• Counterforce Brace Design: This is a counterforce or epicondyle strap — a distinct category of elbow support that functions differently from a neoprene sleeve. A sleeve provides circumferential compression and heat retention across the entire elbow joint. A counterforce strap applies focused mechanical pressure to the proximal forearm musculature just distal to the tendon attachment, altering the biomechanics of force transmission through the tendon during wrist and finger extension or flexion movements. This is the clinically established mechanism by which epicondyle straps reduce pain during activity in lateral and medial epicondylitis.
• Cushioned Tendon Pad: The pad is the functional core of the device. When positioned correctly over the lateral epicondyle (outer elbow) or medial epicondyle (inner elbow), it creates a focal pressure point at the periosteal tendon insertion — the exact site where epicondylitis pain originates. The cushioned construction distributes this pressure evenly to maximise effectiveness without causing discomfort at the pad contact point.
• Support Level 4 Classification: Level 4 in the Kedley elbow range reflects targeted, functional support rather than circumferential immobilisation. This device is designed to be worn during activity — maintaining full elbow range of motion — rather than to restrict the joint. The support level indicates the meaningful degree of symptom relief the counterforce mechanism provides during occupational and sporting use.
• Aero-Tech Neoprene Strap: The strap body uses Kedley's Aero-Tech neoprene with Polyamide, Polyester, and Elastane content — providing the structural integrity needed to maintain consistent pad pressure throughout wear and during dynamic forearm activity, while remaining comfortable against the skin during extended use.
• Intended Clinical Uses: Lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), general elbow tendon pain from overuse, and occupational or sport-related epicondyle conditions during activity management.

This support is indicated for both principal epicondylitis presentations. Correct identification of the affected epicondyle is essential for correct pad placement — the same brace is used for both conditions but positioned on the opposite side of the elbow.

• Load Redistribution at the Tendon Origin: When the common extensor muscles (in lateral epicondylitis) contract during wrist extension and grip activities, they generate tensile force transmitted through the tendon to its attachment at the lateral epicondyle. In tendinopathy, this attachment site is the zone of pathological tissue change and pain. The counterforce strap, positioned just distal to this attachment, compresses the underlying muscle belly and alters the mechanical loading pattern of the tendon — effectively reducing the peak tensile force reaching the degenerate attachment zone during contraction.
• Focal Pad Pressure: The cushioned pad positioned directly over the epicondyle provides a secondary pain-relief mechanism through sensory modulation — the constant tactile input from the pad influences the local nociceptive signal from the irritated periosteum and tendon insertion, contributing to the pain relief experienced during wear. This is distinct from the mechanical load-redistribution effect of the strap itself, and the combination of both mechanisms is why correctly positioned counterforce braces consistently outperform placebo in short-term pain reduction studies.
• Preserved Elbow Range of Motion: Unlike a circumferential sleeve or hinged brace, the counterforce strap does not restrict elbow flexion or extension. The elbow moves freely during sport, work, and daily activity — the brace's effect is entirely on the forearm musculature force distribution rather than on joint movement. This makes it practical for use during the full range of activities that provoke epicondylitis symptoms.
• Neoprene Thermal Contribution: The Aero-Tech neoprene strap provides a degree of local heat retention at the proximal forearm during wear. Increased tissue temperature improves tendon extensibility and may reduce the stiffness-related component of morning and post-rest pain — providing an additive benefit to the counterforce mechanism during sustained activity.

• Identifying the Correct Pad Position: Before fitting, palpate the elbow to locate the painful epicondyle. For lateral epicondylitis: the lateral epicondyle is the bony prominence on the outer aspect of the elbow; tenderness is typically maximal 1–2cm distal to the epicondyle tip at the common extensor origin. For medial epicondylitis: the medial epicondyle is the bony prominence on the inner aspect of the elbow, with tenderness at the common flexor-pronator origin just distal to the prominence.
• Step 1 – Form the Loop: Fold the strap to create a loop of appropriate diameter for the forearm. The strap should sit 2–3cm distal (below) the affected epicondyle — over the proximal forearm musculature, not directly over the epicondyle bone itself.
• Step 2 – Apply the Arm: Slide the appropriate arm through the loop so the strap sits in the correct subepicondylar position on the forearm.
• Step 3 – Position the Pad: Rotate the strap so the cushioned pad sits directly over the point of maximum tenderness at the epicondyle. This is the critical step — the pad must be centred on the painful tendon origin, not on the strap material, for the brace to function correctly.
• Step 4 – Fasten and Adjust: Close the Velcro fastener and tighten until the pad applies firm, targeted pressure to the epicondyle. The strap should be snug — firm enough that the pad maintains consistent contact during activity — but should not cause discomfort, numbness, or tingling in the forearm or hand. If any neurological symptoms develop, loosen immediately.
• Circulation Check: After fitting, confirm that the hand is warm with normal sensation and grip strength is unaffected. Re-adjust if there is any tightness, tingling, or numbness.
• When to Wear: Wear during activities that provoke epicondylitis symptoms — sporting activity, manual work, typing, or any forearm-loading task. Remove during rest and when sleeping. The brace is not intended for continuous all-day wear — targeted use during provocative activities is the appropriate approach.
• Washing & Storage: Hand wash in lukewarm soapy water. Rinse and air dry. Do not machine wash, tumble dry, or iron. Store in a cool, dry place away from direct heat and sunlight.