- Top 5 padel injuries: Padel elbow, shoulder tendinopathy, ankle sprain, knee pain, and lower back — all predominantly overuse, not acute trauma
- 60% of padel injuries are overuse: cumulative load exceeding tissue capacity (Courel-Ibáñez et al., J Sports Sci 2017)
- Padel elbow treatment: Eccentric wrist extension + manual therapy resolves lateral epicondylitis in 6-12 weeks (Landesa-Piñeiro et al., 2022, 19 RCTs)
- Ankle sprain prevention: Proprioceptive training reduces recurrence risk by 50% (van Rijn et al., Br J Gen Pract 2007)
- Price: ₪400 per private 1:1 session · ★5.0 · 187 Google 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.
van Rijn et al. (Br J Gen Pract, 2007): Comprehensive physiotherapy including proprioceptive training reduced ankle sprain recurrence risk by 50% compared to advice alone. For padel players with any previous ankle history: functional ankle bracing during play + 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
- 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. Prevention programme initiated before pain appears is 3x more effective than rehabilitation after injury.
- 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. 15 minutes per week reduces recurrence risk by 50%.
- 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.
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