Tennis elbow vs golfer’s elbow: which one do you actually have?

If your elbow hurts after padel, the question that decides your next three weeks is simple: which side hurts?

• Outside of the elbow: lateral epicondylitis, known as tennis elbow. Wrist extensors. The most common in padel.
• Inside of the elbow: medial epicondylitis, known as golfer’s elbow. Wrist flexors. Less common, but rising because of how the bandeja loads the wrist.

Both names are misleading (most tennis elbow happens to non-tennis-players) but the labels stick. Same mechanism, different location, different fix.

Self-test in two minutes

1. Coffee cup. Lift a full mug. Pain outside the elbow points to tennis elbow; inside points to golfer’s elbow; both means both.
2. Resisted wrist extension. Loose fist, palm down, arm out. Resist a push down on your knuckles. Pain on the outside confirms tennis elbow.
3. Resisted wrist flexion. Same position, palm up. Resist a push down on your fingers. Pain on the inside confirms golfer’s elbow.
4. Mill’s test. Arm out, palm down. Fully flex the wrist with your other hand, then straighten the elbow. A sharp pull on the outside confirms tennis elbow.
5. Pronator test. Arm straight, fist, rotate palm-up against resistance from your other hand. Inside pain confirms golfer’s elbow.

If none are positive but the elbow still hurts, it may be nerve-related or referred from the neck. That is a physio visit.

Why padel players get both

Different shots load different sides:

• Forehands and smashes hammer the wrist extensors on the outside.
• Bandejas and viboras load the flexors and pronators on the inside.
• The backhand loads either, depending on grip and wrist snap.

Roughly a third of padel players with elbow pain have both at once, usually because a weakness on one side breeds a compensation that overloads the other.

The fix for each

Both fixes follow the same principle - progressive eccentric loading - but in opposite directions.

Tennis elbow: eccentric wrist extension. Forearm on a table, hand off the edge, palm down, 1-2 kg weight. Lift with the other hand, lower slowly over 4-5 seconds. 3 x 15 daily, building to 4 x 12 heavier over three weeks. Add heavy grip squeezes and shoulder external rotation work. Full protocol in why your elbow hurts after every padel match.

Golfer’s elbow: eccentric wrist flexion. Same setup, palm up, curling the wrist toward you on the way up and lowering slowly. Same progression. Add slow hammer rotations (thumb-up to palm-down over 4 seconds, 3 x 12) and mid-back rowing work.

Both at once? Do not alternate. One 10-minute session: shoulder warm-up, then eccentric extension, then eccentric flexion, then forearm rotations.

What does not help much

• Foam rolling and stretching: comfort, not treatment.
• Straps and sleeves: fine for a couple of weeks of pain relief, no structural fix.
• Ice: first 48 hours of a flare only.
• Cortisone: short-term relief, worse long-term outcomes than loading work. Avoid unless everything else has failed.

Also check your equipment. A worn or too-thin grip makes you squeeze harder; replace the overgrip every six weeks and try wrapping a second one to test grip size. A very stiff racquet face transmits more vibration to a cranky elbow.

When to escalate

See a specialist if you have pain beyond six months despite loading work, true weakness lifting light objects, numbness or tingling into the hand, a specific moment of injury, or night pain at rest.

Otherwise: expect sharp daily pain to fade in 7-10 days and full pain-free play by week six to eight. Keep one or two short wrist sessions per week afterwards and it rarely comes back.

Padel Mobility runs a structured elbow protocol with daily check-ins and a one-on-one assessment if the public version has not fixed it.