Should you wear a brace as a treatment for your Tennis Elbow?
If so, what’s the best kind of brace? – And when should you wear it?
Although there are a few exceptions, which we’ll discuss, here’s why wearing a brace or support the way they’re typically recommended (all day long – and sometimes even at night) is actually NOT a good idea when it comes to treating Tennis and Golfer’s Elbow!
Yes, it’s true that most of the “authorities,” such as Doctors, consumer medical websites and Physical Therapists do recommend that you wear some kind of support pretty much all the time for a few weeks to help “rest, protect and heal” your Tennis Elbow.
And, intuitively, it just sounds like the right thing to do – but on closer inspection there are several reasons why those supports are not the way to help you heal, (in most cases) and why they can actually end up slowing your recovery instead.
Table Of Contents:
(Links jump down the page to various sections of this article.)
Podcast On Braces And Lateral Epicondylitis
This podcast is an older version, one of my very first. (You can download it for later listening by clicking the “download” link under the player below:)
Why Immobilization Doesn’t Help Tennis Or Golfer’s Elbow Heal
Tennis and Golfer’s Elbow, (along with most other Tendinopathies, which is a fancy name for chronic tendon injuries) are simply not the kinds of injuries that benefit from being bound up with some kind of restrictive “support” all day long.
Tennis Elbow Braces (Infographic)
These “supports” don’t actually support the healing of this kind of tendon injury!
In other words, the “cure” doesn’t fit the “disease!”
So, if you’ve already been wearing a brace and have noticed it’s been feeling a little better – make sure you ask yourself this question:
Does that mean it’s actually healing?
(Unfortunately, NO – It doesn’t.)
Yes, there are a host of things you can do to make your Tennis Elbow feel better, (like icing, resting, using topical creams and lotions, taking anti-inflammatories and, worst of all, getting Cortisone shots.)
But, the problem is, all these so-called treatments do is trick you by suppressing and postponing your pain (and, in some cases, your healing process, along with it.)
And that’s what braces tend to do, too.
- Now, if you broke your arm, then you’d have to put it in a rigid cast while the bone heals – No question about it!
- Or if you sprained your ankle badly, then you’d probably need to wrap it for a while – No argument there either…
But Tennis Elbow has nothing in common with these kinds of injuries!
Tennis Elbow is certainly not a fracture and it’s 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 the case of a significant tear, a brace or support probably would be needed at first – but you’d need to get an MRI in order for a tear to be diagnosed.)
But What About The Possibility of a Smaller Tear?
A lot of Golfer’s and Tennis Elbow sufferers really worry that they might have a tear – often because the pain is so sharp or relentless.
Well, that’s always a possibility, but the truth is the severity of the pain and its persistence often has little to do with it.
Pain does not necessarily = TEAR!
In other words, just because it hurts like hell for weeks or months – or even years doesn’t mean there’s a tear – large or small – Often there isn’t.
Only a very small percentage of Tennis Elbow sufferers end up having surgery (something like 3-4%) and that’s often due to tears, so they’re not that common.
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
The key problem is that tendons heal slowly, and the biggest risk is that they don’t heal fully – Or heal at all!
Tendon healing all too often stalls and the tendon gradually breaks down instead.
THAT’S what’s really going on more often than not in the typical case of Tennis Elbow!
Stagnation and degeneration – NOT runaway inflammation, swelling and big tears!
It’s an insidious, weakening or “decay” of the collagen protein that the tendon is made of, where the normal, expected healing response fails to keep up with the breakdown.
Technically, it’s called ‘Tendinosis’ and there’s no longer any scientific basis for continuing to use the tired, old term of TendonITIS or referring to inflammation (not the problem) any longer.
So it’s a mistake to treat Tennis Elbow as if it were an Acute injury that’s swollen and inflamed, like a sprained ankle or a broken bone.
Especially by immobilizing it!
The key thing to always remember is the fact that Tendons heal slowly – and often don’t heal completely.
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.
What tendons need is the opposite; more circulation.
How Braces Can Slow Tendon Healing
Unfortunately, reducing circulation is exactly what wearing a brace, splint, strap or any other kind of so-called support tends to do where you’re wearing it – Two ways:
- 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 flow (and lymph flow, which is completely dependent on movement.)
- 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 ‘adhesions’ or 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.
What About Resting – Don’t Supports Help It Rest + Heal?
What about the claim that a brace or support helps you rest the area, which helps your tendons heal?
Don’t you need rest?
Yes, but only in the sense that you should try to avoid the kind of stressful, repetitive motions and activities that caused your injury in the first place and which would likely aggravate it.
And in the sense of avoiding heavy, physical activity, in general (if you can and it’s not what you do for a living.)
Not in the sense that you shouldn’t move the area at all, AKA: “Total Rest.”
Too little movement means less circulation, which can contribute to more stagnation and degeneration in the tendon – which is your #1 enemy.
(See the following article and video for more about the question of rest.)
How Important Is Rest In Treating Tennis Elbow?
When To Wear A Brace Or Sleeve
Should you wear your Tennis Elbow brace all the time?
Absolutely not! As we’ve already covered, that may be detrimental to your tendon healing process.
However, there are some times and places when it may make sense to wear a brace or support to help prevent further injury:
- In the case of a tear – As mentioned above, if you’re sure you’ve suffered a significant tear (you had an MRI or sonogram and a tear was diagnosed)…
- When playing tennis / golf – While you’re playing tennis, golf, Pickleball, Pingpong, etc. if you choose to play while you’re still recovering (See below)…
- Heavy exertion – OR possibly while you’re engaging in some kind of short-term forceful activity, like hammering nails, moving furniture or digging in your garden.
In these cases, your goal is to protect your injury (somewhat) from the risk of further damage – while you’re doing something strenuous involving sudden, dynamic, forceful motions.
But only for short periods while exerting yourself, and never the rest of the time, while you’re walking around, sitting at home or while you’re working.
That is, if your work involves doing something repetitive and lower intensity, like working on a computer. Never wear a brace (or wrist splint) then.
If you’re a contractor doing heavy, physical work, then it may be a good idea to wear a brace, and to wear it for longer periods while you’re doing that work.
Hopefully, if your job does not entail heavy, physical work, you can avoid it entirely while you’re recovering. Hire someone else to whack those weeds!
What’s The Best Type Of Tennis Elbow Brace?
There are classic, rigid, “around the whole elbow” supports, Counterforce Braces, (elbow straps) wrist splints, various kinds of tapes and taping techniques AND compression sleeves…
Which is the best kind – IF you’re going to wear one?
When it comes to playing tennis, golf, Racquetball, Pickleball or Pingpong, the Counterforce Brace / elbow strap seems to be the clear winner.
This type of brace is more of a strap that encircles the upper forearm an inch or two below the Lateral Epicondyle / “Tennis Elbow spot.”
It also seems like the best brace to use while performing heavy, physical tasks, whether you’re gardening, doing construction or perhaps while lifting weights at the gym.
It should be obvious this is a temporary, interim measure, though; a crutch, if you will, which should be abandoned as soon as possible.
One of the downsides to playing a racket or paddle sport while wearing a strap / brace is that alters your ‘biomechanics’ – (The normal mechanical function of the muscles and tendons.)
This can lead to the emergence of compensation patterns, and it can stress other joints above or below your elbow; your wrist or shoulder, especially.
Of course, you have to choose a particular brand of strap, but I’ll refer you to these resources to help answer that question:
What About Compression Sleeves?
Another possible exception is the ‘neoprene compression sleeve’ type of support.
It’s different from a classic Tennis Elbow brace in that it’s completely flexible and elastic. There is no rigidity.
I’m skeptical about the “compression” aspect of the sleeve-type support – once again, tendons don’t need compression to heal…
However, these sleeves can provide one key benefit:
Keeping the area warm!
Some people swear they have issues keeping their elbows warm – especially at night, and the compression sleeve helps.
Keeping the area warm is certainly beneficial for circulation, and good blood flow is essential to healing.
I would still recommend caution, though. The compression itself could limit circulation, particularly lymph flow.
Kinesiology Tape
And let’s include the kinesiology / Kinesio Tape and taping techniques, since they’re somewhat related, even though they’re not technically braces.
There are many brands, including Rock Tape and KT Tape.
I don’t see how these athletic taping techniques are going to either help or hurt, so have at it if it speaks to you.
The Worst Types Of Supports
“Around the whole elbow” supports, seen in the picture above, are probably the worst type, since they’re so bulky and restrictive.
Unless you’re doing heavy construction or something like that – They’re certainly not for tennis or golf or even doing work around the house!
Wrist splints are the next worst, since they rigidly immobilize your wrist, preventing flexion and/or extension.
Wrist splints are not elbow braces, per se, however they target and immobilize the wrist, which is controlled by the same muscle groups that are involved in Golfer’s Elbow and Tennis Elbow; the Wrist Flexors and Extensors.
How To Wear A Tennis Elbow Brace Correctly
Here are a couple of resources to guide you in placing and adjusting your elbow strap, starting with a video by a Physiotherapist / Physical Therapist:
Compression sleeves are self-explanatory, but if you choose to buy and use a Tennis or Golfer’s Elbow strap or Counterforce Brace, they have to be placed and adjusted correctly.
Here’s another guide on WikiHow on How to Wear a Tennis Elbow Brace
Placing these braces incorrectly or adjusting them too tight will do you more harm than good.
If you’re tired of chasing your Tennis Elbow pain with things like braces, ice and pills – without ever managing to break the cycle – Then take a look at my program and learn how to help yourself make a full recovery and finally heal…
Learn To Treat And Heal Your Own Tennis Elbow Or Golfer’s Elbow At Home With This Video Program
You’ll get instant access to a complete VIDEO program designed by a professional therapist to help you take charge and break your vicious cycle of pain and frustration!…I’ll be your personal tutor guiding you through step-by-step video lessons, where you’ll get the therapy techniques, key stretches and essential exercises you need to treat and recover from your injury at home. (Without any special equipment.)
Tennis Elbow sufferers: Learn more about the home program here
Golfer’s Elbow sufferers: Learn more about the home program here
Hello just came upon your website via Bing after I entered
in, “Tennis Elbow Treatment – How Braces and Supports Slow Your Healing!” or perhaps something similar (can’t quite remember exactly). In any case, I’m happy I found it simply
because your content is exactly what I’m searching for (writing a university paper) and I hope you don’t
mind if I collect some information from here and I will
of course credit you as the source. Thank
you so much.
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!”
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.)
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!)
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.
“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?)
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!)
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.
Hello, I was just wondering what your credentials in the medical field are? Do you know if there are randomized/blinded studies on tennis elbow – where one group gets braced and another only gets an alternate treatment (eg physical therapy)?
Thanks
I don’t have any medical credentials. I am in what some call “Alternative Medicine” – but I think Alternative TO Medicine would be an even better way to put it.
I’m not sure why you’re asking, but if you or anyone is wondering “What qualifies me to write about Tennis Elbow?” the answer is 25 years in the “soft tissue” (muscle, tendon and ligament) treatment realm – about half of which time has been in treating tendon problems like Tendonitis / Tendinosis and especially Tennis Elbow.
I am aware of some studies that may include braces – and there may be one out there that’s brace -specific (it rings a bell) – but it seems that braces tend to be part of a range of “conservative” treatments being tested against something else.
Hi,
I have had tennis elbow in my left arm for 18
Months. I’ve had 2 cortisone injections and
10 physio sessions , it was so painful everyday life
Caused me tremendous pain. Eventually In May
I asked to be referred, after an MRI scan I was told I had a tear in the tendon and needed surgery to repair it. It’s now 3 months since surgery and it’s doing good although I’m still doing minimal lifting as I’m scared to damage it ! I’m starting gentle weights at the gym and was wondering would the strap be of benefit to me when I do weights and I have to lift at work.
Any advice much appreciated! ( this was a gym injury)
Ali x
Hi Ali, Sorry to hear about your tear. Glad it seems to be doing well. Yes, I think wearing a brace temporarily while doing something strenuous, like lifting weights or other things, makes sense while one is recovering – Just not all the time / all day long or for hours and hours while performing light, repetitive tasks. Hope that helps. Good luck!
Hi, just read your post – very informative. Been struggling with “tendonitis” for about a year. I’m an accountant – do lots of typing & 10-key work with right hand. I’ve had 2 cortisone shots in past year but pain keeps coming back. I get a sharp burning pain above the elbow – aweful. What are your thoughts about “dry needling”? Also about physio-tape? Have an appt with physical therapist to discuss alternative treatments.
Thanks,
Anne
Hi Anne, Glad to hear the post was informative! (Did you see the one on Cortisone shots? – I’d highly recommend it if you haven’t.) I don’t really have much to say about dry needling. I think it makes sense in theory.
As far as physio / athletic tape goes, I think it makes sense for athletic endeavors, but I would question it’s helpfulness / sensibility for you in your work or for anyone doing low-intensity, long-duration repetitive tasks.
Alan, if I would like to wear a brace just while I’m playing golf, is there one you would recommend?
As a few of the above comments spoke about, I play tennis pretty much everyday. I am in excruciating pain and weakness just trying to get through a match. I am a lefty and it is literally “more than dominate”. Like the comments above I am awakened all through the night in terrible pain, can’t lift anything, ( and I baby-sit my toddler grandsons every other day, picking them up on an average of 20-30 times in 10 hrs. . The pain is radiating upwards toward my shoulder now, which was operated on 4 years ago to clean up a tear, and insert an anchor. I’m at my wits end with, wraps, KT tape, every brace made and anti-inflamitories. I’ve heard people speak of “tens units”. What is your opinion?
Sorry to hear that you are is so much pain, MaryAnne. I have to say, it sounds to me like you are in way too much pain to be safely continuing to play tennis at this point. I don’t know if you saw it or would find it helpful, but here are my thoughts on when and how some players can continue to play:
Can You Keep Playing Tennis Or Golf When You Have Tennis Elbow?
As far as Tens Units go, I think the only benefit you might derive from one is some temporary pain relief – It’s not going to help you heal. (And I wouldn’t expect much relief from it, either. My understanding is that those things can be helpful for certain kinds of pain – back pain is the first thing that comes to mind – but I am skeptical that it could help much with Tennis Elbow.)
Please let us know what you find if you decide / already decided to try one, though! – All the best to you!
Hi Allen,
I have read with great interest your posts on using braces for tennis elbow, and thank you for the enlightening information.
I personally haven’t noticed much help in wearing them. I do wear copperware sleeves but also don’t get much relief.
Have you seen any improvement or have any thoughts with people exercising their arms with a flexbar?
They come in resistance of light to heavy. I have suffered from tennis elbow for about a year in both arms but have refused
the doctors advice for cortisone shots and also prolotherapy. Any help you can give would be appreciated.
Thank you! Jm
You’re welcome, Jm. Very glad to hear you turned down the Cortisone shot! Smart move. (Your Doctor also recommended Prolotherapy? – If so, that’s like hitting the gas and the brake at the same time or trying to drive forward and backward simultaneously.)
I continue to hear mixed reviews about the Flexbar – Usually very positive or completely negative (as in it aggravated the person’s pain) – I have an article with a video with my thoughts on the bar here:
Tennis Elbow, Eccentric Exercise And Rubber Bars: The Right Road To Rehab?
Hi Allen
I’ve been emailing with you today via You Tube regarding my tennis elbow. You asked me:
“Sorry to hear that! Did you get any therapy for your elbow from your Chiropractor while you were seeing him/her for your back? (By the way, do you know about my self-help program? – I checked to see if you were a member and your name didn’t come up.)”
I did go to acupuncture for a while with limited results, I also have a portable stimulation device that seems to be ok, I used for my back as well when it was bothering me. The chiropractor was treating my back but did use a little laser heating device a few times, and he did mention the twisting (clockwise exercise) that seemed to be helpful for a while (maybe pushups recently could be hurting me). And I did physical therapy last year (mostly massage and strength building). I do agree with your techniques so let me know how to become a member. I think my main issue now could be that I do wear a neoprene brace / sleeve much of the time and I wear a cutoff cotton sock to bed. This is because the elbow feels much better when it is warm, especially at night, where I could wake up with a lot of pain from lack of movement and cool air (if my arm comes out of the covers). I listened to your no elbow brace audio and it made sense. Thanks, John
It sounds like you’ve had quite a bit of therapy, but tendons can be very stubborn. I like the laser idea, but I wonder if the massage you got in P.T. was specific enough. I believe it often needs to be very precise (the way I teach.)
(Nothing wrong with trying to keep your arm warm and the blood flowing. I think that’s a good idea. As long as the Neoprene sleeve is loose-fitting and doesn’t impact your circulation.)
I just sent you an email in case you have questions about membership. That will be better for a faster back and forth conversation!
hi Allen , been searching the web for tendonitis/ tendonosis treatments and I came across this page . would greatly appreciate any advice … been struggling with tendonitis in the elbow/forarm/hand for about a year now . stoped lifting weights about 6 months ago because of it . been getting deep tissue message done for past 2 months once a week . seeing very mild improvments ( might be plasibo ) and been iceing and heating . I work as a mechanic and constantly agrivate the tendons at work . havnt been wearing a tennis elbow brace at all but was considering doing it just at work since I have such a physical job .would love your opinion….. also I have a friend who had severe knee problems for years , it took a cycle of specific anabolic steroids that increase collagen sysnthasis . joint fluid and bone density . ( test, deca, anavar ) hes has been of the drugs for 5 months now and claims his knees are 90 percnt better . was curious if you have any knowledge of this type of thing and its possible success . .. sorry for the long message , and sorry for the terrible grammar lol hopefully I hear back from you soon ,
thanks
ben
Ben, I would not go anywhere near anabolic – or any other type of steroid (Cortisone, ect.) if I were you. Would your recovery from your tendon problem be worth it if it ended up messing up your endocrine system? (Is the massage that you’re getting really specific to the muscles and tendons involved?)
I’ve had tennis elbow for almost 2 years. Physical therapy did nothing. I;ve had 3 cortisone shots before switching to another orthopedic. New guy said is more inclined to operate but is hoping it will heal itself with rest (I had shoulder surgery so my arm use is limited now). I just started wearing a brace again and it seems to be helping. Since you are against that, what other options does someone have that has been dealing with this for 2 years?
Matt, I’m sorry to have to say this, but in my experience, people who have had 3 or more shots have a very, very tough time recovering (without surgery, anyway.) I would not put much hope into the idea that it will heal with rest. (See my posts on Cortisone and Rest if you haven’t yet.) The brace may help you feel better temporarily, and if that’s important to you, I’m not against it. I’m against (or highly skeptical of) the idea that these things “support” healing – based on reasons given – but you have to decide for yourself what makes the most sense.
Hello Allen,
I’ve developed tennis elbow recently (over the last four months) from continuously carrying heavy things. Last week it was very painful and I was tempted to get a brace. After reading this, I decided against it. Obviously I stopped doing the strenuous things that caused it in the first place, but I continued to do other things that did not aggravate it, in order to keep it mobile. It is still sore and painful, but not as much as last week and I’m now able to make a fist again without wincing. I can only assume that it is healing and this is without using a brace. I’m glad I fell upon your website.
Thanks, Laura! That sounds like a wise approach. Glad I could help.
Hi. I know your views on NSAIDs, but what about painkillers which aren’t anti inflammatories? Are they okay to have if the pain is too much to bear? I know the things which cause my golfer’s elbow to worsen so I’ll be sure to avoid those even if they feel okay to do while on painkillers.
Do what you feel you need to do to get through the day. I would personally still try to avoid them, though.
Hello,
I finally went to my Ortho yesterday and was diagnosed with TE. The pain is so intense and I’m experiencing loss of grip function in my hand. The doctor gave me a Cortisone shot, elbow brace, and wrist brace to wear at night.
My day job is at a computer desk so it’s easy to allow my arm to relax. The greater issue is I ride motorcycles on a race track….. with the season over for now, I am desperately trying to let my arm get back into functional shape.
My question, outside of the constant intense pain, loss of function etc… how do I know if there could be a tare? Also how to press a doctor who doesn’t want to move forward with doing this type of exam?
Hi Heather, Have you had any kind of forceful injury (Acute trauma) to your arm / wrist that would lead you to believe that you might have torn a muscle or tendon?
If your Tennis Elbow is the result of your gripping bike handle grips, breaking and/or clutching and using your computer then I wouldn’t be thinking “tear” at this point. Tennis Elbow can be intensely painful with no tear and tears are not that common.
BUT if you’re really worried and need to know, you might be able to get a sonogram rather than an MRI, but you might have to push for it. See the following article I wrote about this type of simple, easy scan:
The Sonogram: A Tennis Elbow Diagnostic Test Your Doctor Won’t Give You
Thank you for your expertise. I am wondering about your opinion about a wrist brace. An ortho recommended the wrist brace along with physical therapy…after an x-ray and exam.
I have been suffering from Tennis Elbow and mild Golfers for two years. First in my non-dominant arm (left), which is mostly healed after two years, but now is in my dominant arm (right). Everyday activities, picking up a coffee cup, pulling on or off a wetsuit, pulling covers on and off in me while in bed all are really painful. I’m fine with the pain but my fear is that I am causing more damage. I am also worried that I will overcompensate with my left and cause a flare up. The left is definitely not completely healed.
So…wrist brace to protect wrist flexors and tensors ok or not ok? I was told to wear it while I sleep and at all times. Thoughts?
Hi Lori Ann! I’m sorry to hear you’ve been suffering for 2 years. That’s a long time! You say that you’re “fine with the pain but my fear is that I am causing more damage.”
But the kind of damage that we (usually) need to be concerned about is gradual, degenerative tendon changes – and braces do not protect us from that. Everything I have seen and learned suggests it’s just the opposite.
Those tweaks and twinges you get doing little, everyday things like taking the milk out of the fridge are something many Tennis Elbow sufferers worry about (needlessly, though) 99 times out of a 100 it’s just an overreaction by our nervous systems – and not an indication that there has been further damage (like a tear!)
The only time a brace makes sense to me, as I say in the article, is when you’re performing a more dynamic, forceful activity (that you would ideally avoid, but perhaps can’t.)
Thank you Allen. I’m so impressed that you responded! Can you then help me differentiate between “Pain=bad, stop doing it!!” and “Pain=no worries”
Just to clarify, you are saying that the day to day activities in which I feel pain are not causing further damage (good news). But you (and many others) also say to stop an activity if you feel pain, for example, when working out. This is where I am confused. I’m not sure, then, what the pain will feel like when I am supposed to stop an activity. For example, sometimes picking up a coffee cup or carton of milk will cause enough pain that I wince and almost drop the object, and the pain sort of continues for a period of time after. Pretty much any time I have to grab something and use any forearm strength it hurts. On the other hand, when working out or during yoga, for example doing burpees or chaturanga will not really cause pain at the time, but later I feel soreness and pain. Burpees and Chaturanga both have a push-up component. Another example, biking doesn’t hurt my elbows during the activity (does hurt my wrists), but soreness in elbows and forearms and writsts later. I could go on and on. Its been my hobby these past two year trying to find an invigorating workout regime that will not cause further damage. I’m super discouraged with my body. I am hopeful you can help.
thanks again!
Just to clarify, you are saying that the day to day activities in which I feel pain are not causing further damage
That’s right – Chances are they are not damaging you – Not in the way people often think, anyway – like tendon tearing.
But you (and many others) also say to stop an activity if you feel pain, for example, when working out. This is where I am confused. I’m not sure, then, what the pain will feel like when I am supposed to stop an activity.
There are things you have to do in life and if you feel pain while doing those things – Especially short-duration things like the classic “taking the milk out of the fridge” then try not to worry and certainly don’t stop doing them.
However, do try to avoid LONG-duration activities – especially if they are physically intense – My favorite example being something like weed-whacking, because it involves a lot of static holding / gripping and vibration and somewhat awkward motions for a significant period of time.
Exercising is very important, overall and for rehab, but you don’t want to do an exercise over and over when it’s hurting. This is a nuanced question and issue though. It comes up frequently when I do consults with people over the phone or on Skype.
In the long run, I believe it’s better to be active (as long as you’re not feeling significant pain while exercising or doing yoga) even if there is soreness and maybe even some pain later – as long as it’s not severe.
That’s about all I have time to say for now. Hope that helps!
Hi.
I’ve had tennis and golfers elbow in my dominant (right) arm for about seven months now and I’m only 19. I don’t know how I got it but after three months of having it and stopping all physical activity i went to the doctor and got an ill-advised shot, wore an arm brace, went through physical therapy and still had pain on my medial epicondyle. For the past two months the pain has decreased but there is still sensitivity on my ulnar nerve so my doctor told me to get an MRI but no swelling showed up on it. I still have pain and sensitivity on the medial epicondyle and occasionally on the lateral epicondyle and was wondering what to do. I was wondering if wrist braces are any different and might help my situation. I was also wondering if I can start working out again without free weights and if I should continue to do my physical therapy exercizes or should I just let my arm rest for a month.
My tennis elbow symptoms started the next day, after one time using a sledge hammer with great force for about 20 minutes. For 5 months since this episode the pain has been light or moderate and with slight swelling. I still have full range of motion, although with pain. From what I am reading it sounds like my injury might have been due to a tear. So maybe I should have worn a brace right away after the injury. But now it has been 5 months, would it benefit me to use brace at this point? I don’t want to go to doctor for a variety of reasons. Can you give me any advice? Should I try wearing a brace for a few weeks? If so what kind? Do exercises and stretching? Thank you!
You can’t assume a tear, R.J. There’s only one way to know and that’s to get a scan (and MRI, or much cheaper and easier, a Sonogram / Diagnostic Ultrasound.) If I were you I might wear a brace while doing forceful work (like using a sledgehammer – or even a regular hammer!) for short periods – but I would not wear one continuously. Have you looked at my program as a possibility for self treatment?
For elbow braces, would it be okay to wear while driving or depends how long?
I wouldn’t. That falls under the category of “Long periods of low intensity activity” which is not a recommended time to wear a brace.
great advice, I have recently been advised that I have Tennis Elbow and got a brace recently and tend to use it on and off as required.
I was also advised that taking BCCA’s and Protein can help the healing process, as I want to get back in the gym – is this sensible and would it work.
Note I did not get tennis elbow from Gym work.
I don’t think protein deficiency plays a role in Tennis Elbow and I don’t see how taking branched-chain amino acids would be particularly helpful (but I could be wrong.)
When it comes to supplements, I have a strong suspicion that low levels of Vitamin D may play a role. Here’s my article on Supplements for Tennis and Golfer’s Elbow if you’re interested.
And it sounds like my article and video on the Exercises To Avoid With Tennis Elbow may also come in handy to you.
My doctor thinks mine came from an Aggressive IV Insertion during a CT scan. She thinks there could have been a tendon tear from the insertion. Pain started the day after in elbow as if it was tennis elbow. Now pain is down the arm and particularly the wrist. I have tried hydroculator and ice as well as brace and sleeve. What do you recommend?
Hi,
I seem to have Tennis Elbow due to lifting weights. probably due to lifting heavier weights when I haven’t been to the gym a in a long time. The dips might have caused it. I iced and rested for couple of days and then went back to the gym, did a lot of different dumbbell exercises. Now the injury is worse than before. I stopped gym for 3 days, wearing brace on and off, icing. The brace helps but since reading your article I am wondering whether I should wear it or not. Please advise. Thank you.
I have good experience from adjusting the neck (c7 and/or c8) with a chiropractor. Then hard massage on shoulder/neck and arm followed up with acupuncture. I had it for months but after this treatment it went away in 4 weeks. Play tennis 5-6 times a week.
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