A counterforce strap is a firm band worn around the upper forearm, just below the elbow, that can ease TENNIS ELBOW pain during gripping and lifting.
It’s thought to spread the pull of the forearm muscles so less force reaches the sore tendon at the elbow. Clinicians are kinda split on whether it is worth wearing, and both schools of thought are set out below.
It doesn’t heal the tendon. It can make the loading work that DOES heal it more comfortable.
How it’s meant to work
- The muscles that lift the wrist start from a small tendon on the outer elbow. Every grip pulls on it. See tennis elbow
- A band pressing on those muscles a short way down the forearm is thought to change where the pull is concentrated
- The result, for some people, is less pain while gripping, carrying or playing
The strap is for getting through the day. The exercises are for getting better.
Two schools of thought
Clinicians genuinely disagree about straps, and both camps have a fair case.
Use it: the strap as a tool
- It can reduce pain during grip. Some trials and biomechanical studies suggest a strap changes muscle activity and the load reaching the tendon origin while you grip
- It keeps people working and playing, which matters when the alternative is stopping altogether
- It can make loading exercises more tolerable in the early, irritable weeks
- It is cheap, low risk and easy to stop
Skip it: the strap as a distraction
- Tendons recover by adapting to load, not by being offloaded. A strap does nothing to build that capacity
- The benefit in trials is small and short-lived, and long-term results are not clearly better than exercise and load management alone
- It can become a crutch, reinforcing the idea that the elbow is fragile and delaying the loading work
- Worn too tight or too low, it can irritate the radial nerve and add a second problem
Where both schools agree: exercise and load management do the healing. If a strap lets you do more of that work with less pain, it is earning its place.
If it is replacing that work, it is not.
Which is a fine line if you ask me….
Wearing it properly
- Position: about two to three finger-widths below the bony point on the outside of the elbow, over the muscle, not on the bone
- Tension: tighten it with the forearm muscles relaxed, so it’s firm when you grip but not tight at rest
- When: during the tasks that hurt, such as lifting, tools, racquet sport and long computer sessions
- Not at night and not all day. Take it off between tasks
Strap or wrist splint
- Strap: low profile, lets the wrist move, suits sport and work
- Wrist cock-up splint: rests the wrist-lifting muscles more completely, sometimes used during a bad flare
- Studies haven’t clearly shown one beats the other. Choose what lets you keep doing your loading program
What actually changes tennis elbow
- Progressive tendon loading, slow and heavy enough to challenge the tendon. See tennis elbow exercises
- Load management: reducing the grip-heavy tasks that flare it, then building back
- Grip changes: thicker handles, lifting with the palm up
- Time. Tennis elbow commonly takes months to settle, even when managed well
For inner elbow pain, the same strap design is worn over the inner forearm muscles. See golfer’s elbow.
Problems to watch for
- Tingling or aching in the forearm from a strap that’s too tight or too low, pressing near the radial nerve. See radial tunnel syndrome
- Swelling in the hand below a tight strap
- Relying on it instead of doing the exercises
Get it checked if
- Pain at night or at rest
- Numbness in the fingers
- Grip weakness getting worse
- No improvement after 12 weeks of loading exercises and load changes
For buying advice, see wrist braces: what to buy and what to skip. This is one of dozens of splints and supports a hand therapist uses.
See what a hand therapist does for the full list.
Wear the strap for the tasks, and do the exercises for the tendon.
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.