Padel Shoulder and Padel Elbow: New Overuse Injuries in a Fast-Growing Sport

Padel has gone from niche to global in just a few years. Courts are appearing in Europe, the Middle East, Asia and the Americas, and participation is rising in adults of all ages, from teenagers to seniors.^[1,2]

With that growth has come a surge in overuse injuries in padel players. Systematic reviews and epidemiological studies show that:

• Overall injury incidence in padel is about 3 injuries per 1,000 hours of training and 8 injuries per 1,000 matches.^[3]
• Lifetime injury prevalence in padel players ranges from 60 to 95 percent.^[3]
• The elbow is consistently reported as the most common injury site, followed closely by the shoulder and knee, with tendinous and muscular overuse problems dominating the profile.^[3,4,5]

This has led clinicians and coaches to talk about “padel shoulder” and “padel elbow” – new names for a very old problem: racket-sport overuse injuries that are now appearing in this younger sport.

Padel looks friendly: smaller court, doubles play, glass walls, and a low net. But it combines unique elements that load the upper limb in demanding ways:

• Frequent overhead shots (smash, bandeja, viborá)
• Repetitive high-speed forehands and backhands
• Decelerating the ball off the glass and reacting quickly
• A solid, non-strung racket that may transmit more vibration to the arm compared with stringed tennis rackets^[6]

Injury papers on padel note that upper extremity complaints – particularly lateral elbow pain and shoulder pain – are strongly associated with high training volume, poor technique, inadequate strength, and rapid increases in load.^[4,5,7]

In other words: padel’s fast rallies, overhead work and continuous gripping make it a perfect breeding ground for overuse in the shoulder and elbow.

The overhead athlete’s shoulder in a glass-walled court

From a medical perspective, padel shoulder is not a brand-new diagnosis. It is usually a combination of:

• Rotator cuff tendinopathy or irritation (often supraspinatus)
• Shoulder impingement syndrome (structures being pinched under the acromion)
• Sometimes internal impingement, where the rotator cuff is squeezed between the humeral head and the glenoid in extreme abduction and external rotation^[8–11]

These conditions are well documented in tennis players and other overhead athletes such as baseball pitchers, javelin throwers and volleyball players.^[8–10,12]

In padel, the shoulder is repeatedly placed into:

• Abduction and external rotation for smashes and viborás
• Overhead positions when retrieving lobs off the glass
• Rapid eccentric loading as players decelerate the arm after powerful strokes^[6,13]

A recent narrative review on musculoskeletal disorders in padel notes that shoulder problems in these athletes often mirror those seen in tennis, with rotator cuff tendinopathy and impingement as key patterns.^[6,13]

Players with padel shoulder often report:

• Pain in the front or side of the shoulder, sometimes radiating down the upper arm
• Discomfort during or after overhead shots (smash, bandeja)
• Pain lifting the arm to the side or overhead, especially around 60–120 degrees
• Tenderness over the rotator cuff or biceps tendon
• Loss of power in overhead strokes

This is consistent with shoulder impingement and rotator cuff tendinopathy described in overhead sports.^[9–11,14]

Lateral elbow tendinopathy in a new racket sport

Padel elbow usually refers to lateral elbow tendinopathy, the same pathology many people know as “tennis elbow.” It affects the common extensor tendon on the outside of the elbow, especially the extensor carpi radialis brevis tendon.^[6,15,16]

A large systematic review of padel injuries concluded that the elbow is the single most common injury site in padel, with tendinous and muscular overuse injuries dominating the clinical picture.^[3,4,17]

Articles focused specifically on “padel tennis elbow” describe:

• High mechanical loads on the lateral elbow due to repetitive backhand strokes
• Continuous eccentric contraction of the forearm extensor muscles as they brake the racket and ball
• Extra vibration transferred by the solid, perforated padel racket face
• Technique faults, such as gripping too tightly or using a handle too small or too big^[18–21]

Typical features include:

• Pain on the outer side of the elbow, often with a burning or aching character
• Worsening when gripping the racket, shaking hands, lifting kettles, or opening jars
• Tenderness when pressing over the lateral epicondyle (bony bump on the outer elbow)
• Reduced grip strength and a feeling of weakness in the forearm

Cleveland Clinic and orthopaedic guidelines describe tennis elbow as a classic overuse tendon injury, with pain that worsens with repetitive gripping or wrist extension.^[15,16]

In padel, this is exactly what the elbow does: gripping, swinging, and decelerating the racket hundreds of times per match.

Research on padel injuries points to several risk factors:

• Higher training volume and match frequency – more hours on court, more risk^[3,4,14,22]
• Less padel-playing experience – newer players often have higher injury rates, possibly due to poorer technique and fatigue management^[5,14]
• Age over about 30 years – some studies find higher injury rates in adults over 30, likely due to tissue aging and recovery issues^[5,17]
• Poor sleep or insomnia, which can impair tissue recovery and increase injury risk^[5]
• Inadequate physical preparation – weak rotator cuff and scapular muscles, and poor forearm strength, make overuse more likely^[8,13,23]
• Equipment and technique factors – heavy rackets, incorrect grip size, very open racket faces on impact, and extreme wrist use have all been linked to elbow issues in padel-specific articles.^[18–21]

Youth padel research also shows that overuse injuries are common in young players with high weekly training loads, reminding us that this is not only an adult problem.^[14]

During an overhead smash or powerful bandeja, the shoulder goes into abduction and external rotation, then accelerates violently forward and down. In overhead athletes, this movement pattern is known to cause:

• Repetitive pinching of the rotator cuff tendons against the acromion (shoulder impingement syndrome)
• Undersurface tears of the rotator cuff due to internal impingement in extreme positions
• Strain on the long head of the biceps tendon and the labrum^{[8–11,23,24]}

The Aspetar “Injuries in padel” review notes that the supraspinatus tendon is often the most affected in padel players, mirroring tennis and other overhead sports.^[13]

Padel-specific biomechanics papers and coaching experience highlight some common shoulder-risk patterns:

• Overusing the arm and shoulder rather than involving the legs and trunk
• Hitting smashes too far behind the head, forcing extreme shoulder rotation
• Poor scapular control (shoulder blade movement), increasing impingement risk

In overhead athletes generally, poor scapular control and strength imbalances are well-recognised contributors to shoulder overuse injuries.^[8,23]

Padel elbow is usually driven by:

• Repetitive single-handed backhand strokes, especially with incorrect timing or late contact
• Heavy reliance on the wrist and forearm rather than using the whole kinetic chain
• Eccentric loading of the extensor tendons as the racket decelerates after impact^[18–21]

Articles written specifically for padel players emphasize that late contact, stiff grip, and inappropriate racket weight all amplify forces at the lateral elbow.^{[18,20,21,25]}

Unlike tennis rackets, padel rackets have:

• A solid face with holes, not strings
• Generally shorter handles and different balance points

Some padel injury resources suggest that this design may increase vibration transmission to the arm, particularly if the racket is too stiff or too heavy, though high-quality research is still emerging.^[6,21,33]

Combined with high volumes of play on hard surfaces, this can create persistent tendon overload and micro-damage.

You should seek a sports medicine or physiotherapy assessment if:

• Shoulder pain persists for more than a couple of weeks, especially if it limits overhead shots
• Elbow pain on the outside persists, or grip strength drops noticeably
• Pain is present even at rest or at night
• There is obvious loss of range of motion or weakness

Clinicians will usually:

• Take a detailed history of training load, technique, and equipment
• Examine posture, scapular movement, shoulder strength and flexibility
• Test the elbow extensor tendons and grip strength
• Use ultrasound or magnetic resonance imaging only if needed to clarify diagnosis or guide treatment

Most cases of padel shoulder and padel elbow are overuse tendinopathies, not complete tears, and respond well to conservative management when addressed early.^{[6,13,15–17]}

Completely stopping all movement is rarely ideal. Instead:

• Reduce painful overhead shots or heavy backhands
• Temporarily lower weekly padel volume and intensity
• Maintain general fitness through cycling, walking or lower-stress training

This allows tendon irritation to calm without losing overall conditioning.

Evidence on injury prevention in overhead athletes shows that specific rotator cuff and scapular muscle strengthening reduces shoulder injury risk and helps recovery.^[8,23]

For padel shoulder, programs typically focus on:

• External rotation and internal rotation strengthening with bands
• Scapular stabiliser work (lower trapezius, serratus anterior)
• Posterior shoulder stretching if there is tightness

For padel elbow, programs emphasise:

• Eccentric and heavy slow resistance exercises for wrist extensors
• Forearm and grip strengthening
• Stretching of the wrist and finger extensor muscles

These approaches echo best practice for tennis elbow rehabilitation.^[15,16]

In the short term, clinicians may use:

• Soft tissue techniques and joint mobilisation
• Taping or bracing, such as counterforce elbow straps
• Ice or short-term pain-relief strategies

These methods help control pain and allow more effective participation in exercise-based rehab, though long-term recovery still depends on load management and strengthening.

Padel-specific advice from physiotherapists and coaches includes:^[18–21,25]

• Using a racket with appropriate weight, balance and grip size
• Avoiding overly stiff or heavy rackets if you are newer or have a history of elbow pain
• Learning efficient stroke mechanics, using the legs and trunk to generate power instead of only the arm
• Hitting backhand shots with earlier preparation and contact in front of the body
• Avoiding extreme wrist flicking, especially when tired

Working with a qualified padel coach to refine technique is a key part of long-term prevention.

If conservative care does not improve symptoms, doctors may consider:

• Short courses of nonsteroidal anti-inflammatory medication
• Guided injection therapies in selected cases
• Very rarely, surgery, if there are significant structural tears or refractory cases

Most padel shoulder and padel elbow problems, however, resolve with load modification and progressive rehabilitation, not surgery.^{[6,13,15–17]}

Epidemiological work in padel shows that high volume and rapid load increases are major risk factors for both acute and overuse injuries.^{[3,4,14,22,26]}

Practical guidelines:

• Increase weekly playing time by no more than about 10–15 percent
• Avoid adding extra matches and new strength programs at the same time
• Plan rest days, especially after tournaments or intense sessions

A good padel warm-up should last at least ten minutes and include:

• Light jogging or skipping
• Dynamic shoulder movements (arm circles, cross-body swings)
• Scapular activation (band pull-aparts, wall slides)
• Forearm and wrist activation with light bands or hand grips
• Short, progressive practice rallies at lower intensity

This prepares both shoulder and elbow tendons for the work to come.

To keep overuse at bay:

• Maintain a regular shoulder and elbow strength routine, even during competition periods
• Include exercises for core and lower body, so the arm is not doing all the work
• Balance training between pushing and pulling movements to avoid strength imbalances

Reviews on overhead sports repeatedly highlight general conditioning and balanced strength as crucial prevention strategies.^[8,23]

Do not ignore:

• Persistent shoulder ache after overhead shots
• Forearm and elbow pain that lingers more than a few days
• Loss of power or control in strokes

Backing off early and adjusting load for a week or two is far better than forcing through and ending up with months of tendinopathy.

Padel is fun, social, and here to stay. The rise of padel shoulder and padel elbow does not mean the sport is dangerous; it means players and coaches need to treat it with the same respect given to other high-demand racket sports.

Key points to remember:

• Injuries in padel are common, with the elbow and shoulder among the most affected regions.^[3,4,17]
• Padel shoulder is usually a form of rotator cuff overuse and impingement, and padel elbow is typically lateral elbow tendinopathy.
• Risk rises with high training volume, poor technique, inadequate strength, older age, and rapid increases in play.
• Most cases improve with early diagnosis, smart load management, targeted rehabilitation, and coaching input.

If you love padel and want a long playing career, invest in your shoulder and elbow the same way you invest in court fees and rackets. Strong, well-prepared joints are the best insurance policy against overuse injuries in this fast-growing sport.

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