Blog 2: Everything Padel
Part 2: Shoulder and Elbow Injuries in Padel (And How to Fix Them)
Welcome back to Everything Padel. I'm Dr. Keirstyn, a chiropractor and endurance coach at Endurance Therapeutics in Oakville. In Part 1, we looked at why padel is hard on your body and the most common injury patterns in the sport. Today, we're diving into the two most common upper body complaints I see in padel players: shoulder pain and tennis elbow.
If you've been playing padel for more than a few months, you've probably felt at least one of these. That nagging ache at the front of your shoulder after a long match. The sharp pain on the outside of your elbow when you grip your racket. The stiffness that shows up the next morning and takes hours to loosen up.
These injuries are not random. They follow predictable patterns, and they're driven by the same underlying issues: weak stabilizers, poor movement mechanics, and repetitive load that exceeds your tissue's adaptive capacity.
Shoulder Pain in Padel Players
Shoulder pain in padel usually shows up as rotator cuff impingement or rotator cuff tendinopathy. It starts as a dull ache at the front of your shoulder during overhead shots, and it gets worse as the match goes on. At first, you only notice it when you're tired and your mechanics start to break down. But as the weeks go on, the ache shows up earlier, and eventually it hurts to reach overhead even when you're not playing.
Your rotator cuff is a group of four muscles that stabilize your shoulder joint and control the position of your upper arm bone in the socket. Every time you take an overhead shot, your rotator cuff muscles work to keep your shoulder stable while your larger muscles like the deltoid and lats generate power.
Rotator cuff impingement occurs when the space between your upper arm bone and the bony roof of your shoulder narrows, pinching the rotator cuff tendons and the bursa. This creates inflammation, pain, and eventually tendon damage if left untreated.
Rotator cuff tendinopathy develops when your training volume increases too quickly or when your stroke mechanics break down under fatigue. The tendons are overloaded beyond their adaptive capacity, leading to pain, weakness, and loss of function.
Why Your Shoulder Is Overworking
Shoulder pain in padel players is rarely just about the shoulder itself. It's usually a sign of weakness and instability elsewhere in the chain.
Poor Stroke Mechanics: If your racket arm crosses your body on the follow through, or if you're reaching too far behind your body on the backhand, your shoulder is being loaded in a compromised position.
Weak Rotator Cuff and Scapular Stabilizers: If your rotator cuff and shoulder blade muscles are not strong enough to stabilize your shoulder through thousands of repetitive strokes, the larger muscles take over and the smaller stabilizers get overloaded.
Poor Posture from Desk Work: If you spend most of your day sitting with rounded shoulders and a forward head posture, your shoulder blade position is already compromised before you even step on the court. This creates impingement and reduces the space available for your rotator cuff tendons.
Sudden Increases in Playing Volume: Ramping up your playing volume too quickly without adequate preparation is one of the most reliable injury triggers available. The shoulder structures are under repetitive load that accumulates across matches and training sessions.
Tennis Elbow in Padel Players
Tennis elbow, or lateral epicondylitis, is pain on the outside of your elbow that gets worse with gripping, lifting, or hitting backhands. It's one of the most common overuse injuries in racket sports, and it shows up in padel players who play frequently or who have poor backhand mechanics.
The pain is caused by inflammation and microtears in the tendons that attach to the outside of your elbow. These tendons control wrist extension and grip strength, and they're under repetitive load every time you hit a shot.
Why Tennis Elbow Shows Up
Tennis elbow in padel players is usually driven by a combination of poor mechanics, weak forearm muscles, and excessive grip tension.
Poor Backhand Mechanics: If you're hitting your backhand with a locked wrist or if you're using too much wrist extension to generate power, your forearm tendons are being overloaded with every shot.
Weak Forearm Muscles: If your forearm muscles are not strong enough to handle the repetitive demands of the sport, the tendons take on more load than they should.
Excessive Grip Tension: If you're gripping your racket too tightly, your forearm muscles are constantly under tension, which increases the load on the tendons and reduces blood flow to the area.
Sudden Increases in Playing Volume: Just like with shoulder pain, ramping up your playing volume too quickly without adequate preparation is a reliable way to develop tennis elbow.
How to Actually Fix Shoulder and Elbow Pain
To heal shoulder and elbow pain in padel, we need to reduce the irritation and build the strength and stability your upper body needs to handle the load.
For Shoulder Pain:
Manage the Load: Avoid activities that cause sharp pain or a lingering ache. If overhead shots hurt, reduce your playing volume and focus on groundstrokes and volleys at lower intensity.
Fix Your Stroke Mechanics: Work with a coach to address racket arm crossover, excessive reach on the backhand, and inadequate body rotation. Small changes in your stroke can make a massive difference in how your shoulder is loaded.
Build Rotator Cuff Strength: Your rotator cuff muscles are the primary protective mechanism for your shoulder. Incorporate external rotation exercises and scapular stabilization work to build the strength your shoulder needs to handle repetitive overhead motion. Check out my YouTube channel for rotator cuff strengthening exercises: endurancetherapeutics.com/youtube
Improve Scapular Control: Your shoulder blade must move properly to create space for your rotator cuff tendons. Incorporate exercises that teach your shoulder blade to move in coordination with your arm, ensuring your shoulder is stable through the full range of motion.
Address Posture: If you spend most of your day sitting with rounded shoulders, your shoulder blade position is already compromised. Work on thoracic extension and scapular retraction to restore proper posture and create space for your rotator cuff tendons.
Manual Therapy: In the clinic, I use soft tissue therapy and joint mobilizations to restore proper movement to your shoulder, shoulder blade, and thoracic spine, ensuring your shoulder is moving efficiently.
For Tennis Elbow:
Manage the Load: Avoid activities that cause sharp pain or a lingering ache. If backhands hurt, reduce your playing volume and focus on forehands and volleys at lower intensity.
Fix Your Backhand Mechanics: Work with a coach to address locked wrist position, excessive wrist extension, and inadequate body rotation. Small changes in your stroke can make a massive difference in how your elbow is loaded.
Build Forearm Strength: Your forearm muscles need to be strong enough to handle the repetitive demands of the sport. Incorporate wrist extension exercises, wrist flexion exercises, and grip strengthening work to build the strength your forearm needs.
Reduce Grip Tension: Practice holding your racket with a lighter grip. Your grip should be firm enough to control the racket but not so tight that your forearm muscles are constantly under tension.
Manual Therapy: In the clinic, I use soft tissue therapy and joint mobilizations to restore proper movement to your elbow, wrist, and forearm, ensuring your elbow is moving efficiently and the tendons are healing properly.
What to Watch For
If your shoulder pain is accompanied by numbness, tingling, or weakness in your arm, it's a sign that the issue may involve nerve compression. These are red flags that require immediate attention.
If your elbow pain is getting worse despite rest and you're experiencing weakness in your grip, it's a sign that the tendon damage is progressing and you need professional help.
Final Word
Shoulder and elbow pain in padel players are signs that your stroke mechanics, rotator cuff strength, scapular control, and forearm strength need attention. By addressing the root cause, you can get back to playing with full, powerful strokes.
In Part 3, we'll look at lower back pain and core stability, the foundation that supports every shot you take.
Struggling with shoulder or elbow pain that keeps coming back? Book an assessment with me, Dr. Keirstyn, at Endurance Therapeutics. Let's find the root cause and build a plan to get you back on the court pain free.
📍 Endurance Therapeutics | Oakville, Ontario
📞 905-288-7161