What Is Pickleball Elbow?
Pickleball elbow — often called lateral epicondylitis or "tennis elbow" — is an overuse injury that causes pain and tenderness on the outer side of the elbow. It's the most common injury among pickleball players of all levels.
The condition occurs when the tendons that connect your forearm muscles to the bony bump on the outside of your elbow become inflamed or develop small tears from repetitive stress.
Symptoms to Watch For
Pain or burning on the outer elbow that gets worse with gripping or twisting motions. Weak grip strength — you may notice difficulty holding a paddle, opening jars, or shaking hands. Stiffness and soreness that's worst in the morning or after playing.
If ignored, symptoms can become chronic and significantly harder to treat. Early intervention is key.
Why Pickleball Causes It
The compact swing mechanics of pickleball — especially the dink shot and hard drives — create repetitive strain on the forearm extensors. Unlike tennis, rallies in pickleball are faster and more frequent, meaning your elbow absorbs far more cumulative load per session.
Poor technique (leading with the elbow instead of the shoulder), a grip that's too tight, or a paddle that's too heavy or stiff can all accelerate the problem.
Treatment Options
Rest and ice in the short term to calm inflammation. A physical therapist can guide you through eccentric strengthening exercises specifically for the wrist extensors — these have the strongest evidence base for full recovery.
Chiropractic care can address elbow joint mechanics and any referred issues from the neck or shoulder. Massage therapy, particularly deep tissue work on the forearm, breaks up adhesions and improves blood flow to the tendon.
A counterforce brace worn during play can reduce strain on the tendon while you're still recovering.
When to See a Specialist
If pain persists beyond 2 weeks of rest, or if you notice swelling, numbness, or pain that radiates up the arm, see a specialist. Left untreated, pickleball elbow can sideline you for months.
The good news: most cases resolve completely with the right treatment plan. The earlier you start, the faster you recover.