How to identify, treat and avoid Pickleball Elbow

Is there a pain in your elbow while playing pickleball? Is it getting worse? There’s a chance you might be developing pickleball elbow.

One of the selling points of playing pickleball is that you are less likely to get injured while playing when compared to other sports such as tennis — and it has a lot of other health benefits too — but that doesn’t mean there is no chance of getting injured!

Before we get into this: I am not a physician or physical therapist. The below is based on the best research I could find, so please do not rely solely on this information – consult your doctor or physical therapist if you are having issues! At the very least you can be more informed about the issue if you do need to visit a medical professional.

(Some of the below links are affiliate links which means we get paid a bit if you click through and buy something — don’t worry it doesn’t add anything to your cost! Just helps keep the site running.)

What is pickleball elbow?

Pickleball elbow (which also can be called tennis elbow) is a pain on the outside and above part of the elbow where muscle, forearm and tendons are attached that develops through repeated usage and overuse — something you should watch out for if you’re drilling with a pickleball machine a lot — it’s also called lateral epicondylitis if you want to get fancy.

As Webmd puts it: you will feel

“pain and tenderness in the bony knob on the outside of your elbow. This knob is where the injured tendons connect to the bone. The pain may also radiate into the upper or lower arm.”

There’s also a related issue called Golfer’s elbow (or Medial epicondylopathy). This occurs on the inner bony part of your elbow and, shockingly, is associated to an injury which you might get while playing golf. (1)

Regardless of whether it’s pickleball/tennis or golfer’s elbow, they all relate to the tendons in your arm.

So how do you know if you’ve got it, what are the symptoms?

First, a pain in your elbow as you are playing (duh). But more specifically it will manifest as perhaps a burning pain around the bony knobs on the outside of the elbow of your paddle arm. You might also feel some stiffness, sharp pain or general soreness in the elbow area.

Tennis and pickleball elbow can tend to build up more pain over time, but it usually doesn’t swell up. So it’s best to pay attention to your elbow as soon as you start to feel discomfort and pain because the more you use and abuse it the worse it will get.

If you’re still not sure if you’ve got it, here are some tests you can do in increasing order of intensity (2):

Using your opposite hand, push and massage the areas all around your elbow. If you feel pain or sensitivity that’s a sign of it.
Bend your arm in a 90 degree angle, with your hand pointing straight up. Try to bend your hand at the wrist using your opposite hand. If you feel pain on your elbow, that’s another sign of having it.
In the same position as #2, try to move just your middle finger down toward the palm with the opposite hand, while trying to keep your hand/finger straight. Discomfort in the elbow? A sign of pickleball elbow.
Hold your arm out straight in front of you. Stand behind a chair. With your straight arm, try to pick up the chair using your thumb and first three fingers (not your pinky). If you’ve read this far, you know: pain = likely pickleball elbow.

Who is most likely to get it?

Really anyone can get pickelball elbow but some of the elements that will increase your risk are (3):

being over 30
not sufficiently warming up your muscles and tendons before playing
bad form and mechanics
if you’ve had some kind of injury to your elbow
playing a lot

What causes PIckleball Elbow?

According to the USAPA “the Extensor Carpi Radialis Brevis (ECRB) has been shown to be most affected and the source of the pain in most individuals” (4)

And what can cause and aggravate the issue:

a lot of vibration and a lot of upper body movement.
repetitive stress on the arm/elbow
Constant movement of rotating your elbow while you play pickleball.
Ways to avoid getting pickleball elbow in the first place:
Wear a brace while playing

How can you avoid getting it in the first place?

Wear an elbow brace or elbow strap WHILE you’re playing

According to this Neuromuscular Therapist, there is no benefit or need to wear it while you are NOT playing.

Here are a selection of the best reviewed elbow braces you can wear during pickleball that I found on Amazon. Please note, I have not had pickleball elbow myself so I have not used an elbow brace. These are simply the ones that get the best reviews and seem to be the best overall braces to check out. (Note, if you do end up buying something on Amazon, we get a small amount of money which helps keep the site going. The price you pay is no different if you buy through these links.)

Table could not be displayed.

But using a brace is not enough in and of itself. Follow the below advice to avoid getting pickleball elbow in the first place:

Mind your paddle grip

If you grip your paddle too hard, you could aggravate your elbow. Work on relaxing grip while you’re playing.

Pay attention to your back hand form

The way you’re hitting your back hand: Pay attention to how you’re swinging your back hand. If you’re bending your elbow a lot and there’s lot of movement around your elbow where you’re snapping your arm out, that can be a problem. Look to swing your backhands from your shoulder using a straighter arm. The pros will either keep their elbow down lower and arm straighter or move their whole arm from their shoulder.

Get a lesson from a pro to get your mechanics right

Get some lessons from a coach and ask them to help review your mechanics during the sessions. They can point out any issues you might be having that might contribute to pain.

Good form and mechanics can go a long way.

Warm up adequately and stretch before playing

The USAPA has some tips about ways to warm up and stretch. They recommend 5 minutes of warm-up followed by stretching.

Get a paddle that doesn’t aggravate your arm

If all else fails, your paddle might be contributing to the issue. You might want to try a different style of paddle — borrow one from a friend or at a pickleball club to see if a different type of paddle would help you.

Paddle weight: If you get a heavier paddle, that puts more strain when you swing, however if you get a lighter paddle you might also swing harder in order to get good power behind your hits. If your paddle is either on the heavy or lighter weight side, consider getting a mid-weight paddle (between 7.5 and 8.5 ounces)

Grip size: if it’s too big or too small it might mess up your grip.

Paddle face size/shape: It’s possible a very large or long blade style paddle face might contribute – for example, hitting the ball outside the sweet spot or way out on the end of the paddle will cause significant vibration which is bad for your elbow.

Paddle material: Graphite composite paddles should be better for shock absorption.

This paddle is specifically designed for combating pickleball elbow. Haven’t played with it myself but based on a few reviews on Amazon it does help some people:

No products found.

How to treat pickleball elbow?

Okay, so you know what it is, you’ve tried to avoid it but you find yourself developing or having developed pickleball elbow. What should you do? (Reminder about my disclaimer above: I’m not a physician. Consult a physician or physical therapist. Whatever you do of the below, start slow.)

First up, if you are experiencing pain, you should stop what you’re doing that is causing the pain because it will only get worse! Tough to hear that you should stop playing pickleball when this starts to happen, but it will be for the best and playing more will just prolong and worsen the issue.

Exercises and stretches

As described in the above video:

Use a door hinge, lotion. put it over muscles of forearm. take tool and follow line of the muscle
Wait until skin turns red as you get blood flow moving
Pin down that muscle and move through range of motion through wrist and arm. do it until it feels better. 30 seconds up to 2 minutes.
Work on the shoulder: put a lacrosse ball (or similar) on the front of the shoulder and push the ball against a wall until you feel better. Then do the same thing on the back of the shoulder and the shoulder blade.
Raise your arm up, down and side to side. Some other stretches you can do without any equipment:

Some other stretches you can do without any equipment:

Straighten your arm in front of you.
Now with the other hand pull your flat hand down towards you, flexing it at your wrist.
Flip your palm the other way and do the same thing in the other direction.
Gently but firmly pull on your hand each time for 15 to 30 seconds.

Exercises you can do with light weights and stretch bands

Sit down.
Put your forearm flat against the top of your leg.
Hold a light weight in your hand parallel to the ground.
Now raise and lower the weight slowly and evenly up and down, flexing at the wrist.
Make sure the weight is light enough that you can do it about 30 times in a session but heavy enough so that you are working.
Now do the same exercise but switch the direction of your palm.

Talk to a professional

The best thing you can do is talk to your doctor or physical therapist. As someone who has benefitted immensely from the help of physical therapists in the past, I highly recommend it!

I like this set of rules laid out by Alpha Chiropractic and Physical Therapy about tendon injuries in general:

Severe injuries produce more pain.
Chronic is bad – Injuries that have been around for months take longer to heal.
It does not get better with continued use. The muscle and tendon need time to heal.
It always takes longer to heal than you think it should.
It does not get better with ignoring the injury.

So if you do start to get pickleball elbow, it will take time to heal so don’t take things too fast!

Last update on 2024-04-03 / Affiliate links / Images from Amazon Product Advertising API