Tennis elbow (lateral epicondylitis) is inflammation of the tendons on the outside of the elbow. It is the most common injury in padel, caused by repetitive impact on grip and wrist. Prevention focuses on racket choice (softer core, lower weight, appropriate grip size), technique (avoiding overly tight grip and wrist flicks) and recovery (strengthening exercises and rest when symptoms appear). Most cases resolve in 4-12 weeks with appropriate treatment.
What tennis elbow actually is
Tennis elbow is the common name for lateral epicondylitis - inflammation of the tendons that connect the forearm muscles to the bony bump on the outside of the elbow. Despite the name, it is more common in padel than in tennis, and many padel players who have never played tennis develop it.
The pain is sharp and specific: on the outside of the elbow, often radiating down the forearm. It hurts when you grip things, when you hit backhands, and sometimes during mundane activities like opening jars or shaking hands. Left untreated, it can persist for months.
Why padel causes tennis elbow
Three factors combine in padel to increase elbow stress compared to tennis:
Stiffer rackets
Padel rackets are solid (no strings) with rigid carbon frames and dense EVA cores. Impact forces transfer more directly to the arm than in tennis, where strings absorb meaningful impact energy. Hard-core diamond rackets are particularly elbow-hostile for players without strong technique.
Shorter, compacted swings
Padel swings are shorter and more compact than tennis, which means less time to generate power smoothly. Players often compensate by using wrist snap and tight grips - both of which increase tendon stress.
Wall reactions
Balls coming off the glass often arrive at awkward heights and angles, forcing improvised contact. These off-centre hits transfer shock directly to the elbow. Players who do not position well for wall rebounds take more of these uncomfortable impacts.
Prevention: equipment choices
The single biggest factor under your control is racket choice. Elbow-friendly rackets share specific features:
- Soft EVA core - absorbs impact rather than transferring it. Hard EVAs save power but cost arm comfort
- Round or teardrop shape - spreads impact across a larger sweet spot than diamond shapes
- Lower weight - 345-365g is easier on the arm than 370g+
- Lower balance - handle-heavy rackets put less torque on the elbow than head-heavy ones
- Vibration damping - many brands market "anti-vibration" features (Nox Pulse System, Head Auxetic, Babolat Vibrasorb). These help meaningfully
If you already have tennis elbow, switching to an elbow-friendly racket is often the difference between healing and ongoing pain. Our best rackets for tennis elbow guide has specific recommendations.
Prevention: technique adjustments
Loose grip
Most amateur players grip the racket too tightly - especially on backhands and uncomfortable shots. A death-grip transfers impact forces directly to the tendons. Hold the racket firmly enough to control it but not tightly enough to tense the forearm muscles between shots.
Avoid wrist flicks
Generating power through wrist motion is harder on the elbow than generating it through body rotation. Use your legs, core and shoulders to swing; let your wrist stay firm and stable.
Lead with the body, not the arm
On every shot, your weight should transfer through the ball. If you find yourself reaching with just your arm, you are overworking the elbow.
Prevention: strengthening
Forearm and grip strength genuinely reduces tennis elbow risk. Three exercises worth doing:
- Wrist curls and reverse wrist curls - light dumbbell, 3 sets of 15, twice a week
- Towel wringing - twist a dry towel as if wringing out water, both directions, 3 sets of 10 seconds
- Grip squeezes - rubber ball or grip strengthener, 3 sets of 20 squeezes
Do these outside of your padel playing days to avoid cumulative fatigue. Two sessions a week on non-playing days makes a meaningful difference over 8-12 weeks.
If you already have tennis elbow
Early stage (mild pain during/after play)
- Reduce playing frequency by half for 2-3 weeks
- Switch to a softer racket if possible
- Ice the elbow for 15 minutes after each session
- Take anti-inflammatory medication short-term if recommended by your doctor
- Start eccentric wrist strengthening exercises (see below)
Moderate stage (persistent pain, affects daily activities)
- Stop playing padel for 4-6 weeks
- See a physiotherapist for an individualised programme
- Consider a tennis elbow brace during recovery and initial return
- Address racket and technique before returning to play
- Return gradually - 1 short session per week, build up over a month
Severe stage (constant pain, night pain, weakness)
See a sports medicine doctor. Options at this stage include ultrasound-guided injection, platelet-rich plasma therapy, and in rare cases surgery. Do not try to play through this - it only extends recovery.
The eccentric exercise that works
Eccentric strengthening (muscle lengthening under load) is the evidence-backed rehabilitation approach for tennis elbow. The exercise is simple:
- Hold a light dumbbell (1-2kg) in your affected hand, palm down, arm resting on a table with wrist off the edge
- Use your opposite hand to lift the weight up into a wrist-curled position
- Release your opposite hand and slowly lower the weight over 3-5 seconds using only the affected arm
- Repeat 10-15 times, 3 sets, once a day
You should feel mild discomfort but not sharp pain. Increase weight gradually as symptoms improve. Multiple clinical trials show this eccentric protocol resolves most tennis elbow cases within 12 weeks.
When to see a physiotherapist
See a physio if:
- Pain persists beyond 4 weeks of self-management
- Pain affects sleep or daily activities (typing, holding a cup)
- You notice weakness in the affected arm
- Symptoms recur each time you return to play
A good sports physiotherapist can identify technique issues contributing to the problem, design a progressive return-to-play programme, and apply hands-on treatment to accelerate healing.