HEALTH & WELLNESS
Pickleball Elbow:
Don’t just ice and rest!
Fix the mechanics!
By The Pickleball Doctor, Noe Sariban, PT, DPT
As more people start playing pickleball, the injuries
specific to the sport are becoming more consistent. A
common complaint found among pickleball players is
Pickleball Elbow (similar to Tennis Elbow). Pickleball elbow
is referred to as Lateral Epicondylitis in the medical field.
It is caused by overuse of the forearm muscles due to bad
mechanics, leading to pain, micro-tearing, inflammation, and
weakness. This condition can be debilitating, as it can affect
a person’s ability to perform daily activities as well as their
recreational activities.
HOW DOES THIS INJURY OCCUR?
The forearm has multiple muscles that run from the hand/
wrist up to the elbow. In this case, the muscles that lead to
Pickleball Elbow are the extensor muscles of the forearm,
which attach to the outside of the elbow (lateral epicondyle).
Of all muscles, the Extensor Carpi Radialis Brevis (ECRB)
has been shown to be most affected and the source of the
pain in most individuals. Repeated stress secondary to poor
mechanics during the backhand motion leads to progressive
micro-tearing and degeneration of the tendon.
If you are experiencing Pickleball Elbow pain, it is imperative
to STOP the activity that causes the pain. This is the hardest
part for pickleball players! However, the only way to treat this
problem is to take away the stress placed on the area. In most
cases, the pain starts because the player has bad mechanics
in the swing when hitting a backhand, excessively relying on the
wrist and causing repetitive trauma to the extensor muscles and
ECRB.
THE TREATMENT COURSE SHOULD LOOK LIKE THIS:
1.
2.
3.
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Stop activity – Control pain, heat, ice, massage
Rehab Phase 1 – Manipulation of elbow and
wrist, dry needling, trigger point and fascia
release, compression therapy, cho-pat strap
Rehab Phase 2 – Strengthening of forearm
musculature focusing on eccentric exercises
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4.
5.
Find a Coach – Fix your swing mechanics in order
to avoid excessive stress on your forearm and
elbow, and improve your strokes
Return to play
It is important to understand why this injury seems to
happen in order to correct it and/or prevent it from getting
worse. Taking the appropriate steps toward your recovery is
your best chance to being back on the courts faster!
When pickleball players find themselves in a defensive
position, they will likely be hitting on their backhand side.
Therefore most volleys during an exchange at the net will
involve a backhand motion. In addition, repetitive dinking
on the backhand side can also be the culprit in causing
Pickleball Elbow. Most people between the 2.0 and 4.5
level are more comfortable with their forehand than their
backhand, and will exhibit poorer mechanics when hitting
a backhand than a forehand. All of these factors contribute
to a repetitive motion and stress being placed on the elbow,
which ultimately leads to injury.
In addition, a lack of mobility and proper footwork
can also be problematic, as players may be prone to
opponents being able to dink “behind” them. If players
let a dink get a little behind them on the backhand side,
then the only way to return to ball in play is to utilize