Pickleball Elbow: What It Is, Why It Happens, and How to Treat It

Quick Answer: Pickleball elbow is lateral epicondylitis, the same tendon injury as tennis elbow. According to the Mayo Clinic, repeated overuse creates tiny tears where forearm tendons attach to the outer elbow, causing pain, tenderness, and a weaker grip. The Cleveland Clinic says most cases improve with rest, ice, and physical therapy, usually within about six months.

Pickleball elbow is a nagging pain on the outside of your elbow. According to a 2025 study in Frontiers in Public Health, elbow or forearm injuries made up 18.1 percent of injuries reported by 232 recreational pickleball players surveyed nationwide, ranking second only to knee injuries at 23.3 percent, with shoulder injuries close behind at 17.2 percent. The condition responds well to the right care, and catching it early makes recovery much faster.

What is pickleball elbow?

Pickleball elbow is lateral epicondylitis, the same injury doctors call tennis elbow. According to the Mayo Clinic, it develops when tendons that lift your wrist and hand form tiny tears where they attach to a bony bump called the lateral epicondyle. The American Academy of Orthopaedic Surgeons (AAOS) explains that the extensor carpi radialis brevis, a specific forearm tendon, is usually the one involved.

Watch for these signs:

• Pain or burning on the outside of your elbow, the hallmark symptom named by the Mayo Clinic.
• Pain that spreads down your forearm toward your wrist.
• A weaker grip, making it hard to hold a coffee cup or open a jar, according to the Cleveland Clinic.
• Pain when you extend your wrist, such as during a serve or a backhand.
• A slow onset, with no single moment of injury.

Pickleball elbow builds gradually, so catching it early makes treatment easier. The Mayo Clinic notes the condition is most common between ages 30 and 60.

Why does pickleball cause elbow pain?

Pickleball elbow comes from repetitive strain, and a few habits make it worse. According to Harvard Health, tight gripping of the paddle and repeated wrist twisting while preparing to hit the ball create the tiny tears that cause pain. Harvard Health quotes Dr. Elizabeth Matzkin, a Harvard-affiliated orthopedic surgeon, warning players against going “from zero to 100 too quickly.”

Other contributing factors include:

• Doing too much too soon. Tendon tissue adapts to load slowly, so jumping from no play to daily hours strains it fast, according to Harvard Health.
• Poor stroke mechanics. Relying on the wrist and arm instead of the body adds stress to the tendon.
• The wrong grip size. Yale Medicine orthopedic surgeon Dr. Howard Hsu says an oversized grip forces the forearm muscles to work harder, while an undersized grip reduces control. A paddle weight chart can help you match your paddle to your hand.
• A stiff, tight grip on contact, especially during volleys and drives.
• Skipping warm-ups before play. Yale Medicine recommends 5 to 10 minutes of dynamic movement, like arm circles and lunges, instead of static stretching.

Building up your playing time slowly gives your tendons time to adapt, which lowers your risk over a season of play.

How do you treat and prevent pickleball elbow?

Most cases of pickleball elbow improve with conservative care, but fixing the cause matters as much as calming the pain. The Cleveland Clinic recommends rest, ice, over-the-counter anti-inflammatories, and a counterforce brace to offload the tendon during activity.

AAOS OrthoInfo reports that about 80 to 95 percent of patients improve with nonsurgical treatment, which includes physical therapy and targeted strengthening. A 2021 systematic review and meta-analysis in the Journal of Clinical Medicine found that adding eccentric exercise, a slow-lowering strengthening motion, to standard therapy produced a meaningful reduction in pain compared with therapy alone. When nonsurgical treatment fails after 6 to 12 months, AAOS OrthoInfo says surgery succeeds in 80 to 90 percent of patients.

Healing takes time. The Cleveland Clinic says tennis elbow usually takes around six months to resolve, though it can last from a few months to more than a year. Harvard Health notes that recovery generally calls for about six weeks away from play, and untreated cases can drag on for up to a year.

Common treatment and prevention steps:

• Rest and reduce play to let the tendon settle before returning at full intensity.
• Ice the area to ease pain and swelling.
• Try a counterforce brace or strap to offload the tendon during activity, per the Cleveland Clinic.
• Build targeted strength, especially eccentric forearm exercises, ideally guided by a physical therapist.
• Fix your technique and equipment, including a properly sized grip and a paddle weight suited to your swing.
• Warm up before every session. Follow a proper warm-up routine to prepare your wrists and forearms.
• Strengthen off the court. Regular off-court strength training builds the shoulder, core, and forearm muscles that protect your elbow.

If pain persists beyond a few weeks, worsens, or limits daily activities, see a physical therapist or sports medicine provider. For more on avoiding this and other overuse issues, see this guide to pickleball injury prevention.

Frequently asked questions

Is pickleball elbow the same as tennis elbow?

Yes. Both terms describe lateral epicondylitis, an overuse injury of the tendons on the outside of the elbow, according to the Mayo Clinic.

What are the symptoms of pickleball elbow?

Pain or burning on the outer elbow, pain that spreads into the forearm, a weaker grip, and pain when you extend your wrist, according to the Mayo Clinic and the Cleveland Clinic.

How do you treat pickleball elbow?

Rest, ice, over-the-counter anti-inflammatories, a counterforce brace, and targeted forearm strengthening, per the Cleveland Clinic. AAOS OrthoInfo reports that 80 to 95 percent of patients improve without surgery.

How long does pickleball elbow take to heal?

The Cleveland Clinic says recovery usually takes around six months, ranging from a few months to more than a year in some cases. Harvard Health notes symptoms can ease after about six weeks away from play.

Can you keep playing with pickleball elbow?

Playing through pain typically slows healing. The Cleveland Clinic recommends rest and modified activity, guided by a professional, for a faster recovery.

What causes pickleball elbow?

Repetitive swinging combined with a tight grip, an oversized or undersized paddle grip, ramping up play too quickly, and skipping warm-ups, according to Harvard Health and Yale Medicine.

How do you prevent pickleball elbow?

Warm up with dynamic movement, choose a properly sized paddle grip, build strength off the court, and increase your playing time gradually, according to Yale Medicine and Harvard Health.

Does eccentric exercise help pickleball elbow?

Yes. A 2021 systematic review in the Journal of Clinical Medicine found eccentric strengthening reduces pain more than standard therapy alone.

Pickleball elbow is very manageable when you catch it early. Build a solid warm-up routine and an off-court strength habit to prevent it, and if pain lingers, browse the Pickler Junction directory of physicians and therapists to find a sports medicine provider near you. This article is general information, not medical advice.

Written by the Pickler Junction Team.