Where Should an Epicondylitis Strap Sit?

Position the strap below the elbow

An epicondylitis strap is designed for the upper forearm, not the elbow joint itself. A common starting point in NHS orthotic guidance is approximately two finger widths below the elbow crease. This places the device over the forearm muscle rather than on the painful bony prominence.

The exact position can vary with the product shape and individual anatomy. Use the supplied instructions and any fitting advice from a physiotherapist, orthotist or doctor.

Find the relevant muscle area

For tennis elbow symptoms on the outer side, the pressure pad is usually positioned over the upper outer forearm muscle. For golfer's elbow symptoms on the inner side, it is positioned over the upper inner forearm muscle. The pad should not press directly on the bony point.

If you have not been assessed, do not assume the side of pain confirms the condition. Inner elbow tingling can involve the ulnar nerve, and pain after trauma may have another cause.

Keep the strap clear of the crease

A strap placed too high may dig into the elbow crease when the arm bends. It can also slip over the joint or press on sensitive structures. Move it slightly lower if the edge catches, while keeping the pressure pad in the intended muscle area.

Set firm but comfortable tension

Fasten the strap so it stays in place during light gripping without sliding or rotating. It should feel firm and supportive, not sharply tight. You should be able to bend and straighten the elbow comfortably, and the hand should remain warm and normally coloured.

A strap is too tight if it causes numbness, persistent pins and needles, coldness, colour change, throbbing, increased swelling or deep marks. Loosen or remove it immediately. If symptoms do not settle promptly, seek advice.

Test the position during a light task

1. Put the strap on with the arm relaxed.
2. Align the pad over the relevant forearm muscle.
3. Fasten gradually until secure.
4. Bend and straighten the elbow several times.
5. Try a gentle grip with an empty cup or other light object.
6. Recheck comfort, warmth, colour and sensation.

If the strap moves, revisit the size and position rather than immediately tightening it further.

Wearing it during activity

Some NHS orthotic services advise using an epicondylitis clasp during daytime activity that aggravates symptoms and removing it at night. That does not create one schedule for every person. Follow the product instructions and any individual clinical advice.

Begin with a short period and inspect the skin after removal. The strap should assist a sensible reduction in load, not allow continued heavy gripping through worsening pain.

Skin and product checks

Keep the skin and strap clean and dry. Check the edge and pressure pad for folds or damage. Persistent redness, blistering or broken skin means the device needs reassessment. People with reduced sensation or circulation problems should obtain advice before prolonged wear.

When fitting advice is needed

Ask a physiotherapist, orthotist or pharmacist if the strap repeatedly slips, causes pressure or does not seem to change symptoms. Arrange medical assessment for persistent or worsening elbow pain, weakness or neurological symptoms. Seek urgent help after significant trauma if there is deformity, severe swelling, loss of movement, numbness or colour change.

Sources and further guidance

• The Rotherham NHS Foundation Trust: Epicondylitis brace
• Northern Care Alliance: Epicondylitis clasps

This guide provides general information and does not replace individual medical advice.