Pickleball Elbow Explained: Causes, Prevention & Strengthening Exercises

Pickleball is one of the most beginner-friendly sports out there — but it also comes with one very common downside: pickleball elbow.

You’ll feel it as a nagging ache on the outer side of your elbow, especially after games. Sometimes it’s mild. Sometimes it becomes the kind of pain that makes you avoid playing altogether.

The good news: pickleball elbow is preventable and reversible in most cases — with the right technique tweaks, recovery habits, and strengthening exercises.

Let’s break it down properly.

What Is Pickleball Elbow?

Pickleball elbow is essentially lateral elbow pain, often the same condition as tennis elbow (lateral epicondylitis). It happens when the tendons that attach your forearm muscles to your elbow become overloaded.

These tendons are responsible for:

• wrist extension (lifting the wrist up)

• gripping

• stabilising the wrist during contact

Pickleball has repetitive wrist-and-grip actions — especially in volleys and quick exchanges — so over time, the tendon gets irritated.

Signs You Might Have Pickleball Elbow

Most players describe it like this:

• soreness on the outside of the elbow

• pain when shaking hands, opening a jar, lifting a bottle

• discomfort while gripping the paddle

• worsening pain after play (especially the next morning)

If left unchecked, it can become a cycle: you play, it hurts, you rest, it reduces, you play again — and it returns.

What Causes Pickleball Elbow?

Pickleball elbow usually isn’t caused by one single thing. It’s often a combination of stress, equipment, and technique.

1. Overgripping the Paddle

This is the biggest one. When players grip too tightly, the forearm muscles stay contracted throughout the game. The tendon never gets relief.

If you’re nervous, playing fast, or new — you likely grip harder than you need.

2. Too Much Wrist Action

Pickleball rewards soft hands, but beginners often “flick” their wrist aggressively for power.

That repeated wrist snapping loads the tendon continuously.

3. Playing Too Often Too Soon

Pickleball is addictive — people jump from playing once a week to playing five days a week.

Tendons don’t adapt as fast as muscles do. So even if your body feels fine, your tendons may silently accumulate stress.

4. Wrong Paddle Weight or Grip Size

• If the paddle is too heavy, it strains the forearm.

• If grip size is too small, you overgrip to control it.

• If grip is too big, your mechanics become awkward.

Even small changes in equipment can reduce tendon load.

5. Not Warming Up (Common with Short Sessions)

Many players walk in and start smashing. Cold tendons + sudden volleys = irritation.

A 5-minute forearm/shoulder warm-up goes a long way.

Prevention: How to Stop Pickleball Elbow Before It Starts

1. Relax Your Grip

Try this simple cue: Hold your paddle at 4/10 tightness, not 9/10.

A relaxed grip improves control and protects your elbow.

2. Use Your Body, Not Your Wrist

Power shouldn’t come from wrist flicking. It should come from:

• shoulder rotation

• core engagement

• footwork into the ball

Think: smooth swing, stable wrist.

3. Increase Playing Frequency Slowly

If you’re new or returning after injury: Start with 2 sessions a week, then build upward gradually.

Tendon adaptation takes time.

4. Warm Up Like You Mean It

Before play:

• wrist circles

• forearm stretch

• shoulder rolls

• a few slow dink rallies

Many regular players book shorter slots for drill-only practice. If you do this (through any court-booking routine), warm-up becomes even more important because the body has less “ramp-up” time.

Strengthening Exercises (The Real Fix)

If you want long-term relief, strengthening is key. It’s not just about stretching — tendons get healthier through controlled loading.

Do these 3–4 times a week.

Exercise 1: Wrist Extensor Eccentrics (Most Important)

This is the gold-standard move for tennis/pickleball elbow.

Sit with your forearm supported on a table, palm facing down. Lift the wrist up, then slowly lower it for 3–5 seconds.

Do 3 sets of 10 reps.

Slow lowering builds tendon strength.

Exercise 2: Wrist Flexor Strengthening

Palm facing up, curl the wrist up and down with a light dumbbell.

Do 2–3 sets of 12 reps.

This balances the forearm musculature.

Exercise 3: Pronation–Supination Rotations

Hold a light dumbbell or hammer upright. Rotate palm up to palm down slowly.

Do 2 sets of 12 each side.

This strengthens the muscles used for paddle control.

Exercise 4: Grip Strength (But Smart Grip Strength)

Use a soft stress ball or hand gripper. Squeeze and hold for 3 seconds.

Do 2 sets of 15 reps.

Avoid overdoing this early — too much grip training can worsen pain.

Exercise 5: Shoulder External Rotation

This one prevents the elbow from compensating.

Use a resistance band. Rotate your forearm outward while keeping elbow close to body.

Do 3 sets of 15 reps.

Stronger shoulders = less strain at elbow.

What to Do If Pain Has Already Started

If you already have symptoms:

• reduce play intensity for 2 weeks

• avoid hard smashes and aggressive wrist flicks

• ice the elbow after play (10 mins)

• wear an elbow strap during games (optional)

• start the strengthening program immediately

If pain persists beyond 3–4 weeks, consult a physiotherapist.

How to Return to Playing Without Reinjury

The safest return-to-play strategy: Start with short sessions, focus on soft play:

• warm-up properly

• dink-heavy games

• fewer back-to-back days

Players who manage court time smartly (for example by spacing sessions and booking shorter drill blocks instead of long matches) usually come back stronger and more consistent.

Final Thoughts

Pickleball elbow is common — but it doesn’t have to become permanent.

With a relaxed grip, better mechanics, structured recovery, and consistent strengthening exercises, most players recover fully and return to pain-free playing.

Your elbow isn’t telling you to quit. It’s telling you to train smarter.

Play Pickleball the right way with Racquetly.