All You Need To Know About Pickleball Elbow Treatment

Pickleball elbow is a growing concern, especially as the sport continues to attract players across all age groups. However, did you know that this condition can affect people who've never touched a paddle?

Whether you're a seasoned pickleball player or just starting out, it is not just time on the court that puts you at risk. Repetitive strain on your forearm muscles and elbow tendons from sport, work, or daily tasks can all contribute to the condition. This highlights the importance of understanding the causes, symptoms, treatment, and prevention.

In this guide, we’ll explain what the pickleball elbow is, how to recognise it, and how to manage it effectively, including how physiotherapy for elbow pain can support recovery and prevent long-term issues.

Pickleball Elbow vs Golfer’s Elbow vs Tennis Elbow

While pickleball elbow shares similarities with both golfer’s elbow and tennis elbow, it’s important to distinguish between them.

• Tennis elbow affects the outside of the elbow and is medically termed lateral epicondylitis.
• Golfer’s elbow impacts the inner part of the elbow (medial epicondyle).
• Pickleball elbow is essentially tennis elbow caused by the repetitive motions specific to pickleball, such as forceful backhand shots.

So, pickleball elbow is a type of lateral epicondylitis, brought on by overuse of the wrist extensor muscles that attach to the lateral epicondyle, or the bony bump on the outside of your elbow.

Affected Areas of the Elbow

The primary pain area is the outside of the elbow, particularly in the lateral epicondyle. The condition affects the forearm muscles, particularly those that extend your wrist and fingers, and is typically felt during gripping or lifting, especially with a pickleball paddle. The pain may radiate down your forearm and into the back of your hand.

Who Else Develops Pickleball Elbow (Not Just Pickleball Players)

Although commonly associated with pickleball players, this injury isn’t limited to the sport. Anyone who engages in repetitive arm motions can have it, and even your daily posture contributes to its development.

People in the following professions can also develop this condition:

• Cooks
• Carpenters
• Plumbers
• Painters
• Office workers using a mouse

So if you are experiencing elbow discomfort, don’t dismiss pickleball elbow just because you’re not playing the sport.

What Causes Pickleball Elbow

Pickleball elbow is an overuse injury. Specifically, it occurs when tiny tears or strains develop in the muscles and tendons attached to the outside of the elbow. It stems from repeated stress on the elbow and forearm muscles, especially from improper pickleball technique, poor equipment, late strokes, or excessive play without rest. In particular, repetitive backhand shots, over-gripping the paddle, or playing with a heavy or unbalanced paddle can all lead to excessive strain.

Using too much wrist during impact places tremendous stress on the elbow and wrist joints, along with the surrounding soft tissue. Unlike tennis, which uses a softer ball and stringed racquet that help absorb impact, pickleball involves a hard, plastic ball and a firm paddle with no string flex. This lack of shock absorption means more force travels directly through the arm and elbow during play, increasing strain on the joints and tendons.

Ageing also contributes to the risk of injury in pickleball, with men more likely to sustain pickleball-related injuries than women.

Symptoms of Pickleball Elbow

Pickleball elbow symptoms tend to appear gradually over time, rather than from one clear incident. Many people don’t recall a specific moment of injury. Instead, the discomfort builds up with repeated use. Common signs often include:

• Pain or burning sensation on the outside of your elbow
• Tenderness to the lateral epicondyle
• Weak grip strength
• Pain that worsens when lifting, gripping, or twisting
• Dull ache to sharp pain may radiate down the forearm
• Swelling on the outside of the elbow
• Worsening pain with specific activities

Symptoms are often exacerbated by activities that involve repetitive wrist and arm movements. These include holding a paddle, shaking hands, lifting heavy objects, making a fist, and turning a door handle. Certain pickleball techniques, like executing backhand strokes or using poor form, can also contribute to worsening the condition.

If you feel discomfort in your elbow during or after play, it’s important to assess the symptoms of pickleball elbow early to avoid long-term damage.

Importance of Pickleball Elbow Treatment

Early and proper treatment of pickleball elbow is essential. Ignoring the pain or playing through it can worsen the condition, prolong recovery, and cause compensatory injuries to your wrist, shoulder, or even your body’s movement patterns. Acting early can help you return to the court faster and healthier.

Pickleball Elbow Treatment

Managing pickleball elbow often involves a combination of home remedies, self-care, and medical interventions if necessary. They can include the following:

Rest and Ice or Heat

Rest: Taking a break from activities, especially intense games or those that cause pain, allows the elbow time to heal. Stop playing pickleball or reduce your sessions.

Ice: Apply an ice pack or a bag of frozen vegetables wrapped in a thin towel to the affected area for the first 48–72 hours to reduce inflammation, followed by heat therapy to improve blood flow if the pain persists.

Heat: Cold therapy is particularly beneficial in the initial stages or after activities that exacerbate symptoms. On the other hand, applying heat therapy (like a heating pad or warm bath) can relax muscles, improve blood circulation, and promote healing, especially for chronic conditions or stiffness. It can be effective before gentle exercises or stretching.

Pain Medication

Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Aspirin, Naprosyn, or Ibuprofen may be used to help reduce pain, inflammation, and swelling. Over-the-counter pain relievers like Tylenol or Advil can also be a temporary option for pain and swelling. These should be used according to the manufacturer’s instructions and can be effective when combined with other methods like cold therapy or stretching.

Elbow Brace

Wearing a brace on the forearm just below the elbow can reduce stress on the lateral epicondyle by altering the load path through the muscles. It’s a popular and low-cost option for pickleball players recovering from pickleball elbow. A counterforce brace specifically applies pressure below the elbow to help disperse tension and relieve stress on inflamed tendons.

Stretching and Exercise

Gentle stretches and strengthening exercises for your forearm and wrist extensor muscles can restore function and prevent recurrence. A common exercise is the “wrist extensor stretch,” which involves extending your arm straight with the palm facing down and gently pulling the fingers back.

Physiotherapy

A physiotherapist can help tailor a rehabilitation programme that improves flexibility, strengthens the forearm, and reduces strain on your elbow. Certain techniques used in physiotherapy for fractured elbow help restore mobility, strength, and function after the bone has started healing. These include guided stretching, strengthening exercises, manual therapy, and swelling management, which are used to support a progressive recovery and reduce the risk of long-term stiffness or joint complications.

Recovery Time and Resuming Play

The recovery time for pickleball elbow and when you can resume playing is not given as a single, fixed duration. Recovery depends on the severity of the injury and how soon you start treatment.

Mild cases may resolve in a few weeks, while chronic conditions can take several months. Resume play gradually and be sure to warm up properly. If pickleball elbow pain returns, stop and reassess. Don’t rush the process. Healing requires patience and consistency.

Surgical intervention is generally considered a last resort if conservative treatment fails after 6-12 months. This implies that non-surgical treatments are typically pursued for a period of many months before surgery is even considered, indicating that recovery under conservative care can be a lengthy process for some individuals.

Pickleball Elbow Prevention

There are several key strategies for preventing pickleball elbow. These preventative measures focus on proper preparation, technique, equipment, and conditioning.

Proper Technique

Many cases of pickleball elbow and similar injuries arise from poor technique. Learn the correct grip, avoid excessive wrist flicking, and engage your body, not just your arm, during shots. A coach or instructor can help you adjust your form on the court. Here are some tips:

• Pay close attention to your stroke technique.
• Avoid hitting shots with an unstable wrist, as using too much wrist during impact places tremendous stress on the elbow and wrist joints.
• Ensure your strokes originate from your shoulder and core rather than relying solely on your arm.
• Maintain a relaxed grip on the paddle to avoid excessive tension.

Proper Equipment

Choosing the right equipment is important. First, use a lightweight and well-balanced pickleball paddle with a grip size that fits your hand well. A grip that’s too small forces the wrist and forearm muscles to work harder, increasing stress on the outside of the elbow.

Grip size can be measured by placing an index finger between the fingers and the base of the thumb when gripping the paddle. You can also measure the distance from the crease of your palm to the tip of your ring finger.

Next, consider using a paddle that is compatible with your grip size and player style, possibly a lighter paddle (between 7.3 and 8.4 ounces). A paddle with vibration control technology or a softer, flexible core material (like graphite or composite with a honeycomb core) can help absorb vibrations and reduce impact.

Finally, adding an overgrip to your paddle handle can also provide extra cushioning and reduce impact on the elbow.

Conclusion

Unfortunately, pickleball elbow is not a minor ache you can brush off. It can actually be your body signalling that something’s off, whether you’re playing or not. While it’s closely tied to the movements of pickleball, the condition can just as easily affect anyone doing repetitive tasks that strain the outside of the elbow. Learning to spot the signs early, knowing what triggers it, and taking simple steps can make all the difference. Treat it early, move smarter, and you’ll keep both your game and your daily routine in good shape.