Tennis and pickleball are different sports in many ways, but unfortunately, tennis elbow being a common problem is one thing that they share in common.
Today, I want to teach you guys a little bit about what tennis elbow is, why it happens, and how it can be avoided.
If you’ve never had tennis elbow yourself, I guarantee that you’ve encountered multiple people dealing with the issue if you hang around the pickleball courts often. The majority of people walking around with elbow braces are doing so because of this specific issue.
What is it? If you put your palm down, and raise your hand up towards the sky, the motion that you’re creating is called wrist extension. The muscles that create this motion run all the way up the back of your forearm, and they all connect into the outside of the elbow (where people with tennis elbow tend to experience the worst pain).
Tennis elbow is ultimately an overuse injury. If the issue is new (within the first few days of starting), tennis elbow should be a purely inflammatory condition. Rest the issue at this point, correct any glaring issues in training, technique, and pacing, and the problem should go away easily at this point.
So, why is it such a big issue in pickleball? If I had to pick a slogan to describe pickleball players, it would be something along the lines of “Just one more game.” Pickleball players and rest get along about as well as oil and vinegar.
The longer tennis elbow persists, the more complex the issue becomes. When inflammation is a persisting issue, the extensor muscles and their tendons actually begin to undergo structural changes in response. They become thickened, less flexible, and gradually start to function improperly.
Once someone gets to this point, simple rest alone typically isn’t going to solve the problem, or it’ll just come right back. The extensors need to be properly ‘loosened up’ and retrained to restore natural function. The good news is that this issue does still get better with the right program, but it does absolutely take more time and work than it would have when the problem was exclusively swelling.
Why does it happen? Ultimately, it all comes down to body mechanics and training. In pickleball, the wrist extending should not be one of your most commonly used movements, but there are definitely times when it is appropriate.
So, imagine that your friend just introduced you to pickleball. He’s instilled the pickleball bug in you, and you both play for a few hours on a daily basis. You both have similar play styles, but he’s been playing for six months, while you were a competitive couch potato prior to picking up the sport a few weeks ago.
Your elbow and forearm begin to hurt when you hit the ball. His does not, and somehow it just doesn’t seem quite fair.
The difference is that your friend started to play and train his body more gradually. His muscles were able to properly adapt and strengthen to accommodate what he was doing. On the other hand, you pushed yourself past the point where your muscles were fatigued. You could continue to play, but gradually small injuries started to occur under the surface.
How to avoid it? As implied above, proper pacing is critical for minimizing the likelihood of developing tennis elbow. Optimizing form and technique are the other key factors.
If you have a good pickleball friend, have them watch you play and look at your strategy. When it’s proper technique for the wrist to be still, is it? Many people use the wrist to make returns when it shouldn’t really be participating, and unless you’re really paying attention to it, you probably won’t even notice. Even taking video of your play to see what you’re really doing out there is a fantastic idea.
Understand that muscles don’t become strong and accommodate to new activities just overnight. In fact, it takes somewhere between 6-8 weeks for true changes in muscle strength to set in. If you want to increase your play time or practice new techniques that rely on a lot of wrist movement, add onto what you’re doing gradually, and take notice of what your body is telling you.
What are other considerations? Outside of training and pacing issues, weakness, stiffness, and other problems in areas such as the shoulder can also result in overuse of the wrist and elbow. Nerve issues can also mimic symptoms such as tennis elbow, so if you have pain there, it’s important to make sure that you’re actually treating the correct thing. Otherwise, as you can imagine, you’ll wind up frustrated and not making progress.
Equipment wise, you may also find it beneficial to take a look at the paddle you’re playing with. Not all paddles were created to have the same shock absorbency when you make a hit, which can make a big difference when it comes to how much stress you’re placing upon your wrist and elbow.
The good news? Once the problem has been properly addressed, tennis elbow is something that typically resolves completely. This isn’t the type of problem that should require injections, surgery, or long term use of braces for most people.
You only have to ‘deal with it’ if you choose to.
Here at Serendipity Physical Therapy and Wellness, we’re well versed in working with pickleball players to help improve body mechanics, technique, and physical issues such as tennis elbow. If there is anything we can help you with, or you have questions, please give us a call at (239) 232-8155, or send us an email at Contact@SerendipityPTW.com. We would love to see how we can help get you moving at your best!
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