Padel Injuries: Preventing and Treating Padel Elbow and More

Padel has become one of the fastest-growing sports in the Netherlands over the past few years, and we notice it in our practice too. More and more people who barely played racket sports before are now on court two to three times a week. That enthusiasm is great, but the body suddenly has to cope with short sprints, quick changes of direction and repeated strokes it isn't used to. In this article we go through the most common padel injuries: where they come from, how to recognise them, and above all what you can do yourself to reduce the risk.

Why padel causes so many injuries

Padel looks approachable: the court is smaller than a tennis court, the ball bounces back off the glass walls, and you always play doubles. Those exact features create a specific loading pattern. Because the ball rebounds, rallies tend to be long, with plenty of short, explosive sprints, abrupt stops and quick turns. Your lower body constantly has to decelerate and accelerate again, while your upper body rotates forcefully with every stroke.

On top of that, many padel players take up the sport later in life or from a less active starting point, often with no racket sport background. Technique and coordination still need to develop, while the intensity of the game is already fairly high. The combination of little build-up time, a compact court and repeated impact on joints and tendons explains why elbow, knee, ankle and shoulder complaints are so common among padel players.

Padel elbow (tennis elbow): symptoms and cause

The complaint you see most often in padel players is now widely known as padel elbow, but medically it's the same as tennis elbow: an overload of the tendon attachments on the outside of your elbow. In padel, this load mainly comes from the many volleys and the bandeja, a shot where you tap the ball just over the net with a lot of wrist movement and little follow-through. A racket that's too heavy, or has an ill-fitting grip, can also increase the load on the tendon.

You'll recognise padel elbow by pain on the outside of the elbow that gets worse when gripping the racket, shaking someone's hand, or even lifting a cup of coffee. There's often a tender point just below the bony bump on the outside. The complaint usually develops gradually over several weeks, not from one evening of play to the next, which can make it harder to connect it to your padel load in time.

Want to know more about how this condition develops and is treated? Our tennis elbow page goes deeper into the causes and the role of exercise therapy.

Knee and ankle injuries from the short sprints and turns

Padel's compact court constantly forces you into short sprints, sudden braking and sharp turns, often towards the glass wall. That combination of speed and change of direction puts considerable rotational forces on the knee and ankle. In the knee, this often shows up as complaints in the patellar tendon or the cartilage under the kneecap, particularly in players with relatively little strength in the thigh muscles that stabilise the knee.

At the ankle, a sprain is the classic injury: your foot lands awkwardly during a quick change of direction or after jumping for a lob, causing the ankle to roll outward or inward and overstretch the ligaments. An ankle sprain often comes with immediate pain, swelling and sometimes bruising. Mild sprains often ease on their own with rest, cooling and gradually reloading, but persistent instability or repeated sprains call for targeted guidance, partly to prevent the ankle from giving way again and again.

If your complaints centre on the patellar tendon or the side of the knee, our runner's knee page covers a related type of overuse and how recovery is typically built up for it.

Shoulder and back complaints from the smash

For many padel players, the smash is the most satisfying part of the game, and at the same time one of the most demanding movements for the shoulder and back. During a smash you extend and rotate the shoulder at speed overhead, while your torso rotates along to generate power. Repeat that movement often, with insufficient shoulder stability or back mobility, and it can contribute to irritation of the tendons around the shoulder, sometimes called subacromial complaints, or to tension in the lower back.

Shoulder complaints in padel often show up as pain when raising the arm, a dull ache after playing that's worse the next day, or loss of strength when serving and smashing. Back complaints tend to build up more gradually, starting as a stiff or tense feeling in the lower back after playing that, over time, becomes noticeable during other activities too. If either complaint persists, a physiotherapist can map out the precise cause and how recovery is typically built up during an intake.

Padel warm-up: 5 exercises, 5 minutes

A good number of padel injuries happen because players start at full intensity right away, before muscles, tendons and joints are prepared for the sudden sprints and rotations. A five to ten minute warm-up before your first ball can make that transition more gradual. The routine below is general guidance, not a substitute for individual advice. Ease off or stop if anything hurts:

• Light cardio, about 1 minute: gentle jogging on the spot or side steps across the width of the court, to get blood flowing through the legs and torso before dynamic stretching.
• Dynamic leg swings, about 1 minute: swing each leg gently forward and back and side to side, holding lightly onto the fence if needed, to open up hip and hamstring mobility ahead of the sprints.
• Torso rotations with your racket, about 1 minute: stand upright, hold your racket with both hands in front of your chest and rotate calmly from left to right through your torso, starting with small, controlled turns that gradually get slightly bigger.
• Wrist circles and gentle wrist stretches, about 1 minute: make slow circles with both wrists and then carefully bend and extend them, to gently wake up the forearm muscles that carry the load in padel elbow.
• Side steps and direction changes, about 1 minute: take a few controlled side steps left and right, then gradually build up to short sprints with a deliberate stop, so you rehearse the game's sprint-and-stop pattern at low speed.

Finish with a few relaxed rallies at half pace before playing at full intensity. This warm-up is general information, not a substitute for an individual assessment: if you already have symptoms, adjust the exercises or skip them and check with a physiotherapist first.

Strength and technique: reducing the load on your elbow

Alongside a good warm-up, strength and technique play a major role in reducing the load on your elbow and other joints. Research shows that building strength in the forearm and shoulder muscles can contribute to a better load capacity in the tendons used during padel. A few practical points that help many players:

• Check the weight and grip of your racket: a racket that's too heavy, or a grip that's too thick or too thin, demands more from your forearm on every shot. Have this assessed in-store or by your coach if you regularly get elbow complaints.
• Build forearm strength gradually: squeezing exercises with a soft ball or a light weight, and slow wrist curls with a small weight in hand, can contribute to better tendon load capacity. Start light and build up gradually, and stop if pain increases.
• Work on shoulder and core stability: exercises that engage the shoulder blade muscles and core support a more efficient stroke technique and reduce the compensation that otherwise often lands on the elbow.
• Ask your coach about technique: a bandeja with too much wrist and too little movement from the shoulder and torso, or a backhand with a late contact point, increases the load on the elbow. Small technical adjustments often make more difference than you'd expect.
• Build up playing frequency and duration gradually: going from twice a week to four times a week within a few weeks gives tendons and joints little time to adapt. Build up new load step by step, just as you would with any other sport.

These adjustments are supportive and general in nature. They don't replace an individual assessment: if symptoms persist despite changes to strength and technique, a targeted assessment by a physiotherapist is the logical next step.

When to see a physiotherapist for padel complaints

For most mild, short-lived complaints after playing padel there's no reason for concern: some muscle soreness or mild fatigue in the elbow or knee can be part of adapting to a new load and often eases within a few days. There are, however, a few signs that suggest a physiotherapist can help:

• Pain that persists or worsens for more than one to two weeks, despite rest and adjusting your playing load.
• Pain that's also present outside of playing padel, for example during everyday actions like lifting, typing or turning a door handle.
• Clear swelling, a feeling of instability in a joint, or noticeable loss of strength in an arm or leg.
• Symptoms that keep coming back as soon as you start playing again, even after a period of rest.

Contact your GP directly, or go to A&E, if you can no longer bear weight on an ankle or knee after an acute twisting injury, if there's a visible deformity of a joint, if swelling develops rapidly and severely, or if you have a fever combined with joint pain. These signs may point to something needing further medical assessment, beyond the usual overuse picture.

At Physical Studio you don't need a referral from your GP for physiotherapy: you can book an intake directly. During your first appointment we map out your symptoms and padel load, and where clinically useful we use ultrasound or VALD Force Decks to get an objective picture of tendon and muscle load capacity. Because our physiotherapists are also personal trainers, the step from treating symptoms to targeted strength building for your next padel season happens within a single track.

Physiotherapy is typically covered from your supplementary insurance. This varies by policy and insurer, so always check your own policy or use the insurance checker on our site to see what applies to you.

With the right build-up, padel remains a sport you can enjoy for years. A proper warm-up, attention to strength and technique, and seeking help in good time for persistent complaints all help with that. Wondering whether your symptoms match padel elbow? Read more on our tennis elbow page, and if you're unsure about shoulder, knee or ankle complaints, book an appointment for an intake directly.