My elbows have been on fire for a year, regardless of curved handles, palm down starts, stretching, etc. Within one month of going to ML's optimized rope, my elbows are 90% healed. I know this is purely anecdotal, but I changed nothing else other than the rope. And for the record, I'm not sponsored by MasterLine and have to buy my ropes just like anyone else. So my observations are honest and voluntary. I was skeptical at first, but now believe this rope is a real breakthrough.