What Is Pickleball Elbow And How Do You Treat It?

If you play Pickleball and are starting to experience pain in your elbow area related to playing, look out! You may be coming down with a case of “Pickleball Elbow!”

Pickleball Injuries Are On The Rise – Especially Elbow Injuries

It’s no joke!… I just did a Skype consultation this morning with one of my student members who plays Pickleball in Arizona (where the sport is apparently VERY popular) and he told me that half the people he plays with are having elbow pain!

Well, maybe not HALF – but a large percentage of Pickleball players are either walking wounded, all wrapped up in braces or bands – or dropping out of matches like flies.

Why so many? One theory, proposed by my student-member is that the vibrations involved in hitting a hard, plastic Pickleball, with the paddle used in the game, are considerably more intense than the vibrations involved in hitting a tennis ball with a tennis racket.

And that seems like a good working theory to me! (I also notice that the volleys seem a lot faster than in tennis – There’s less running around, it’s more upper-body focused and the players are a lot closer together – so there are a lot more repetitions involved.)

What Are The Symptoms Of Pickleball Elbow?

The most common symptom is burning pain at the inner or outer elbow area, which can feel like the little bony knob is literally “on fire!”

The major symptoms are:

• Burning pain at the outer elbow
• And/or burning pain at the inner elbow
• Occasional sharp twinges of pain at either location (from the tendons, usually)
• Tension, weakness, soreness and pain in the muscles of the forearm (on either side)
• Stiffness, achiness and soreness in those areas upon waking every morning

Now, clinically speaking, I should point out that there isn’t really a medical condition known as ‘Pickleball Elbow’

There’s Tennis Elbow – (Technically Lateral Epicondylopathy / Epicondylitis)…
And there’s Golfer’s Elbow – (Technically Medial Epicondylopathy / Epicondylitis)

(Just between you and me, though, if you have an elbow injury related to playing Pickleball, ‘Pickleball Elbow’ works just fine, and seems to be coming into popular use!)

But, technically, it doesn’t matter what you play; Pickleball, Racquetball, Tennis or Golf – Or whether you play at all! – It’s all about which tendons at which part of your elbow are injured:

• It’s probably Tennis Elbow if it’s your outer elbow area – (where the tendons of your Wrist and Finger Extensor Muscles originate from a little bony knob, known as the Lateral Epicondyle)
  
  
• It’s probably Golfer’s Elbow if it’s your inner elbow area – (where the tendons of your Wrist and Finger Flexsor Muscles originate from a little bony knob, known as the Medial Epicondyle)

And Tennis Elbow is by far the most common of these injuries (even among golfers these days!)

I should also point out that we’re not talking about the BIG bony knob at the bottom of the elbow (what is often referred to as THE elbow)…

But, rather the little bony knobs on either side of it, which are about the size of your little finger’s knuckle.

Before we go further, if you don’t already have a good sense of which one you have, Tennis or Golfer’s Elbow – Or IF you have one of these problems at all…

I invite you to take my free video course called ‘Tennis Elbow 101’

You’ll learn the differences between Golfer’s and Tennis Elbow, and I’ll walk you through some simple tests you can do to quickly assess yourself.

Here’s where you can learn more and get the free Tennis Elbow 101 Video Course.

Now, assuming you have a pretty good idea that you have either a Golfer’s Elbow or a Tennis Elbow Pickleball injury, what do you do about it?

How Do You Treat Pickleball / Tennis Elbow?

As far as treatment goes, it doesn’t matter what the source of the injury is; Pickleball, Racquetball, Tennis or Golf – You treat your muscles and tendons the same way!

There is, of course, the question of “How do I prevent recurrences and what, exactly, may have caused or contributed to my injury?” (Was it simply playing way too much Pickleball? Sub-optimal technique? Etc.)…

But I leave those questions to the Pickleball Pros – Or to the Racquetball, Tennis and Golf professionals, respectively.

I’m not a pro or even a player – I’m someone who treats these vexing conditions and teaches people how to treat themselves at home.

I’ll link to a few resources on Pickleball injury prevention at the end of this post.

Now, back to treatment, which this site is all about, it’s critical to begin with the right picture in mind of what this nasty injury is all about (in most cases)…

The first big hurdle that most sufferers trip over (unknowingly) is that it’s not usually the kind of injury that you’re often told is is…

It’s very seldom an Acute Injury, like a tear

(It’s hard to know what the exact numbers are but tears are the problem in only about 1-3% of Tennis Elbow sufferers.)

And it’s NOT an inflammatory condition, like Tendonitis, either!

This is also something covered in more detail in the free Tennis Elbow 101 video course – AND

Here in my Tendonitis / Inflammation Myth Article and Video

And the really good news is that only a small minority of sufferers end up needing surgery!

(Again, only about 1-3% of Tennis Elbow sufferers have surgery, because of severe tears and other serious damage.)

But it is often a VERY stubborn, chronic injury that far too many sufferers fail to take seriously at first and far too often end up struggling with for months or even years!

That’s what I’m going to try and help you avoid!

Starting with understanding the true nature of this beast and avoiding making all the mistakes in treating it that most people make…

Mistakes made in complete innocence – Not knowing any better, because friends, experts, coaches and medical “authorities” told them and they were just “following the common wisdom”

So, let’s get right into why the common wisdom may be common – but it’s NOT so wise.

The first key thing is knowing that Tennis and Golfer’s Elbow / “Pickleball Elbow” is a tendon injury.

Usually a tendon injury that turns out to be Tendin-OSIS – NOT Tendon-ITIS!

TendinOSIS is a typically-slow, chronic, degenerative condition…

Whereas TendonITIS is an inflammatory condition.

I assure you that regardless of how much nasty, burning, “searing” PAIN one feels – that pain is not usually coming from inflammation (at least usually not significantly.)

That’s part of the common misunderstanding and why it just seems like a natural assumption:

It FEELS like burning pain, therefore it’s inflamed!

No. Usually it isn’t – At least not past the earliest stage lasting a few days.

There IS such a thing as chronic inflammation and that’s bad – but this just isn’t one of those cases.

The simple truth is that inflammation is a natural, necessary, normal part of your healing process when it comes to healing injured tissues…

And that’s why trying to chase it away (suppress it) by way of the standard treatments is wrong and completely misguided.

I have entire articles and videos explaining why, in greater detail, if you’d like to learn more:

• Why Icing / Cryotherapy Is Wrong
• Why Taking Anti-Inflammatories Is A Bad Idea
• Why Topical Treatments (Creams, Etc.) Are A Waste Of Time
• And Why Getting Cortisone Shots Is A Terrible Mistake!

We should also bring up the question of braces and rest, but for different reasons not having to do with inflammation:

• Why Wearing A Brace Is The Wrong Approach – (Except while you’re playing)
• Why “Total Rest” Is Also Not The Key

The short answer being: It’s not the kind of injury you immobilize, so wearing a brace around all day and not moving at all (“total rest”) is a bad idea regardless of whether it feels better.

If you want to optimize healing, it’s important to allow gentle, normal movement as you go about your day.

It IS, however, probably a good idea to wear a brace while you’re playing Pickleball – while you’re recovering from your injury if you decide to keep playing or for a while when you resume playing.

Which brings up the question of whether you should stop playing or not. Here’s my article on that nuanced dilemma:

Can You Keep Playing Tennis, Golf OR Pickleball If You Have Tennis Elbow?

NOW, I want to point out that IF you can see significant swelling (significant visible puffiness) and redness around your elbow area, that’s an exception and it may mean you may have an Acute injury or a more serious Chronic injury, and you may need medical attention and a different treatment approach.

But swelling and redness are very rare with Tennis and Golfer’s Elbow.

If one minute you’re fine and you play Pickleball and later your elbow blows up like a balloon – That suggests a more serious, Acute Injury.

Tennis Elbow and Golfer’s Elbow, however, tend to sneak up on you, gradually getting worse and worse over weeks or months…

Although, yes, sometimes the pain appears suddenly, even in the middle of a match!

But it doesn’t usually swell up – And although it may calm down with pills, ice, wearing a brace and resting it – IF you’re still having pain weeks later, that’s a classic sign of Golfer’s or Tennis Elbow…

A Wacky-Waving-Inflatable-Arm-Flailing-Tube-Man SIGN that you probably have a chronic tendon injury in the making!

Okay, now that we’ve covered the WRONG way to treat a Pickleball Elbow Injury…

What’s The RIGHT Way To Treat It?

1. We mobilize our muscles and tendons with specific hands-on techniques, and gentle stretches (instead of immobilizing them with a brace) See this article and video on the importance of Advanced Self-Massage Techniques
   
   
2. We warm the area regularly to stimulate circulation and the healing that comes with good blood flow (or at least refrain from freezing our muscles and tendons with ice and inhibiting circulation)
   
   
3. We allow the inflammation process to do what it’s there to do, which is to initiate the healing process (rather than relentlessly trying to suppress it through pills, shots and ice)
   
   
4. And we delay rehab exercises – Yes, strengthening exercises are essential at the right time, but the problem, in my experience, is that they’re often begun too early

Our approach here at Tennis Elbow Classroom is to postpone rehab exercise until we first make some progress with the Therapy Techniques and the worst symptoms have significantly subsided…

Here’s more on The Tennis Elbow Classroom Treatment Strategy

And here’s more about The Three Key Principles Of Rehab Exercise

AND if you need some help putting together a self-help plan, you’re certainly in the right place!…

Learn To Treat And Heal Your Own Tennis Elbow Or Golfer’s Elbow At Home With This Video Program

You’ll get instant access to a complete VIDEO program designed by a professional therapist to help you take charge and break your vicious cycle of pain and frustration!…

I’ll be your personal tutor guiding you through step-by-step video lessons, where you’ll get the therapy techniques, key stretches and essential exercises you need to treat and recover from your injury at home. (Without any special equipment.)

Just watch the videos, follow along and start putting an end to your elbow pain today, whether you have Golfer’s or Tennis Elbow from playing your guitar – or other stringed instrument or ANY instrument, for that matter!)

Tennis Elbow sufferers: Learn more about the Tennis Elbow program here

Golfer’s Elbow sufferers: Learn more about the Golfer’s Elbow program here

Pickelball Injury Prevention Resources

Here’s a video on avoiding Pickleball injuries, mainly by warming up properly, by CJ Johnson, whose Youtube channel focuses on Pickleball and “Health and Sports Fitness for the Over 40 Crowd”

Video On How To Avoid Pickleball Injuries

And here are a few more resources on injury prevention from Pickleball-specific sites, coaches and associations:

• Pickleball Injuries And Prevention Tips: Limiting “wrist action,” How grip size affects Tennis Elbow, Paddle size; The correct grip size, etc. – PickleballPortal.com
  
  
• Top 3 Tips Of Avoiding Pickleball Injuries: Knowing your limits, increasing stamina, warming up, etc. – From The Pickleball Guru / PickleballHelp.com
  
  
• Health And Safety Tips: Warming up, stretching, protection, footwear, cooling down, etc. – USAPA.org / Pickleball