Why Tennis Elbow Is on the Rise with Padel's Popularity
By Toby Sullivan, MCSP - Chartered Physiotherapist
Padel has exploded in popularity over the past couple of years, and South West London has been right in the middle of that. New courts, more clubs offering it, and a lot of people picking up a racket for the first time in years, or ever. Alongside that, I've seen a clear rise in one particular injury coming through the clinic door: tennis elbow, sometimes now nicknamed "padel elbow."
What's actually going on
Tennis elbow is pain on the outside of the elbow, where the tendons of the forearm muscles attach to the bone. It's an overload injury - the tendon has been asked to do more than it's currently able to cope with, and it starts to complain. That attachment point doesn't have a great blood supply, which is part of why it can nag on for weeks rather than settling quickly on its own.
Why padel specifically seems to cause it
A few things about padel make the elbow more likely to flare up than in a lot of other sports:
• The racket is solid, not strung. That means more of the impact vibration goes straight through to your arm rather than being absorbed.
• The backhand is often the problem. New players tend to hit it with a lot of wrist involvement rather than the arm and shoulder doing the work, which loads the elbow tendon more than it needs to.
• It's social and addictive. This is the biggest factor I see in practice. People go from playing once a week to three or four times within a month, because it's fun and easy to book with friends. The tendon doesn't get time to adapt to that jump.
The real pattern behind most cases
This last point is the one I'd flag above the others. It's rarely just about technique, and it's not really about the racket either, although both play a part. Almost every padel elbow I see comes down to the same thing I see in running injuries too: load going up faster than the tendon can adapt to it. Three sessions a week, out of nowhere, after months of not playing at all, is a lot to ask of a tendon that hasn't done that kind of work in a while.
What actually helps
The instinct is usually to rest completely until it stops hurting, then go straight back to the same amount of play. That tends to just repeat the cycle. What generally works better is a short period of easing the load, followed by a proper strengthening programme for the forearm, and a more gradual return to your usual playing frequency rather than jumping straight back to three sessions a week. For pain that's been hanging around for a while, focused shockwave therapy can help alongside this, though it's not usually needed for a straightforward case caught early.
When to get it looked at
A day or two of soreness after a heavy padel session is normal. If it's still there after a couple of weeks, getting worse rather than better, or starting to affect your grip on everyday things like holding a mug or turning a key, it's worth getting assessed properly rather than waiting it out.