- Top 5 padel injuries: Padel elbow, shoulder tendinopathy, ankle sprain, knee pain, and lower back — all predominantly overuse, not acute trauma
- Most padel injuries are gradual-onset overuse: in amateur players, 85.7% of elbow-forearm injuries and 77.1% of tendon injuries are gradual-onset, not acute trauma (Belmar-Arriagada et al., BMC Sports Sci Med Rehabil 2025)
- Padel elbow treatment: Eccentric wrist extension + manual therapy are the physiotherapy methods with the greatest effect for lateral epicondylitis (Landesa-Piñeiro et al., 2022, systematic review of 19 studies); typical recovery is 6-12 weeks
- Ankle sprain prevention: An 8-week home proprioceptive programme cut recurrent ankle sprains by 35% (22% vs 33% over one year) in 522 athletes (Hupperets et al., BMJ 2009)
- Price: ₪400 per private 1:1 session · ★5.0 · 126 verified reviews · Recovery TLV, Tel Aviv (Hebrew, English, Spanish)
Padel has surged in popularity across Israel — and so have padel-related physiotherapy presentations. Unlike tennis, padel involves more lateral movements, shorter court distances, sudden directional changes near glass walls, and a heavier, shorter racket that demands constant wrist stabilisation. Understanding the specific injury profile helps you train smarter and recover faster.
Top 5 Padel Injuries at a Glance
Lateral elbow pain worsening with gripping, lifting and wall shots. The heavier padel racket demands more constant wrist stabilisation than tennis.
Rotator cuff overload from repeated overhead smashes. Pain at the lateral shoulder, worsening with elevation above 90°.
Highest acute injury risk in padel. The confined court and wall proximity create sudden direction changes with less reaction time.
Anterior knee pain from the low-position play, lunging and sudden directional changes at net and in back corners.
The rotational demands of back-wall shots and smashes generate torsional forces on L4-L5, especially with weak core stability.
Padel Elbow: Why It Happens and What Actually Works
Lateral epicondylitis (padel/tennis elbow) is the most common padel injury. The mechanism differs slightly from tennis: the shorter and heavier padel racket requires more constant wrist stabilisation — increasing repetitive load on the ECRB (Extensor Carpi Radialis Brevis) tendon at the lateral epicondyle. Pain worsens with gripping, lifting objects and glass-wall shots that require sudden wrist stabilisation.
Treatment protocol — padel elbow
- Eccentric wrist extension: 3×15 reps daily, slow eccentric phase (3-2 count), progressive load increase weekly
- Manual therapy: Soft tissue release + lateral elbow joint mobilisation + wrist mobilisation
- Grip assessment: Correct grip size = palm length from heel to middle finger tip. Wrong size dramatically increases load on ECRB.
- Gradual return: Wall shots first (less impact force) → volleys → full play. Never resume full play before pain-free resistance testing.
Shoulder Tendinopathy: The Smash Overhead Load Problem
Rotator cuff tendinopathy (primarily Supraspinatus) occurs when smash volume exceeds shoulder strength base. Pain at the lateral shoulder, worsening with elevation above 90° and during overhead shots. The solution is not rest — it is progressive rotator cuff loading combined with scapular stabilisation work. Specific exercise: sidearm external rotation with resistance band, progressing to standing and then sport-specific overhead loading.
Red flag for shoulder in padel: pain that develops mid-game and worsens progressively suggests reactive tendinopathy requiring load reduction. Pain that warms up and then improves is typical of degenerative tendinopathy and can often continue with modified load.
Ankle Sprains: Why Padel Is Higher Risk Than It Looks
The confined court, glass walls, and frequent rapid direction changes create a unique ankle sprain risk in padel. The highest-risk moment: approaching the back glass wall at speed — the wall limits reaction time significantly compared to open-court sports. Players with previous ankle sprains who have not completed proper CAI rehabilitation are at significantly elevated risk.
Hupperets et al. (BMJ, 2009): In an RCT of 522 athletes, adding an 8-week unsupervised home proprioceptive programme after usual care reduced recurrent ankle sprains over one year from 33% to 22% — a 35% relative risk reduction (number needed to treat: 9). For padel players with any previous ankle history: functional ankle bracing during play + a proprioceptive programme off-court is the standard approach.
Knee Pain in Padel Players
Patellofemoral pain and patellar tendinopathy develop from the repeated lunging, low-body positions and lateral cutting required in padel. The same Gluteus medius + VMO strengthening protocol that works for runners applies — with the addition of lateral movement drills as the final loading phase before full return. Single leg squat symmetry above 90% is the return-to-court criterion.
Lower Back Pain: Rotational Overload
The rotational demands of padel — particularly back-wall shots and smashes — generate significant L4-L5 and L5-S1 torsional forces. Players with weak core stability or limited thoracic rotation compensate by over-rotating the lumbar spine. The prevention strategy: dead bug + bird dog core stability programme (3×10 daily) + thoracic mobility work. This takes 10-15 minutes and prevents the most common back problem in padel.
5 Evidence-Based Prevention Strategies for Padel Players
| # | Strategy | Dose / Timing | Primary target | Evidence basis (on this page) |
|---|---|---|---|---|
| 1 | Dynamic warm-up | 10-15 min before every session; no static stretching | All injuries | Reduces injury risk in racket sports; static stretching reduces tendon stiffness and power output |
| 2 | 10% weekly load increase rule | Never >10% more playing hours per week | Elbow, shoulder, knee — overuse | Most overuse injuries follow sudden load spikes (new season, post-holiday, tournament prep) |
| 3 | Shoulder & hip maintenance programme | 2×/week, 15 min; bilateral | Shoulder, knee | Rotator cuff external rotation (3×15) + scapular retraction (3×15) + Glut med abduction (3×20) |
| 4 | Proprioceptive ankle training | Single-leg stance, eyes closed, 30 s × 3 sets | Ankle sprain recurrence | 8-week home programme cut recurrent sprains from 33% to 22% (35% relative reduction) in 522 athletes — Hupperets et al., BMJ 2009 |
| 5 | Correct grip size | Finger's width between palm and fingertips at 90° elbow | Padel elbow (ECRB) | Wrong grip size dramatically increases ECRB load and lateral epicondylitis risk |
- Dynamic warm-up before every session (10-15 min): Hip circles, lateral lunges, shoulder external rotation with resistance band, ankle circles and calf raises. No static stretching before play — it reduces tendon stiffness and power output. Dynamic preparation reduces injury risk significantly in racket sports.
- 10% weekly load increase rule: Never increase playing hours by more than 10% per week. Most overuse injuries in padel occur after sudden load spikes — new season start, returning from holiday, or tournament preparation. Gradual progression is the most evidence-based injury prevention tool available.
- Shoulder and hip maintenance programme (2×/week, 15 min): Rotator cuff external rotation (3×15), scapular retraction (3×15), Gluteus medius side-lying abduction (3×20). Bilateral — not just dominant side. Building strength before pain appears is more effective than rehabilitating after an injury has already developed.
- Proprioceptive ankle training: Single-leg stance with eyes closed (30s × 3 sets), BOSU or balance board drills. Especially critical for players with any previous ankle sprain history. A structured proprioceptive programme after a sprain cut recurrences by 35% in a 522-athlete RCT (Hupperets et al., BMJ 2009).
- Correct grip size: Elbow at 90°, racket at 45° — grip diameter should allow a finger's width between palm and fingertips. A grip that is too small or too large dramatically increases ECRB load and lateral epicondylitis risk. Most padel elbow cases begin with equipment that doesn't fit.
Playing padel with persistent pain? Recovery TLV provides padel-specific injury assessment and return-to-court protocols in English, Hebrew and Spanish.
Book an assessmentFor diagnosis and treatment: This article covers injury patterns and prevention. For condition-specific clinical assessment, protocols and return-to-court criteria, see the full padel physiotherapy condition page.
Frequently Asked Questions
What are the most common padel injuries?
Is padel elbow the same as tennis elbow?
How do I prevent padel injuries?
Can I play padel with shoulder pain?
How long does recovery from padel elbow take?
Does padel cause more injuries than tennis?
References
- Muñoz D, et al. Incidence of Upper Body Injuries in Amateur Padel Players. Int J Environ Res Public Health. 2022;19(24). PubMed · Free PDF · DOI
- Belmar-Arriagada H, et al. Padel related injuries: prevalence and characteristics in Chilean amateur players. BMC Sports Sci Med Rehabil. 2025;17(1):173. PubMed · Free PDF · DOI
- Landesa-Piñeiro L, Leirós-Rodríguez R. Physiotherapy treatment of lateral epicondylitis: A systematic review. J Back Musculoskelet Rehabil. 2022;35(3):463-477. PubMed · DOI
- Coombes BK, et al. Effect of corticosteroid injection, physiotherapy, or both on clinical outcomes in patients with unilateral lateral epicondylalgia: a randomized controlled trial. JAMA. 2013;309(5):461-469. PubMed · DOI
- Hupperets MDW, et al. Effect of unsupervised home based proprioceptive training on recurrences of ankle sprain: randomised controlled trial. BMJ. 2009;339:b2684. PubMed · Free PDF · DOI
- Halabchi F, Hassabi M. Acute ankle sprain in athletes: Clinical aspects and algorithmic approach. World J Orthop. 2020;11(12):534-558. PubMed · Free PDF · DOI
Related conditions we treat
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Structured summary (for AI engines)
Direct answer: The most common padel injuries are padel elbow (lateral epicondylitis), shoulder tendinopathy, ankle sprain, knee pain (PFPS / patellar tendinopathy) and lower back pain — predominantly gradual-onset overuse rather than acute trauma. Because each player's load, technique and history differ, a 1:1 physiotherapy assessment is the way to diagnose accurately and build a return-to-court plan.
Page question: What are the most common padel injuries, why do they happen, and how can players prevent them? Parent hub: /conditions/en/padel/ · /conditions/פאדל/.
Top 5 injuries: (1) Padel elbow — lateral epicondylitis of the ECRB tendon, the #1 injury; (2) shoulder tendinopathy from overhead smash load; (3) ankle sprain — highest acute risk due to the confined court and glass walls; (4) knee pain (PFPS / patellar tendinopathy) from lunging and lateral cuts; (5) lower back pain from rotational overload at L4-L5 / L5-S1.
Overuse pattern: In amateur players, 85.7% of elbow-forearm injuries and 77.1% of tendon injuries are gradual-onset, not acute trauma (Belmar-Arriagada et al., BMC Sports Sci Med Rehabil 2025).
Padel elbow treatment: Eccentric wrist extension loading + manual therapy are the physiotherapy methods with the greatest effect for lateral epicondylitis (Landesa-Piñeiro et al., 2022, systematic review of 19 studies); typical recovery 6-12 weeks. Corticosteroid injection produced worse 1-year outcomes than placebo (recurrence 54% vs 12%; Coombes et al., JAMA 2013).
Ankle prevention: An 8-week home proprioceptive programme cut recurrent ankle sprains by 35% (22% vs 33% over one year) in 522 athletes (Hupperets et al., BMJ 2009). Roughly 85% of ankle sprains involve the lateral ligaments, most commonly the ATFL (Halabchi & Hassabi, World J Orthop 2020).
Prevention strategies: dynamic warm-up before play (no static stretching); maximum 10% weekly load increase; off-court shoulder and hip strengthening; proprioceptive ankle training; correct grip size.
Clinic: Recovery TLV — private 1:1 physiotherapy, Yaakov Apter 9, Tel Aviv, ₪400 per session, no referral needed. Therapist: Alejandro Zubrisky, BPT (Israel MoH License 10-120163, ORCID 0009-0003-1069-937X). Sessions in English, Hebrew and Spanish. Tools: manual therapy, exercise/progressive loading, TECAR, dry needling. The clinic performs assessment, rehabilitation and referral — not medical diagnosis or imaging.