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Pickleball Elbow prevention and treatment

Updated: Nov 21, 2023

Pickleball is an exhilarating sport that combines elements of tennis, badminton, and table tennis. It's a game that can provide hours of fun and competitive play. However, like any physical activity, pickleball can also lead to overuse injuries. One common injury that pickleball players may experience is Pickleball Elbow, also known as lateral epicondylitis or tennis elbow. In this comprehensive guide, we will explore the causes, prevention, and treatment of Pickleball Elbow, so you can continue enjoying the game without the pain and discomfort.

Two Women Playing Pickleball

What is Pickleball Elbow?

Pickleball Elbow is a condition that occurs when the extensor muscles and tendons in the forearm become damaged due to overuse. The repetitive motion of hitting the ball with a paddle can cause vibratory forces to accumulate in the connective tissue, leading to pain, weakness, and decreased grip strength. The lateral epicondyle, a bony protrusion on the outside of the elbow, is particularly susceptible to this type of injury.

Understanding the Architecture of the Elbow

To fully grasp the mechanics of Pickleball Elbow, it's essential to understand the structure of the elbow joint. The extensor muscles and tendons originate from a common tendon anchored at the lateral epicondyle. These muscles run down the forearm and attach to the carpal and phalange bones. Wrist extension, the movement responsible for bringing the wrist closer to the elbow, is controlled by these muscles and tendons.

Pickleball Elbow prevention and treatment

Prevention is always better than cure when it comes to Pickleball Elbow. By implementing a comprehensive injury prevention program, you can minimize the risk of developing this condition. Here are some effective strategies to consider:

Proper Warm-up and Stretching

Before each pickleball session, it's crucial to warm up your muscles and prepare them for the activity ahead. Start with some light cardio exercises to increase blood flow and raise your body temperature. Follow this with dynamic stretching, focusing on the muscles and tendons in your upper back, chest, shoulders, arms, wrists, and forearms.

Strengthening and Conditioning Exercises

Incorporating specific strengthening and conditioning exercises into your fitness routine can help improve the structural integrity of the muscles and tendons involved in pickleball. Exercises such as wrist curls, forearm pronation and supination, and eccentric wrist extensions are beneficial for preventing Pickleball Elbow.

Technique and Form

Proper technique and form are essential in any sport, including pickleball. Ensure that you have proper paddle grip, use the correct swing technique, and maintain a relaxed and controlled motion during gameplay. Avoid excessive force and unnecessary strain on your forearm muscles and tendons.

Rest and Recovery

Allowing your body time to rest and recover is crucial for preventing overuse injuries. Take regular breaks during gameplay, especially if you start experiencing any discomfort or pain in your elbow. Incorporate rest days into your weekly schedule and listen to your body's signals for when to take a break.

Treatment Options for Pickleball Elbow

If you do experience symptoms of Pickleball Elbow, it's essential to seek appropriate treatment to prevent further damage and promote healing. Here are some treatment options to consider:

Rest the elbow enough to avoid excessive stress on the injured tendon.

Immediately begin active recovery exercises that promote lengthening of the muscles of the forearm. Avoid any activities that worsen the pain and discomfort, but don’t be afraid to perform exercises that are slightly uncomfortable.

ActiveRelease Techniques (ART)

ART can be highly beneficial in the treatment of Pickleball Elbow. A qualified therapist can guide you through exercises and stretches that help strengthen the affected muscles and improve your range of motion. Contact us for a consultation about ART.

ARP Wave Stimulation

Eccentric muscle stimulation to the affected tendon and the muscles of that tendon will wake up and activate the muscle properly. When muscle moves effectively it absorbs the forces applied to it during pickleball. If a muscle is tight and does not absorb shock of the ball hitting the paddle, that force travels through the tendon at the elbow, producing microtears and subsequent scar tissue.

Bracing and Supports

Wearing a brace or support band around the forearm can provide a different point of origin of the muscle, relieving stress on the affected tendons. These braces can be worn during gameplay or during periods of rest to facilitate healing and reduce strain on the elbow joint, allowing it to heal quicker.

Rehabilitation and Strengthening Exercises

Once the initial pain and inflammation subside, it's crucial to engage in rehabilitation exercises to restore strength and flexibility to the affected muscles and tendons.

Here are some rehabilitation exercises that can help with Pickleball Elbow:

Eccentric Wrist Extension Exercise

The eccentric wrist extension exercise is a potent exercise for alleviating Pickleball Elbow pain and reinforcing the structural integrity of the connective tissue. Follow these steps to perform the exercise:

  • Obtain a weight, such as a dumbbell or a water bottle filled with water or soup can.

  • Sit down and place your forearm on your thigh.

  • Start with an extended wrist position, where the knuckle of your hand is cocked toward your elbow.

  • Slowly let the knuckles drop toward the ground, hinging at the wrist for about five seconds.

  • Keep the wrist and elbow in a solid position throughout the exercise.

  • Use your free hand to help lift the hand holding the weight back into extension, without lifting the knuckles.

  • Repeat the exercise for eight to ten repetitions, performing one to three sets before playing pickleball or on days you are not playing.

Isometric Wrist Exercises

The isometric exercise is performed by doing lateral raises or front raises while holding a dumbbell with the palms facing down. This exercise stimulates the muscle to contract enough to maintain a neutral position while placing a healthy stress on the tendons that should stimulate strengthening and thickening of tendons. If pain is felt a elbow brace can be used to overcome this initial problem. Consult a qualified trainer or therapist.

Returning to Pickleball

Once you have successfully treated and rehabilitated your Pickleball Elbow, it's essential to ease back into the game gradually. Start with shorter play sessions and lower intensity levels to allow your body to readjust. Pay attention to any signs of discomfort or pain during gameplay and modify your activities accordingly. Remember to continue incorporating strengthening and conditioning exercises into your fitness routine to prevent future injuries.

Pickleball Elbow can be a frustrating and painful condition, but with proper prevention strategies and treatment, you can overcome it and continue enjoying the sport. Remember to warm up, strengthen your muscles, use proper technique, and listen to your body's signals to avoid overuse injuries. If you do experience symptoms of Pickleball Elbow, seek appropriate treatment and follow a comprehensive rehabilitation program. By taking care of your body, you can prevent and treat Pickleball Elbow, allowing you to play the game you love without pain and discomfort.


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