Common padel injuries, and what to do about them

Padel is easy to pick up and hard to put down, which is most of its appeal and part of the reason so many players end up with a sore elbow. A systematic review of padel injury studies found that the elbow is the most commonly injured area, followed by the knee, the shoulder and the lower back, and that most padel injuries affect tendons and muscles rather than bone [1].

That pattern is not random. It follows from what the sport actually asks the body to do, and knowing which demand produces which problem is the most useful thing a player can take away.

Why does padel cause the injuries it does?

Padel loads the body in a particular way. Repeated overhead shots load the shoulder, repeated gripping and wrist extension load the elbow, and a small court means constant short, sharp changes of direction. Because the walls keep the ball in play, rallies last longer and those same movements repeat more often [2].

Four demands do most of the work:

• The overhead smash. Raising the arm repeatedly above shoulder height, and rotating it outwards as you do, reduces the space available under the top of the shoulder. Padel's smaller court increases both the number of overhead shots played and the number of these combined movements [2].
• Gripping and wrist extension. Holding and controlling the racket means the forearm muscles that straighten the wrist contract over and over. The overload that follows lands on their shared attachment on the outside of the elbow [2].
• Playing the ball off the glass. The walls keep the ball alive, so points last longer and are played from later, more awkward positions than they would be in tennis. More shots per point means more repetitions of everything above [2].
• Lateral movement and lunging low volleys. Fast sideways movement, quick changes of direction and explosive pushes towards the net are what the lower limb absorbs [2].

There is a nuance in the research worth knowing. The elbow is the most commonly injured single structure, but the lower limb as a whole region accounts for more injuries than anywhere else, with the knee leading it [2]. A separate study of padel players treated at a German trauma centre found the lower leg, ankle and foot to be the most affected region in that group, ahead of the elbow [4]. Findings differ by population and setting, and both are useful: the elbow is the one you are most likely to feel, the lower limb is where the volume sits.

The padel injuries physiotherapists see most often

Padel elbow

"Padel elbow" is what players call pain on the outside of the elbow, and it is the same tendon problem as tennis elbow. It is typically described as a tender point on the bony ridge on the outside of the elbow, sore when gripping the racket, shaking hands or lifting a kettle, and often worse the morning after a match than during it.

Padel produces it through repeated contraction of the forearm extensor muscles and the mechanical overload that follows, particularly on the extensor carpi radialis brevis tendon - one of the tendons that straightens the wrist and attaches at the outside of the elbow [2]. There is a detail here that matters for club players: in the German study, players who did not also play other rebound sports injured their elbow significantly more often than those who did [4], which puts newcomers to racket sports in the group most likely to feel it.

An assessment usually looks at how much you have been playing, your grip and your technique as well as the elbow itself, and management typically combines adjusting load with progressive strengthening. There is more detail on our tennis elbow and golfer's elbow page.

Knee pain

The knee is the second most commonly injured area in padel [1], and among non-professional players in the German study it was the most common site of all, accounting for around one in five injuries [4]. It is the joint that pays for the split steps, the lunging low volleys and the repeated pushing off sideways on a short court.

Padel knees usually present in one of two ways: pain that builds gradually over several weeks of playing more than usual, or a sudden twisting incident during a point. The first is typically an overload problem; the second needs looking at, and a meniscus tear is one of the things an assessment would rule in or out. Our knee pain and injuries page covers both.

Shoulder pain

Shoulder pain is the third most commonly reported area [1], and the smash is the shot behind it. Three-dimensional motion analysis of professional and amateur padel players found that the large ranges of movement used in overhead strokes could raise the risk of shoulder impingement, tears to the rim of the shoulder socket, and a loss of inward rotation at the joint [3]. Players tend to notice it as an ache at the front or side of the shoulder when reaching overhead, and sometimes as a night-time ache lying on that side.

The encouraging half of the same research is that technique matters: correct execution of the stroke was linked to better dynamic control of the ball of the shoulder joint, and the more experienced players moved differently from the less experienced ones [3]. Coaching on the smash is a reasonable thing to invest in for reasons beyond winning the point. See shoulder impingement and shoulder pain and rotator cuff injuries.

Lower back pain

The lower back is fourth in the review's rank order [1]. Padel asks it to rotate, extend and stay low, often in the same rally, and it is usually the players who spend the working week sitting and the weekend playing three matches who feel it. Back pain that keeps returning after every session, or that limits how you move for days afterwards, is worth having assessed rather than managed match by match. Our lower back pain page explains what that involves.

Achilles and calf

The lower leg, ankle and foot were the single most affected region in the German trauma-centre study, at around 18% of injuries [4]. Padel's short accelerations towards the net and repeated push-offs load the calf and Achilles tendon heavily, and the classic presentation is either a gradual morning stiffness at the back of the heel or a sudden sharp pain in the calf mid-point. The first is usually an overload problem; the second needs assessing promptly. See Achilles tendon pain.

Ankle sprains

Ankles get turned in padel the way they do in every court sport: a change of direction that arrives faster than expected, or an awkward landing after a smash. Sprains vary a great deal in what has actually been damaged, so an ankle that keeps going over, or that feels unreliable on a quick turn weeks later, is worth assessing rather than strapping. Our ankle sprains and ligament injuries page sets out what recovery usually looks like.

Wrist and forearm

Wrist and forearm soreness often travels with elbow pain, because the muscles doing the gripping run between the two [2]. There is no padel-specific injury data on the wrist that we would rely on, so treat forearm ache as what it usually is: a signal that grip, racket weight and playing volume are worth a look before it becomes an elbow problem.

Can you reduce your risk of a padel injury?

No sport removes the risk of injury, but there is reasonable evidence that technique and strength matter. The authors of the German study recommend training aimed at improving playing technique and muscle strength [4], and the motion-analysis research found correct stroke execution linked to better control at the shoulder [3]. Four general principles follow from that.

• Warm up before the match rather than during the first two games. Something that raises the heart rate and takes the shoulders, hips and ankles through the ranges the game will demand. Many players find the first few points feel a lot less abrupt for it.
• Get eyes on your technique, especially the smash. Padel is easy enough to play badly and still enjoy, which is exactly why self-taught overhead technique goes unchecked for years.
• Increase how much you play gradually. Tendon and muscle injuries are the most reported type in padel [1], and they build over weeks rather than arriving in a moment. Going from one session a week to four is the kind of change worth making in steps.
• Do some general strength work. Legs, hips and shoulders. It is the least padel-specific advice here and probably the most useful.

Two things are worth adding for younger players. Juniors are often playing several sports in the same season, so the total load across all of them is what counts, not just the padel. And pain that a young player keeps mentioning is worth having looked at rather than played through - it is far easier to manage a grumbling tendon than a stubborn one.

Padel is a sport worth playing regularly, and most players who look after these basics keep playing it for years. If you are looking for courts near you, our guide to where to play padel in Sheffield, Derbyshire and Nottinghamshire covers the region.

When should you see a physiotherapist about a padel injury?

It is worth booking an assessment if any of the following apply:

• Pain that is still there after a week or two of playing less.
• Pain that returns every time you play, however well it settles in between.
• Swelling, a joint that gives way, locks or catches, or a loss of movement.
• Pins and needles, numbness or weakness in the arm or leg.
• A sudden, sharp injury during a point, particularly in the calf, knee or ankle.
• Any pain in a junior player that keeps coming back.

An assessment is there to work out what is actually happening, not to tell you to stop playing. Our physiotherapy service and our sports injuries service both handle padel injuries, and you can book without a referral. We also run [a physiotherapy clinic inside Padel 18 in Dronfield]([TO CONFIRM: Dronfield relaunch article URL]).

Book an appointment

This article is general information and not a substitute for individual assessment. To have a padel injury looked at, book an appointment online or call 0114 230 2030 to speak to a member of the physiotherapy team. The White House Clinic has 14 clinics across South Yorkshire, North East Derbyshire and Nottinghamshire, and no referral is needed to be seen.

References

1. Dahmen J, Emanuel KS, Fontanellas-Fes A, Verhagen E, Kerkhoffs GMMJ, Pluim BM. "Incidence, prevalence and nature of injuries in padel: a systematic review." BMJ Open Sport & Exercise Medicine, 2023; 9(2): e001607. Eight studies, 2,022 participants; approximately 3 injuries per 1,000 hours of training and 8 injuries per 1,000 matches: https://pubmed.ncbi.nlm.nih.gov/37337550/
2. Cocco G, Ricci V, Corvino A, Abate M, Vaccaro A, Bernabei C, Cantisani V, Vallone G, Caiazzo C, Caulo M, Delli Pizzi A. "Musculoskeletal disorders in padel: from biomechanics to sonography." Journal of Ultrasound, 2024: https://pmc.ncbi.nlm.nih.gov/articles/PMC11178742/
3. de Sire A, Demeco A, Frizziero A, Marotta N, Spanò R, Carozzo S, Costantino C, Ammendolia A. "Risk of injury and kinematic assessment of the shoulder biomechanics during strokes in padel players: a cross-sectional study." Journal of Sports Medicine and Physical Fitness, 2024; 64(4): 383-391: https://pubmed.ncbi.nlm.nih.gov/37955931/
4. Meyer H-L, Birkner L, Polan C, Mester B, Herten M, Dudda M, Burggraf M. "Injuries and overuse injuries in padel tennis: a retrospective epidemiological cross-sectional study of a level 1 trauma center in Germany." Journal of Sports Medicine and Physical Fitness, 2025. 234 players; lower leg, ankle and foot the most affected region at 18%; knee the most common site in non-professionals at 19.6%: https://pubmed.ncbi.nlm.nih.gov/40677135/