If you love the court but dread the ache in your arm, learning how to prevent tennis elbow in pickleball is essential for your longevity in the sport. It is one of the most common complaints we hear from players, but with the right approach, it doesn’t have to sideline you permanently. At TruStrength Performance and Rehab, our goal is to help you stay active and resilient so you can keep conquering your goals on the court.
Pickleball has exploded in popularity across Denver and Centennial, bringing people together for fitness and fun. However, the repetitive nature of the sport—specifically the backhand stroke and the quick wrist snaps—can place significant stress on the elbow tendons. Whether you are a weekend warrior or a competitive player, understanding the mechanics of this injury is the first step toward a pain-free game.
Understanding Tennis Elbow (Lateral Epicondylitis)
Before diving into prevention, it helps to understand what is actually happening in your arm. Tennis elbow, clinically known as lateral epicondylitis, is an overuse injury of the tendons that attach to the bony bump on the outside of your elbow.
These tendons are responsible for extending your wrist and fingers. In pickleball, every time you grip the paddle tight or snap your wrist for a backhand spin, you are engaging these muscles. When the load exceeds the tissue’s capacity, micro-tears occur, leading to inflammation and pain.
While it is called “tennis” elbow, the mechanics of pickleball can actually make players more susceptible to it. The paddle is solid (unlike a stringed racquet), which transmits more vibration up the arm, and the game involves frequent, sudden volleys that require rapid wrist stabilization.
5 Strategies on How to Prevent Tennis Elbow in Pickleball
You don’t need to stop playing to stay healthy. By making a few adjustments to your gear, technique, and recovery routine, you can significantly reduce your risk of injury.
1. Check Your Grip Size and Paddle Weight
Your equipment plays a massive role in injury prevention. If your paddle grip is too small or too large, you have to squeeze harder to maintain control. This constant, excessive gripping fatigues the forearm muscles quickly.
The Test: When you hold your paddle, there should be enough space to fit your index finger of the other hand between your palm and fingertips. If there is no space, the grip is likely too small.
Additionally, consider the weight of your paddle. A paddle that is too heavy puts unnecessary drag on the elbow, while a paddle that is too light requires you to swing harder to generate power, increasing impact vibration. Finding a mid-weight paddle that absorbs shock can be a game-changer.
2. Focus on Mechanics and Form
Many injuries stem from poor mechanics. A common mistake among amateur players is relying entirely on the wrist and elbow to generate power. This isolates the small muscles in the forearm, which aren’t designed to handle that much force repeatedly.
Instead, engage your entire kinetic chain. Power should generate from your legs and core, transferring through the shoulder and into the arm. When hitting a backhand, try to keep your wrist relatively firm and use your shoulder to swing through the ball. If you are unsure about your form, a session with a coach or an assessment at our Sports Rehab clinic can identify movement faults before they become injuries.
3. Warm Up Properly
Walking onto the court and immediately smashing a ball is a recipe for disaster. Cold tendons are stiff and more prone to tearing. Before you start a match, spend 5–10 minutes doing dynamic movements to get blood flowing to the upper extremities.
Try these simple movements:
- Arm Circles: Large circles to warm up the shoulder capsule.
- Wrist Flexion/Extension: Gently stretching the wrist back and forth.
- Torso Twists: To engage the core muscles.
4. Prioritize Forearm Strengthening
Prevention isn’t just about avoiding stress; it’s about building capacity. If your tissues are strong enough to handle the load of the game, you won’t get injured. Eccentric exercises—where you lengthen the muscle under tension—are the gold standard for tendon health.
Simple exercises using a resistance band or a light dumbbell can help. Strengthening the shoulder is equally important; a weak rotator cuff forces the distal muscles (like those in the forearm) to work overtime to stabilize the arm.
5. Listen to Your Body
Pain is a signal, not a challenge. If you feel that familiar burning sensation on the outside of your elbow, take a break. Pushing through the pain often turns a minor inflammatory issue into a chronic degenerative condition that takes months to heal.
What To Do If You Are Already in Pain
If you are already experiencing symptoms, “how to prevent tennis elbow in pickleball” shifts to “how to treat it.” Ignoring the problem usually leads to compensation patterns, where you might start hurting your shoulder or wrist because you are altering your swing to avoid elbow pain.
Physical Therapy
Our personalized Physical Therapy programs in Denver and Centennial are designed to get to the root cause of your pain. We don’t just treat the elbow; we look at your shoulder mobility, thoracic spine rotation, and grip strength to build a comprehensive recovery plan.
Dry Needling
For many active individuals, tight muscle knots (trigger points) in the forearm contribute to the tension pulling on the elbow tendon. Dry Needling is a highly effective treatment we offer that can release these trigger points, improve blood flow, and reduce pain signals, often providing immediate relief.
Massage Therapy
Regular soft tissue work keeps the muscles pliable and prevents the buildup of scar tissue. Our Massage Therapy services focus on active individuals, ensuring your muscles are recovering properly between matches.
Frequently Asked Questions
Can I keep playing pickleball with tennis elbow?
We generally recommend a short period of active rest to allow the acute inflammation to subside. Continuing to play through sharp pain can worsen the tissue damage. However, our therapists can teach you how to modify your training so you can remain active while you heal.
Is a brace helpful for pickleball elbow?
A counterforce brace (a strap worn just below the elbow) can help distribute forces away from the injured tendon, providing temporary relief during daily activities or light play. However, a brace is a band-aid, not a cure. Strengthening the tissue is the only long-term solution.
How long does it take for tennis elbow to heal?
Without treatment, tennis elbow can linger for 6 to 12 months. With a structured rehabilitation program including manual therapy and strengthening exercises, most patients see significant improvement in a much shorter timeframe.
Stay on the Court and Out of the Clinic
Pickleball is a fantastic way to stay fit and social, and you shouldn’t have to give it up because of a preventable injury. By checking your equipment, warming up, and listening to your body, you can enjoy the game for years to come.
If you are dealing with elbow pain or want a professional assessment of your movement to prevent future injuries, TruStrength Performance and Rehab is here to help. We are an out-of-network provider, which allows us to provide one-on-one, high-quality care without insurance dictates limiting your recovery.