Pickleball elbow, similar to tennis elbow, is an overuse injury caused by repeated strain on the forearm tendons. The good news is that most cases are preventable with a few smart adjustments to how you play and train.

One of the biggest factors is how you swing the paddle. If you rely heavily on your wrist or grip the paddle too tightly, you put extra stress on the elbow. Instead, focus on using your shoulder and core to guide your shots, keeping your wrist more stable. A relaxed grip or “soft hands” reduces tension and helps absorb impact, especially during quick exchanges at the net.

Your equipment also matters more than people think. Using a paddle with the right grip size is critical. If it’s too small or too large, your forearm muscles have to work harder. Many players also benefit from paddles designed to reduce vibration, which lowers stress on the tendons over time.

Another key piece is warming up and strengthening. Before playing, spend a few minutes loosening your wrist, forearm, and shoulder with light movements and stretches. Off the court, strengthening exercises like wrist curls or resistance band work help build resilience in the muscles that support your elbow.

It’s also important to manage how much you play. Sudden increases in playing time or intensity are a common cause of injury. If you’re playing more frequently, build up gradually and take breaks to avoid overloading your arm. If you feel early soreness, don’t push through it. Rest and recovery early on can prevent a longer-term issue.

Finally, pay attention to early warning signs. Mild pain or stiffness on the outside of your elbow after playing is often the first signal. Addressing it quickly with rest, icing, and technique adjustments can stop it from turning into a chronic problem.

Here’s a simple routine you can use before and after playing to help prevent pickleball elbow.

It’s quick, practical, and targets the muscles that usually get overworked.

Before play (3–5 minutes)

The goal here is to warm up and activate, not stretch aggressively.

1. Wrist circles (30 seconds each direction)
- Hold your arm out and slowly rotate your wrist both clockwise and counterclockwise. - - This gets blood flowing into the joint.

2. Forearm activation (1 minute)
- Make a fist, then open your hand wide. Repeat 15–20 times.
- Then lightly squeeze a ball or towel for another 15–20 reps.

3. Light shadow swings (1–2 minutes)
- Take a few slow, controlled swings with your paddle. Focus on:

- Using your shoulder and torso
- Keeping your wrist stable
- Staying relaxed (don’t grip tightly)

4. Gentle forearm stretch (30 seconds each side)

- Arm straight in front, palm down
- Use your other hand to lightly pull fingers back
- You should feel a mild stretch, not pain

After play (5 minutes)

Now you’re focusing on recovery and reducing tension.

1. Forearm stretch (1–2 minutes total)
- Do both directions:

- Palm down (top of forearm)
- Palm up (underside of forearm)
- Hold each for approximately 30 seconds

2. Eccentric wrist exercise (2–3 minutes)
- This is one of the most effective ways to prevent tendon pain:

- Hold a light weight (or water bottle)
- Use your other hand to help lift your wrist up
- Slowly lower it down on its own (3–4 seconds)
- Do 8–12 reps

3. Massage or roll out (1–2 minutes)
- Use your fingers or a massage ball to gently press into the forearm muscles.
- Focus on tight or sore spots.