Why your elbow hurts after every padel match - and how to fix it

If the outside of your elbow aches after matches and now complains when you lift a coffee cup, you almost certainly have lateral epicondylitis - tennis elbow. It is the most common padel injury we see, and the usual advice (“rest it”) undertreats it.

What is actually going on

The tendons that pull your wrist backwards all attach to a bony bump on the outside of the elbow. The main one belongs to a muscle called ECRB. Every forehand and smash, ECRB clamps down to stop the racquet twisting out of your hand. Over thousands of swings the tendon accumulates damage faster than it repairs.

The key point: the tendon is not inflamed, it is degenerating. That is why rest alone fails - six weeks off just gives you a weaker tendon that hurts again the moment you play.

Padel loads this tendon harder than tennis because:

• The racquet is shorter, so your wrist absorbs more torque per shot.
• Bandejas and viboras load the wrist extensors at end-range.
• Wall play means more late, reaching strikes that make ECRB fire hard.

Gripping too tight makes all of it worse.

The 30-second self-test

• Coffee cup. Lift a full mug. Sharp pain on the outside of the elbow confirms it.
• Resisted middle finger. Palm down, someone pushes your middle finger down while you resist. Pain on the outside of the elbow points to ECRB.
• Resisted wrist extension. Loose fist, palm down, resist a push on your knuckles. Same signal.

Two of three positive: you have what most padel players have. All three negative but still in pain: see a physio, it may be something else.

The three-week fix

Tendons heal when you load them progressively, not when you avoid them. The core exercise is the eccentric wrist extension: forearm on a table, hand off the edge, palm down, holding 1-2 kg. Lift the weight up with your other hand, then lower it slowly over 4-5 seconds. Only the lowering is loaded.

Week 1 - calm it down. Cut playing volume in half and skip overheads. Daily: eccentric wrist extensions 3 x 15, a 30-second forearm stretch x 3, and shoulder external rotation isometrics against a wall.

Week 2 - build tolerance. Add 0.5-1 kg to the eccentrics. Add heavy grip squeezes, 5 x 30 seconds. Add slow hammer rotations, 3 x 10 each way. Resume padel at half volume, no overheads, and put a fresh overgrip on.

Week 3 - return to load. Eccentrics at 4 x 12 with the heaviest weight you can lower cleanly. Add reverse curls 3 x 10 and 30-second farmer’s carries. Resume full volume, overheads included. A small morning-after ache that fades by lunch is fine; sharp pain on the coffee-cup test means dial back.

The five mistakes to avoid

1. Stretching instead of loading. Stretches feel nice and do almost nothing for tendinopathy.
2. Resting too long. The tendon comes back weaker, not healed.
3. Relying on a brace. It buys short-term relief, nothing structural.
4. Playing on a worn grip. Slippery grip means white-knuckle squeezing. Replace it every six weeks.
5. Treating only the elbow. A stiff upper back makes the elbow do its rotating. See the seven-minute warm-up.

When to see someone

Pain for more than six months, pain at rest, numbness or tingling in the hand, or weakness lifting light objects: book a sports physio. Everyone else, run the protocol. Sharp daily pain usually fades within ten days; keep loading for a full eight weeks so it stays gone.

Want a coach watching your progression? Padel Mobility runs a supervised three-week elbow protocol with daily check-ins.