Padel was created in the 1960s by Enrique Corcuera, a Mexican entrepreneur, who adapted tennis to be played in a smaller space. It first spread in Spain, and then the sport quickly expanded to over 40 countries, becoming one of the most widely practiced sports in the world.
Although the popularity of padel has grown exponentially, knowledge about injury rates is limited. There is no consensus on the definition of injury provided by the International Padel Federation, which can lead to misdiagnoses and an underestimation of injuries.
Scientific studies have shown that injuries are common among padel players, with an incidence rate of 3 injuries per 1,000 hours of training.
The elbow is the most frequently reported injury site, with lateral epicondylitis being the most commonly diagnosed condition. Compared to other racket sports, padel appears to have a higher incidence of elbow injuries.
This finding may be related to the fact that the elbow is subjected to high mechanical demands due to the repeated eccentric contractions that occur after hitting the ball. Another reason for the high prevalence of tendon injuries could be that the racket does not have strings.
Elbow tendinitis: Why does it occur?
Elbow tendinitis, also known as “tennis elbow,” primarily develops due to:
- Muscle overuse: Excessive use of the forearm muscles, combined with incorrect technique, can lead to tendon overload. Hitting the ball with too much force or without proper alignment increases the risk of inflammation.
- Repetitive movements: Repeated strokes, especially those requiring strong wrist extension and forearm twisting, place significant stress on the elbow tendons.
- Inadequate posture: Incorrect technique, especially in strokes involving the arm and wrist, can place excessive stress on the tendons of the elbow.
- Stiff rackets: Using rackets that are too stiff or have overly tight strings transfers greater impact to the arms and elbows, causing repeated micro-traumas.
Symptoms of Tendinitis
The main symptoms of elbow tendinitis are:
- Localized pain on the lateral epicondyle, which may extend along the forearm.
- Stiffness and weakness in the arm, especially when trying to grip or lift objects.
- Pain during the execution of strokes, such as forehand or backhand, especially when performed with force and without proper technique.
- Increased pain with physical activity, which improves only with rest.
During the examination, the doctor checks for signs of tenderness or swelling and then assesses the strength and mobility of the forearm, also observing how the elbow responds to specific stress tests to gain a more comprehensive understanding of the patient’s condition.
To confirm the diagnosis, specific provocation tests are used, such as Cozen’s test, Mill’s test, and Maudsley’s test.
Although the diagnosis is primarily based on the clinical examination, in some cases, the doctor may decide to use imaging tests to rule out other conditions or to more precisely assess the extent of inflammation and tendon damage. An ultrasound can help identify signs of inflammation, tendon injuries, or the presence of calcifications. In more severe or complex cases, an MRI may be recommended for a detailed analysis.
My elbow hurts. What should I do?
The treatment for elbow tendinitis primarily focuses on giving the elbow the necessary time to heal. If the pain persists, it is advisable to reduce or temporarily suspend sports activities to prevent the condition from worsening.
An effective remedy is applying ice for 15-20 minutes several times a day; it helps reduce inflammation and swelling.
In some cases, the use of non-steroidal anti-inflammatory drugs (NSAIDs) can be helpful in relieving both pain and inflammation, facilitating the recovery process.
Treatments such as ultrasound, laser therapy, or shockwave therapy can be used to stimulate tendon healing and accelerate recovery.
Joint mobilization throughout the entire arm plays a crucial role in the treatment of tendinitis. It is essential to maintain proper movement in all joints, from the shoulder to the elbow, wrist, and hand. Pain often causes these joints to stiffen, and continuing treatment without addressing this stiffness is ineffective. Ensuring that the joints can move correctly is, therefore, vital for a full recovery.
At the same time, performing muscle-strengthening exercises is equally important. Strengthening the muscular structures that support the joints and increasing their load capacity is a fundamental step in rehabilitation. Exercises for strengthening the wrist, hand, elbow, and shoulder should be introduced in the early stages of rehabilitation, starting with isometric contractions to avoid excessive strain, and gradually progressing to exercises involving greater movement and more complex joint control. This gradual approach helps restore proper balance and functionality to the arm.
Prevention: A Key Factor
To prevent elbow tendinitis, it is essential to learn and maintain proper playing technique, avoiding overly forceful strokes, especially when control is limited. Regular stretching is important to improve the flexibility of the forearm muscles and tendons. Additionally, muscle strengthening helps prevent tendon overload, as does strengthening the shoulder and wrist muscles, which play a crucial role. Avoid playing for long periods without breaks; even with mild pain, it is vital to give the elbow time to recover to prevent more severe inflammation. Lastly, an overly tight or incorrect grip can increase stress on the elbow.
Elbow tendinitis in padel is an injury that can be prevented with proper technique, adequate training, correct warm-up, and the use of appropriate equipment. If pain arises, it is important not to ignore it and take measures to reduce the overload, preventing the inflammation from becoming chronic and jeopardizing the ability to play.
