Managing tennis elbow for pickleball players

Tennis elbow is a common overuse injury among recreational pickleball and tennis players, especially those who play multiple times per week. Many search for tennis elbow exercises for pickleball only after pain starts affecting their game.

If ignored, tennis elbow can be quite painful and limit your ability to play. If you play with tennis elbow, you may need to avoid certain shots, especially volleys and overheads, due to discomfort.

With the right approach and recovery procedures, you can reduce pain while continuing to play. The key is to address both the physical strain and the underlying habits that are causing it.

What is tennis elbow?

Tennis elbow, medically known as lateral epicondylitis, is irritation and breakdown of the tendons that attach to the outside of the elbow. These tendons help control your wrist and grip strength, which are heavily involved in pickleball strokes like drives, volleys, speedups, serves, and especially backhands.

Over time, repetitive stress causes small amounts of damage to the tendon tissue. If the tendon does not have enough time or capacity to recover, it can become painful, irritated, and weaker.

In pickleball, this often happens from:

• Playing too frequently without enough recovery
• Poor stroke mechanics
• Excessive wrist usage
• Gripping the paddle too tightly
• Using an overpowered or stiff paddle
• Sudden increases in playing volume
• Weak forearm and upper body strength

Many recreational players also start playing pickleball later in life, after years away from racket sports. The cardiovascular system may feel fine, but the tendons are often not physically prepared for the repetitive impact and load pickleball creates.

Tennis elbow happens when the demands of playing exceed what the tendons are currently strong enough to handle.

Why is tennis elbow common in pickleball players

Pickleball involves constant short, repetitive contacts. Even though many of the shots are not hit with maximum power, the sheer repetition adds up quickly.

Another major factor is that pickleball is easy to start, but the body may not be physically prepared for how often people play. Many players go from relatively inactive lifestyles to suddenly playing:

• 2–4 hours at a time
• Multiple days per week
• Back-to-back sessions
• Tournaments on weekends

The cardiovascular system often adapts more quickly than tendons do. A player may feel energetic enough to keep playing, while the tendons are gradually becoming overloaded underneath the surface.

Technique also plays a large role.

Many recreational players:

• Use excessive wrist action
• Flick the paddle excessively on dinks or speedups
• Grip the paddle too tightly
• Arm the ball instead of using the larger muscles of the body
• Hit the ball late
• Swing too hard for their current mechanics

All of these increase stress directly on the forearm tendons near the elbow.

Equipment can contribute as well. Certain paddles may create more vibration or feel stiffer on off-center contact, especially when combined with poor technique or high playing volume.

Age is another factor. Tendons generally become less resilient and slower to recover over time, which is why tennis elbow is especially common among adult recreational players in the 40+ age range.

How tennis elbow affects your performance

Tennis elbow does not just create discomfort. It directly impacts how you play and how you make decisions during points.

If you have tennis elbow, you may experience the following effects:

• Pain during contact, especially on drives or when trying to speed up the ball at the kitchen
• Reduced control on volleys and drives
• Hesitation during firefights, where you feel late reacting or putting the ball away
• Difficulty maintaining consistency during a long point

At the kitchen line, where reaction time is limited, even small discomfort can cause hesitation. This often leads to late contact or compensations such as overusing the wrist or swinging harder than necessary.

In longer sessions, fatigue increases the likelihood of poor mechanics. When the body is tired, players tend to revert to inefficient movement patterns, which places even more stress on the elbow.

Over time, this creates a cycle where poor mechanics increase strain, and strain leads to even worse mechanics.

Exercises to treat tennis elbow for pickleball players

These tennis elbow exercises for pickleball are designed to improve strength and reduce strain during play.

Improving tennis elbow requires a combination of strengthening, mobility, and controlled return to play. The goal is to build forearm resilience while reducing unnecessary stress during play.

Forearm strengthening exercises

These exercises help build strength in the muscles of the forearm, which support the elbow:

• Wrist curls (palm facing up, light weight)
• Reverse wrist curls (palm facing down)
• Therabar or towel twist

Start with light resistance and focus on control. The goal is not to fatigue the muscle, but to improve its ability to handle repeated stress over time.

Consistency is more important than intensity. Performing these exercises regularly will produce better results than doing them occasionally with a heavier weight.

Mobility and stretching exercises

Flexibility in the forearm is important as it reduces tendon tension and allows for smoother movement. These common stretches are simple but effective:

• Wrist flexor stretch
• Wrist extensor stretch

Perform each stretch after each day you play and hold each one for 15 to 30 seconds. Complete two to four sets on each arm. Stretching after sessions helps reduce accumulated tension and supports recovery.

Load management and recovery

Recovery is just as important as strengthening. Without proper recovery, even the best exercises may not be effective because the tendon never has enough time to fully adapt and heal.

Many players try to “play through” the discomfort, but this often prolongs the issue and reinforces the same habits and overload patterns that caused the pain in the first place.

If the tendons are already irritated, continuing to play the same amount — or more — without adjusting your workload can keep the cycle going.

This does not always mean you need to stop playing completely. In many cases, the goal is simply learning how to better manage stress on the body so the tendons have time to recover and rebuild capacity.

Here are the basic approaches you should take to avoid developing chronic pain:

• Reduce the amount of time you are playing
• Avoid playing if you are experiencing flare-ups
• Gradually reintroducing hitting as symptoms improve
• Prioritizing sleep and recovery between sessions

If you experience pain or soreness after playing, icing the area for about 20 minutes may help temporarily reduce pain and irritation. Be sure to place a fabric layer between the ice pack and your skin.

Technique adjustments to reduce elbow strain

Did you know tennis elbow can be reduced with proper technique?

In general, keep these technique points in mind:

• Use shorter, more compact swings
• Reduce excessive wrist movement
• Maintain a relaxed grip instead of squeezing the paddle too hard
• Use your body weight transfer instead of forcing power—bend your knees, lean slightly forward, hit the ball in front of your body, not behind it

These adjustments reduce the force placed directly on the elbow and prevent your arm from muscling through the ball. By moving your arm and body unit and recruiting more muscle groups, you develop more stability, and stability equals consistency.

These subtle changes are easy to do and have a significant impact on both performance and injury prevention.

Conclusion

Tennis elbow can be frustrating, especially when pickleball is something you love and want to play regularly. But in most cases, the solution is not simply resting forever or pushing through pain endlessly. The key is understanding why the issue developed in the first place.

For many pickleball players, tennis elbow results from a combination of repetitive loading, playing volume, recovery, technique, and tendon capacity.

By managing your workload, improving mechanics, strengthening the forearm and upper body, and allowing proper recovery, most players can continue enjoying pickleball while reducing pain and lowering the likelihood of future flare-ups.

The goal is not just getting out of pain temporarily. The goal is to build a body that can tolerate the amount of pickleball you want to play long term.

To see our full module on treatment, strengthening, and recovery exercises, check it out in my Skool community below.