Shoulder and elbow pain from pickleball
Why does pickleball cause shoulder and elbow pain, and what helps?
By Pickleball Safety editors · Published October 4, 2026 · Last reviewed October 4, 2026
How common it is
Sore arms come with the game for a lot of players. In a 2026 nationwide survey of 1,758 players, 39% said they'd had at least one injury to the arm, shoulder or hand in the past year. Long-running overuse problems were the most common type (41%), ahead of sprains (24%) and strains (20%) [1].
A smaller survey of 253 recreational players found much the same thing. Of those, 41% reported at least one arm or shoulder injury, and most were chronic: 37.5% chronic against 10% sudden [2].
Elbow pain
Tennis elbow is the one most people have heard of. It causes pain or burning on the outer part of the elbow and can weaken your grip. It comes from overuse, repeating the same motions again and again, and it's most common between ages 30 and 50 [3].
In pickleball, though, the inner elbow may be the bigger problem. Researchers tested the playing arm of 129 players courtside. Tests for inner elbow pain were positive in 7% of them, and tests for outer elbow pain in 5.4%. The authors think lower elbow strain than tennis might explain fewer outer elbow cases, and the way players put spin on the ball might explain more inner ones [4].
Shoulder pain
Rotator cuff tears are among the injuries pickleball players get most often [5]. A fall onto an outstretched arm can tear the rotator cuff, and so can lifting something too heavy with a jerk. Most tears, though, come from wear over time, and the risk climbs after 40. Repeated overhead motion in sports like tennis adds to it [6].
Typical signs are pain at rest and at night, especially lying on that shoulder, weakness when lifting or rotating the arm, and a crackling feeling when you move it in certain positions [6].
What the research links it to
How much you play, and how you play it. In the survey of 253 players, the risk of an arm injury was 1.51 to 1.53 times higher in people who played longer or more often, or on back-to-back days. Sudden injuries were more likely with sessions over two hours, with play on consecutive days, and with a tight grip on baseline shots. Chronic injuries were more common in people who'd played more than two years, played at a higher level, or played more than six hours a week [2].
The nationwide survey found that men, people who played more days a week, newer players, and players who didn't think injury prevention mattered much were more likely to be hurt [1].
Both were surveys, so they show links rather than proof of cause. One result surprised us: in the smaller survey, players who did strengthening or stretching exercises had no fewer arm injuries than those who didn't [2].
Lowering the risk
The evidence here is thin, so treat these as sensible steps rather than proven ones.
Start with how much you play. In the survey of 253 players, sudden arm injuries were tied to sessions longer than two hours and to playing on back-to-back days [2]. Shorter sessions with a rest day between them cut out both. Grip matters as well. Players who held the paddle tightly on baseline shots had more sudden injuries [2].
For the elbow, the orthopaedic academy names poor stroke technique and the wrong equipment as possible risk factors for tennis elbow in racquet sports. If you're already sore, your doctor may suggest having your equipment checked for fit [3].
Don't play through shoulder pain that keeps building. Using a torn rotator cuff despite rising pain can make the damage worse [6]. Once a tear is diagnosed, strengthening the muscles that support the shoulder can ease the pain and help prevent further injury, but the academy says to check with a doctor or physical therapist before you start any shoulder exercises [6].
When to get it checked
For a shoulder, see a doctor about pain that keeps hanging on, because early treatment can stop the symptoms getting worse. If an injury leaves you suddenly weak, get it seen promptly, since a rotator cuff tear can grow over time [6].
Tennis elbow usually responds to treatment without surgery. Rest, anti-inflammatory medicine and physical therapy come first, and about 80 to 95% of patients do well without an operation [3].
Sources
- Understanding upper extremity injury prevalence and risk in pickleball players: a nationwide surveyBellm EJV, et al. JOSPT Open, 2026How common arm and shoulder injuries are, and what predicts them.
- Risk of upper extremity injury in recreational pickleball playersHanks J, Myers B. Journal of Functional Morphology and Kinesiology, 2025How session length, consecutive days and grip relate to arm injuries.
- Tennis elbow (lateral epicondylitis)American Academy of Orthopaedic Surgeons, OrthoInfoCauses, risk factors, symptoms and treatment of tennis elbow.
- Positive clinical tests for medial epicondylalgia are more common than tests for lateral epicondylalgia in recreational pickleball players: a cross-sectional studyMyers BA, Hanks J. Journal of Hand Therapy, 2025Inner and outer elbow pain in pickleball players.
- Common pickleball injuries and preventionSquali B, et al. Orthopaedic Nursing, 2026Common pickleball injuries and recommended prevention steps.
- Rotator cuff tearsAmerican Academy of Orthopaedic Surgeons, OrthoInfoCauses and symptoms of rotator cuff tears, playing through pain, and when to see a doctor.