Pickleball elbow: why it happens and what helps the next morning

You played three games last night. You felt great. This morning you reached for the coffee pot and your outer elbow lit up.

Welcome to pickleball elbow. It is tennis elbow with a smaller court and a louder ball, and because pickleball has pulled millions of adults over 50 onto the court, it has quietly become the most common sore spot in the sport.

This article explains what is happening, why the paddle brings it on, what to change, and what helps the next morning. It is general information, not a diagnosis. If your elbow pain is sharp, swollen, or has lasted more than a week, see a doctor or physical therapist.

What pickleball elbow is

The bony bump on the outside of your elbow is where the muscles that extend your wrist and fingers attach. Those are the muscles you use to grip the paddle, cock your wrist for a dink, and snap through a backhand.

When those muscles do more work than they are used to, the tendon that connects them to the bone gets irritated. That is the ache. It tends to show up on the outside of the elbow, gets worse when you grip or lift with your palm down, and is often at its worst first thing in the morning when everything has stiffened overnight.

Why pickleball specifically

Tennis players have dealt with this for decades. Pickleball adds a few twists.

Short, repetitive strokes. A dink rally is dozens of small wrist-driven shots in a row. There is less shoulder and body rotation than in a tennis groundstroke, so the forearm does more of the work.

Backhand volume. At the kitchen line you hit a lot of backhands, often with a stiff wrist. The backhand is the stroke most associated with outer elbow strain.

Grip pressure. New players tend to strangle the paddle. A death grip keeps the forearm muscles contracted the entire point.

Heavy or head-heavy paddles. Paddle weight has crept up as players chase power. More weight at the end of the lever means more load on the forearm.

Volume, period. Pickleball is easy to play for two hours straight, several days a week. Most people would never do that with tennis.

Put those together and you get a tendon that never gets a day off.

What to change on the court

The next-morning fix matters, but the long-term fix is on the court.

Loosen your grip. On a scale of 1 to 10, hold the paddle at a 4. You will not lose the paddle. You will lose a lot of forearm tension.

Check paddle weight and grip size. If your paddle is over about 8 ounces, or if your fingertips dig into your palm when you grip it, try a lighter paddle or add an overgrip to build up the handle.

Use your legs and shoulder. Bend your knees for dinks instead of flicking from the wrist. On the backhand, turn your shoulders and keep the wrist firm.

Warm up before the first game. Two minutes of arm circles, wrist rolls, and gentle forearm stretches. Most players skip this, and most players with sore elbows are the ones who skip it.

Build in rest days. Tendons adapt more slowly than muscles. Two days on, one day off is a reasonable rhythm while an elbow is cranky.

What helps the next morning

This is the part you are probably here for. Here is a simple routine that takes about ten minutes.

1. Warm it up before you load it

Cold tendons do not like surprises. Before you lift anything, run warm water over the forearm for a minute, or just wrap your other hand around it for thirty seconds. Then open and close your fist slowly ten times.

2. Gentle stretch

Extend the sore arm in front of you, palm down. With the other hand, gently bend the wrist downward until you feel a stretch along the top of the forearm. Hold 20 to 30 seconds. Repeat two or three times. It should feel like a stretch, not a stab.

3. Light self-massage

Use your thumb to work along the muscles of the top of the forearm, from the elbow toward the wrist. Moderate pressure, one to two minutes. This is a good moment to apply a topical balm, because the massage is part of what makes it feel good.

4. A topical balm

A menthol and camphor balm is for the temporary relief of minor aches and pains of muscles and joints associated with strains, sprains, simple backache, and arthritis. On a sore elbow, the cooling and warming sensation gives you a window of comfort to get moving.

Rematch Balm is a plant-based camphor and menthol balm, handmade in Scottsdale, Arizona. Rub a small amount into the outside of the elbow and the top of the forearm, up to 3 to 4 times daily. Do not use it on broken skin, do not wrap the elbow tightly over it, and do not put a heating pad on top. If the pain persists for more than 7 days, stop and ask a doctor.

5. Easy motion through the day

The worst thing for a stiff elbow is to hold it still all day. Every hour or so, do a few slow wrist curls and fist opens. Keep the elbow moving through a pain-free range.

6. Strengthen, slowly

Once the acute soreness settles, the tendon needs to get stronger, not just rested. A light dumbbell or a can of soup works. Rest the forearm on a table, palm down, hand hanging off the edge. Slowly lift the hand, then slowly lower it over three seconds. Ten to fifteen reps, once a day. The slow lowering is the important part.

What does not help

Playing through sharp pain. Dull, morning-stiff ache is one thing. Sharp pain during a stroke is your tendon asking you to stop.

Bracing and forgetting. A counterforce strap can take some load off during play, but it is not a fix. Use it alongside the grip and technique changes.

Stacking products. Do not use a balm and a heating pad together, or two topical analgesics on the same spot.

When to see someone

Make an appointment if the pain is severe, if the elbow is visibly swollen, if you cannot straighten it, if you feel numbness or tingling in the hand, or if it has not improved after a week of rest and the routine above. A physical therapist can check your mechanics and give you a progression that fits your elbow.

The point

Pickleball elbow is common, it is usually manageable, and it is almost always a volume and technique problem. Fix the grip, lighten the paddle, warm up, rest between sessions, and take care of it the next morning. Then get back on the court.

Same time tomorrow.

FAQ

Is pickleball elbow the same as tennis elbow? Yes. Both are irritation of the tendon on the outside of the elbow where the wrist extensor muscles attach. Pickleball tends to cause it through high-volume wrist-driven shots and tight grip.

Can I keep playing with pickleball elbow? If it is a dull ache that eases as you warm up, many people can play with adjustments: lighter grip, lighter paddle, shorter sessions. If it is sharp pain during strokes, rest it and see a professional.

Does menthol balm fix pickleball elbow? No topical product fixes the underlying cause. A menthol and camphor balm is for the temporary relief of minor aches and pains of muscles and joints. It can make the morning easier while you address grip, technique, and rest.