Pickleball and Padel Elbow: Why It Happens and How to Prevent It
Elbow pain is the most common complaint among new paddle players. Grip, technique, and gear choices are usually to blame — and all three are fixable.
Theo Marsh7 min read
In This Story
In This Story
Key Takeaways
- Pickleball and padel elbow is lateral epicondylitis — the same overuse injury as tennis elbow.
- Grip pressure, grip size, wrist-heavy strokes, and sudden increases in play are the main causes.
- Relax your grip, check your grip size, and choose a lower swing-weight, vibration-dampening paddle.
- Eccentric wrist exercises and shoulder strength help prevent and rehab it.
- Rest and see a professional if pain persists — playing through it usually makes it last longer.
Pickleball and padel are easy to pick up and hard to put down — which is exactly how many new players end up with a sore elbow. Playing several times a week with an unfamiliar grip and a tight hand loads the forearm tendons faster than they can adapt.
Fast answer
Loosen your grip, check your grip size, ramp up gradually
Most paddle-sport elbow pain is overuse of the forearm extensor tendons. Grip pressure, grip size, wrist-heavy strokes, and sudden jumps in playing time are the main drivers.
What 'pickleball elbow' is
It is the same condition as tennis elbow: lateral epicondylitis, an overuse injury of the tendons that attach the forearm extensor muscles to the outside of the elbow. Pain is usually felt on the outer elbow and can spread into the forearm, often worse when gripping, lifting a mug, or shaking hands. Less commonly, pain on the inner elbow (medial epicondylitis, or 'golfer's elbow') can occur.
The main causes
- Death grip: squeezing hard on every shot overloads the forearm. Coaches often suggest around 3–4 out of 10 grip pressure.
- Wrong grip size: a handle that is too small or too large makes your forearm work harder. Many players need an overgrip; some need two.
- Wrist-driven strokes: flicking the wrist instead of using compact, shoulder-led swings. In padel especially, most shots are pushes, not big tennis-style hits.
- High swing weight: longer, head-heavy paddles feel powerful but load the arm more. Lower swing weight is gentler.
- Harsh, vibrating paddles: older or very thin paddles transmit more vibration. Modern foam-cored or thicker paddles feel softer — see 14mm vs 16mm paddles.
- Too much, too soon: going from zero to five sessions a week rarely ends well.
How to check your grip size
Hold the paddle or racket with your normal grip. You should be able to fit roughly the width of your opposite index finger between your fingertips and the base of your thumb. No gap means it is too small; a big gap means it is too big. Adding an overgrip is the easiest way to build up a thin handle.
Gear and technique changes
| Compare | Change | Why it helps |
|---|---|---|
| Relax grip to 3–4/10 | Less constant tension on the forearm tendons | — |
| Correct grip size / overgrip | Reduces the effort needed to hold the handle | — |
| Lower swing-weight paddle | Less load on the arm through each swing | — |
| Foam-core or thicker paddle | Dampens vibration | — |
| Compact, shoulder-led strokes | Moves work from wrist to larger muscles | — |
| Lessons | A coach can spot wrist flicks and grip issues quickly | — |
Swipe sideways to see all columns.
Choosing a padel racket? Softer, round-shaped rackets are generally more forgiving; see how to choose a beginner padel racket.
Strengthen the forearm
- Eccentric wrist extension: hold a light dumbbell, palm down, and slowly lower the weight over 3–5 seconds. Use the other hand to lift it back up.
- Flexible-bar twists: a rubber therapy bar is widely used for tennis-elbow rehab.
- Grip and finger work: squeeze a soft ball or putty, and train finger extension with a rubber band.
- Shoulder and upper-back strength: a stronger shoulder takes load off the elbow. Our pickleball warm-up includes simple activation drills.
If it already hurts
Reduce or pause play to let the tendon settle — continuing to play through pain usually prolongs it. Ice can ease symptoms, and a counterforce brace worn just below the elbow helps some players. Most cases improve with rest and progressive strengthening, but recovery can take weeks to months. See a doctor or physiotherapist if pain persists, is severe, affects daily tasks, or comes with numbness or swelling.
Frequently Asked
What causes pickleball elbow?
Overuse of the forearm extensor tendons, usually from gripping too tightly, a grip that is the wrong size, wrist-driven strokes, a heavy or harsh paddle, or increasing playing time too quickly.
Is padel bad for your elbow?
Not inherently, but new players often grip too hard or swing like tennis players. Padel is mostly a pushing game; relaxed, compact strokes and the right grip size reduce elbow strain.
How long does pickleball elbow take to heal?
It varies. Mild cases can settle in a few weeks with reduced play and strengthening; more persistent cases can take several months. See a professional if it is not improving.
Which paddle is best for tennis elbow?
Look for a lower swing weight, a foam or thicker core that dampens vibration, and a grip size that fits your hand. A 16mm paddle often feels softer than a 14mm.
Sources
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