Padel Injuries: Elbow, Shoulder and Lower Back Pain, and What to Do About Them
Updated: 3 hours ago
Padel has taken off in Perth. New courts, a packed social calendar and a game that is easy to pick up all mean more people are playing more often. The flip side is that a lot of us are loading our elbows, shoulders, backs and hips in ways they are not used to, and we are seeing the results in the clinic.
Here is what tends to go wrong in padel, why it happens, a short hip routine to build into your week, and when it is time to get something looked at. If you want the bigger picture on how we work with players, see our padel chiropractic page.
The most common padel niggles
Padel is a mix of quick direction changes, repeated rotation and short, sharp racquet swings. That combination loads a few areas more than others.
The research backs this up. A 2023 systematic review in BMJ Open Sport and Exercise Medicine, which pooled eight studies and more than 2,000 players, found the elbow was the most commonly injured area, followed by the knee, shoulder and lower back. Tendon and muscle injuries were the most common types, and tennis elbow was the single most reported diagnosis.
Elbow. Pain on the outside of the elbow (tennis elbow) or the inside (golfer's elbow), often after a run of games or a change in grip or racquet.
Shoulder. Pinchy or aching shoulders from overhead shots, smashes and bandejas, especially if you also lift or work at a desk.
Wrist and forearm. Tightness or soreness from repeated impact and grip.
Neck. Stiffness from quickly tracking the ball and looking up for overheads.
Lower back. Aching after games, especially after lots of twisting and lunging.
Hips, knees and ankles. Hip flexor and groin tightness, knee pain from stopping and changing direction, and ankle rolls on the turn.
Why does it happen?
There is rarely one single cause. In the clinic, we commonly see a mix of:
A jump in playing volume. Going from one social game a week to three or four, quickly.
Grip and technique. A grip that is too tight, or a swing that relies on the wrist and elbow instead of the legs, hips and trunk.
Stiff hips and upper back. If the hips and thoracic spine do not rotate well, the lower back, shoulder and elbow end up doing the work.
Little warm up. Walking straight onto court from the car or the desk.
Strength that has not kept up. Padel is a sport, but it is not a replacement for strength work. Most of us could be stronger through the shoulders, trunk and legs.
Equipment. A new racquet, a different weight or a worn grip can change the load on your forearm.
This is why we look beyond the sore spot. The elbow is often not the whole story.
A simple hip routine to try
Stiff hips are one of the most common things we find in people who play racquet sports. Here are three simple moves, about 30 seconds each, to give them some attention. They are a good addition to your warm up or an evening at home.
90/90 hip switch. Sit on the floor with both knees bent at 90 degrees, one leg in front and one to the side. Sit tall, then rotate both knees across to switch sides. Keep it slow and controlled. 10 switches.
Long lunge hold. Step one foot well forward into a long lunge, with your back knee down on a cushion if you like. Squeeze the back glute, stay tall and hold for 30 seconds each side.
Lateral lunge. Step wide to one side, sit back into that hip and keep the other leg straight. Hold on to a bench or door frame for support if you need it. 5 slow reps each side.
Ease into each one. If anything feels sharp or pinchy, back off and get it looked at.
Look after your load
Build up, don't jump up. If you are adding games, add them gradually.
Warm up properly. Five minutes of easy movement, shoulder circles, trunk rotations and a few lunges before you hit.
Mix in strength. Two short sessions a week for your legs, trunk, shoulders and grip makes a difference to how your body handles the court.
Check your gear. Grip size, racquet weight and a fresh overgrip are worth a look if your elbow is niggling.
Do not push through sharp pain. Pain that changes how you swing is a sign to get help.
When should you get it assessed?
Book an evaluation if:
Elbow, shoulder or back pain has lasted more than a couple of weeks
It is changing how you play, or stopping you from playing
It keeps coming back
You have numbness, tingling, weakness or pain that started after a fall or a hard hit
Not every sore elbow is tennis elbow, and not every sore back is the back, so a proper assessment is the right first step.
How we work with padel players at North Fremantle Chiropractic
Padel injuries are something we commonly work with. We are the official chiropractic partner of the Padel West State League, and we see players from West Coast Padel Dalkeith, Padel 360 Cockburn, Padel Crush Wembley and clubs across Perth, from social players through to competitive.
Every plan starts with an evaluation. We look at the sore area, and also at the hips, upper back, shoulder and how you move on court. Dr Nathan is a chiropractor and a strength and conditioning coach, so the rehab is programmed in the language of training, with sets, loads and progressions that fit around your playing schedule.
Depending on what we find, care may include joint adjustment, soft tissue work, dry needling, movement screening, strength and conditioning for padel, and advice on managing your playing load. We also work alongside GPs, physios and surgeons, and we will help coordinate imaging or a referral if it is needed.
You do not need to wait until something is sore. Movement screening and load management are just as useful for getting ready for a bigger season, particularly if your playing volume is climbing.
Read more on our padel chiropractic page, or see how we approach sports injuries, shoulder pain and disc injuries.
Frequently asked questions
What injuries are common in padel?
Upper body, tennis elbow and golfer's elbow from racquet impact, rotator cuff strains and shoulder impingement, wrist sprains and forearm tightness, and neck pain from quick head movement. Lower body, lower back pain from rotation under load, hip flexor and groin tightness, knee pain from direction changes, and ankle sprains and Achilles tendon pain.
Why does my elbow hurt after playing padel?
Repeated racquet impact loads the tendons at the elbow, which shows up as tennis elbow on the outside or golfer's elbow on the inside. Grip, technique and how often you play all contribute. An assessment looks at the elbow, the wrist and forearm, and the shoulder and neck that feed into it.
Why does my lower back get sore from padel?
Padel involves repeated rotation under load plus quick direction changes, which places demand on the lower back and hips. Assessment looks at where that rotation is coming from and whether the hips or upper back are contributing.
Should I keep playing while I am sore?
It depends on the injury and what stage it is at. Load management is usually part of the plan, which might mean reducing volume, adjusting intensity or pausing for a defined period rather than stopping indefinitely. You get specific direction rather than a guess.
What does treatment for a padel injury involve?
Depending on what we find, joint adjustment, dry needling, soft tissue therapy, rehabilitation exercises, movement screening, strength and conditioning for padel, and load management advice.
Can you help me before I get injured?
Yes. Movement screening, strength work and load management help you prepare for the demands of the sport, not only respond after something goes wrong. That is useful if your playing volume is going up.
Do I need a referral to book?
No. You can book directly. Allow 45 minutes for your first appointment. If we think you need imaging or input from another practitioner, we will let you know.
Where is North Fremantle Chiropractic?
We are at Unit 1, 210 Queen Victoria Street, North Fremantle. We see people from Fremantle, East Fremantle, Mosman Park, Bicton, Cottesloe and the surrounding suburbs.
Ready to get back on court?
If a sore elbow, shoulder or back is getting in the way of your padel, the first step is an evaluation.
North Fremantle Chiropractic
Unit 1, 210 Queen Victoria Street, North Fremantle WA 6159
Phone: 0414 316 261
About the author
Dr Nathan Bridger is a chiropractor and strength and conditioning coach, and the owner of North Fremantle Chiropractic. He has over a decade of experience across both fields, has practised internationally, and has worked as a clinical supervisor in chiropractic education. He is registered with the Chiropractic Board of Australia through Ahpra and practises in North Fremantle, Western Australia.
