing And Recovery!”

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  1. Sal says:

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  2. Malika says:

    What is your opinion on prolotherapy when it comes to lateral epicondylitis?

    • I’ve heard good things about it and I definitely like the theory behind it. (Stimulating healing by encouraging inflammation rather than suppressing it.)

      I would never get an injection of anything, no matter how apparently innocuous, however – Except as an absolute last resort. To me it wouldn’t be worth the risk. There is no such thing as “minor surgery” or “just an injection!”

  3. Linda Anderson says:

    I have just been diagnosed with Tennis Elbow and got a cortisone injection. That’s what the Doctor said would be my best bet. I don’t know anything about the treatments so I figured he knew best. I’m a sewing machinist and the stuff I work with can be quite heavy and awkward which puts quite a bit of pressure especially on my right arm. After my elbow heels would it be good or bad to use an elbow support when working to take some of the pressure?

    I don’t want to do anything that could possibly weaken my elbow or cause more harm than good.

    Thank you.

    • Hi Linda,

      That sounds like stressful work on the arms that you do. Did you also see my article and video on Cortisone shots? (Link)

      If that’s really your “best bet,” according to your doctor, you need a different one if possible. (In my opinion – Not medical advice.)

      I hate to say it, but the Cortisone shot is already something that can weaken your elbow and cause harm. (This is well established in medical research and all doctors should know it by now.) Well, there’s nothing you can do about that now (except to learn about why that’s the case and hopefully avoid getting another one.)

      One of the worst mistakes I made many years ago when I had “Tendonitis” in both wrists was to wear braces. You can’t support muscles and tendons when they’re healing or afterward by relieving them of their “job” with a brace. (Except in the early stages of a major injury like a tear.)

      • Linda Anderson says:

        Thank you for your reply. Yes I saw your article on cortisone shots which got me wondering. I will be sure to do more research online on Tennis elbow and anything else that might affect tendons or joints if I have any trouble before consulting a doctor to be sure I have information to ask them questions about the right course of action with minimal side effects.

        I may also ask my Chiropractor what she thinks when I see her next who I’ve been seeing for the last 4 years or so for my back and hip when I got no satisfaction from the doctor’s who told me to take painkillers or anti-inflammatories. I’m no doctor but even I know that doesn’t heal the problem, it only stops the pain for a while.

        If I knew cortisone injections done some damage beforehand I wouldn’t have allowed him to give it to me. I’m a great believer in trying to let the body heal and sometimes if necessary give the body a helping hand to heal. I hate taking pills.

        Again thank you for the advice and I’ll make the time to look through your other articles and videos.

        • Fortunately, from what I’ve seen treating Tennis Elbow sufferers in my practice, a single shot doesn’t seem to have a significant negative effect. I’ve really noticed a big difference in the healing and recovery rates of people who’ve had more than one, though.

          This is just my opinion, based on my experience, but I think the damage increases exponentially when you have 2,3 or 4 shots over time. It sounds like you’re not going to go down that road at this point, however, so good for you, Linda! (And good luck!)

          • bugsy says:

            Just like to comment on the 2,3 or 4 shots of cortisone injections – in the uk you are only allowed maximum of 3 injections in your lifetime as they cause bone deterioration.

            I would also like to point out when the pain is at its worst you have to use an aid to help you do normal daily tasks as, in reality, it’s impossible to not use your arm even for a day. I did have the cortisone injection 7 years ago in both elbows, and unfortunately it has come back but not yet as severe as before so I will be looking for an aid to help me get through the day pain free.

          • Do they really make such a “hard” limit in the UK? 3 shots in a lifetime? Wow! (But it’s somehow supposed to be “safe” to use a couple of times?)

            I have nothing against people using an aid to help them get through their normal daily tasks, per se. It’s all about being informed of, understanding and consciously calculating the risks vs. the rewards. Is the short-term relief worth it if it’s going to potentially increase one’s recovery time dramatically? – Possibly making it two, three – or even five times harder to heal and recover in the future?

            And from my experience that’s no exaggeration. There have been numerous Tennis Elbow sufferers I’ve worked with who have had multiple shots in previous months – and sometimes years – and then had a terrible struggle trying to recover later on. (Twice as long to recover after just a couple of shots is the minimum from what I’ve seen.)

            I just realized this thread, which is largely about Cortisone shots, is on my post about braces, bands and straps, and I just want to suggest heading over to my post on Cortisone shots here for any further discussion.

  4. Kari-Lynn Malec says:

    “Hurts like hell” for months with stretching, therapy, strap and now cortisone. Non-dominant hand with original injury pulling weeds. I am sure now tendinosis. Going for second round or physio now. I can barely sleep with the pain now after the cortisone with numbess. I cannot stretch my arm out straight. Again, non dominant …. So if I don’ t wear the strap, do not do another cortison,,,,, do the physio again. (Startng this week)… Then what? I
    Sigh

    Liked your tutorial! Thanks! 6 month wait for orthopedic referral

    Kati

    • That sounds really bad, Kari-Lynn. I’m sorry to hear it’s so bad you can barely sleep. (6 months for a referral!?) I would encourage you to watch my video and read the post on Cortisone shots before you consider having another (but maybe you’ve already made that decision?) Are you doing my program? (or considering joining?)

  5. Tracy says:

    Have you ever heard of tennis elbow popping up for no known reason? I had it in both elbows about 10 years ago when I had 2 year old twins and a newborn. All of a sudden it has reared its ugly head again and I don’t know why (only my right elbow this time). I haven’t changed my routine, I don’t lift weights, and I didn’t injure it. Any thoughts? Will heat/ice help at all? I watched the cortisone video and read some other posts so that is out. Help!

    • Hi Tracy, yes I have seen and heard of Tennis Elbow occurring for “no apparent reason” – at first glance – but there is always a cause and a reason. It’s just a matter of finding it.

      Keeping in mind that it’s almost always cumulative, there are a lot of ordinary activities that we do that “seem fine” for months or years but eventually produce a pattern that leads to the injury.

      Computer use? Ipad? Guitar playing, various repetitive hobbies, biking (the gripping) – and even a “minor” insult to the Rotator Cuff (shoulder) can set off a compensation pattern involving the forearm muscles.

      I’m definitely a fan of heat, and as you’ve seen, don’t see any healing potential for ice. (Usually!)

  6. Kilyle says:

    This is the first and only site I’ve ever seen to offer a user-controlled slideshow version alongside the video.

    Since I usually don’t load videos, this was a great help! Videos tend to be slow and annoying as they pad the necessary info with unnecessary blather – stuff I can’t skip because I don’t know where the necessary info is – and sometimes it takes a long time to load. I can get through a written description much faster by skimming; a slideshow is even better because I see the important parts of the video at my own speed.

    Thank you for providing such a useful format! I wish more websites would follow your example.

    • Thanks, Kilyle! I appreciate the compliment. I would like to make more of these slideshows, but I’ve found them to be very time-consuming. Instead I’ve been focusing my efforts on making shorter, more succinct videos (like my new Two-Minute Tennis Elbow Tutorial series) and trying to cut out the unnecessary blather! I will keep it in mind going forward though.

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