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Sore Elbow After Pickleball? A Tennis Pro's Guide

I've taught tennis for more than 20 years, and over the last few years a lot of my students have picked up a paddle. The first thing many of them tell me after a month of pickleball isn't about their score. It's "the outside of my elbow is killing me when I pick up my coffee."

A sore elbow is one of the most common complaints I hear from pickleball players, and most of the time it comes from how you hit the ball and how much you're playing. That's good news, because both of those are things you can change this week. Here's what I look at when a player shows me that elbow.

Why pickleball is hard on the elbow

A tennis racquet has strings that give a little when the ball hits. A paddle is a solid face. Every dink, volley and reset sends the hit straight into your hand, and your forearm muscles soak it up. Those muscles run from your fingers and wrist up to the bony points on either side of your elbow, so that's where you feel it.

Then add the way the game is played. You hit a lot of balls in a short time, most of them out in front with a firm wrist, and there are always four people ready for another game. New players often go from zero to five days a week. In tennis it takes months to build up to that. In pickleball it takes about two weeks, because the game is so much fun.

Where it hurts tells you a lot

  • Outside of the elbow: usually your backhand side and the muscles that lift your wrist. Punchy backhand volleys and a tight grip are the usual suspects.
  • Inside of the elbow: usually your forehand side. I see it in players who snap the wrist on drives and serves.
  • Top of the forearm: a tired, tight feeling after a long session. That often means you're squeezing the paddle or playing more than your arm is used to.

6 fixes I give my players

1. Loosen your grip

This is the big one. On a scale of 1 to 10, most sore-elbow players are holding the paddle at an 8. I want a 3 or 4 while you wait, tightening only a little at contact. If you can't wiggle your fingers on the handle between shots, you're squeezing. Tell yourself "soft hands" every time you step up to the kitchen.

2. Hit with your shoulder, not your wrist

A dink should feel like a short, smooth lift from the shoulder with a quiet wrist. When I watch players with sore elbows, I see a little flick at the end of every shot. Multiply that by a thousand dinks a week and your forearm is doing a job your shoulder should be doing.

3. Stop punching your backhand

Plenty of players jab at backhand volleys with a bent elbow leading the way. Keep the paddle in front of you, let your body turn a little, and block the ball instead of hitting at it. If you've got a two-handed backhand from tennis, there's nothing wrong with using it at the kitchen. The second hand takes a lot of the load off.

4. Check your grip size and your paddle

Hold the paddle in your normal grip and try to slide the index finger of your other hand into the gap between your fingertips and the heel of your palm. It should just fit. A grip that's too small makes you squeeze harder, and an overgrip is a cheap way to build one up.

Weight matters too. A very head-heavy paddle makes your forearm work on every shot, and a very light one can make you swing harder to get pace. If you've got a sore arm, borrow a friend's mid-weight paddle for a few games and see how it feels.

5. Cut your games by a third for two weeks

Nobody wants to hear this one, but I've never seen a player get better by playing through it at full volume. Take a day off between sessions. Skip the fifth game. When you do play, take the hard drives out and work on your soft game for a while. You won't lose anything, and your dinks will thank you.

6. Build a stronger forearm

Once the soreness settles down, a little strength work goes a long way. Hold a light dumbbell or a can of soup, palm down, and slowly lower your wrist for a count of three. Use your other hand to help it back up. Then do the same palm up. Try 2 sets of 10, three times a week. Squeezing a soft ball and twisting a rolled-up towel are good too. Go easy. This should feel like work, not pain.

A 5-minute warm-up before you play

Most people walk onto the court and start hitting. Give your arm five minutes first:

  • Big arm circles, 20 each way, then shoulder rolls.
  • Wrist circles and opening and closing your hands, 30 seconds.
  • Gently stretch your forearm: arm straight, palm down, use the other hand to bend your wrist down. Hold 20 seconds. Repeat palm up.
  • Shadow-swing your forehand and backhand slowly, 10 each.
  • Start at the kitchen with easy dinks and let the pace build. Save the hard drives for the second game.

After you play

Don't sit down right away. Walk a few minutes and repeat the forearm stretch. Then take a look at your week. If the elbow is sore every time, that's your arm telling you the volume is too high or something in your swing needs a look. A lesson with a local pro is often the best money you can spend, because one small change to your grip or contact point can make a big difference.

Where a topical pain reliever fits

A cream won't fix your grip. That part's on you. But for the ordinary soreness that comes after a long morning of open play, a lot of my players like having something to rub in.

We make Active 10 with menthol, capsaicin and magnesium. It goes on cool, then warms, and it rubs in without a greasy feel. For the elbow and forearm, most players use the 4 oz tube, and the 3 oz roll-on fits in a paddle bag and keeps your hands clean. Active 10 is for the temporary relief of minor aches and pains of muscles and joints associated with simple backache, arthritis, strains, bruises and sprains.

Follow the label. Use it on clean, unbroken skin, wash your hands after you apply it, keep it away from your eyes, and don't use it with a heating pad. Stop and ask a doctor if your symptoms last more than 7 days or get worse.

When to stop and get it checked

Normal soreness is a dull ache that eases as you warm up and fades within a day or two. Stop playing and see a doctor or physical therapist if:

  • you feel a sudden sharp pain or a pop;
  • the elbow is swollen, hot or bruised, or you can't fully bend or straighten it;
  • you have numbness or tingling in your hand or fingers;
  • you're dropping things or your grip feels weak;
  • it hurts at rest or wakes you up at night;
  • it isn't better after about a week, or it comes back every time you play.

Common questions

Why does my elbow hurt after pickleball but not tennis?

A solid paddle has less give than strings, and you hit far more balls at close range with a firm wrist. Many tennis players also hold a paddle the way they'd hold a racquet, with too much squeeze for a much lighter tool.

Should I wear an elbow strap?

Some players like the feel of a forearm strap, and that's a personal choice. It won't change how you hit, so work on your grip and your volume too. If you need a strap to get through a game, it's worth asking a physical therapist to take a look.

Can I keep playing with a sore elbow?

If it's ordinary soreness that eases as you warm up, play less and play softer for a couple of weeks. If it gets worse while you play or you're losing grip strength, stop and get it checked.

Do I need a new paddle?

Maybe, but try the free things first. Loosen your grip, clean up your backhand and cut back your games. If your arm still complains, then try a different weight or a thicker handle before you buy anything.

Heat or ice?

Players have their own preference, and both are common. Just don't combine a heating pad with a topical cream like Active 10.

Keep reading

Darrin Cohen is a tennis pro with more than 20 years of teaching and the founder of Active 10. This page is general information, not medical advice. Read the product label for Drug Facts, directions and warnings before use.