Many pickleball players with elbow pain are told they have "tennis elbow."
While the diagnosis sounds accurate, it often misses an important distinction : pickleball elbow behaves differently, and treating it the same way is one of the biggest reasons pain becomes chronic.
As Houston’s Sports Shockwave MD, I treat pickleball and tennis elbow injuries daily across Houston, Clear Lake, Friendswood, and League City.
Why Pickleball Elbow Is Not the Same as Tennis Elbow
Both conditions involve injury to the tendon on the outside of the elbow (lateral epicondylitis), but the mechanism of injury is different.
Tennis elbow typically results from:
- Heavier racquets
- Longer, more forceful swings
- Higher impact forces with fewer repetitions
Pickleball elbow is commonly caused by:
- Repetitive wrist snapping
- Constant paddle gripping
- Vibration from hard courts
- Playing multiple days per week with minimal recovery
These repeated micro-stresses overwhelm the tendon’s ability to heal, leading to persistent pain and weakness.
Why Traditional Treatments Often Fail
Most players are advised to:
- Rest
- Ice
- Wear braces
- Take anti-inflammatory medications
These treatments may temporarily reduce symptoms, but they do not repair the damaged tendon.
Cortisone injections are also commonly used, but research shows they can:
- Weaken tendon tissue
- Delay long-term healing
- Increase the risk of recurrence
This is why many players feel short-term relief only to experience pain again when returning to play.
The Real Issue: Tendon Degeneration, Not Just Inflammation Chronic pickleball and tennis elbow are not simply inflammatory conditions.
They involve degenerative changes within the tendon, including reduced blood flow and disorganized collagen fibers.
Tendons heal slowly without targeted stimulation, which is why rest alone often fails.
What Actually Works for Pickleball & Tennis Elbow
As Houston’s Sports Shockwave MD, my treatment approach focuses on healing the tendon itself.
Effective management often includes:
- Accurate diagnosis of the tendon injury
- Load modification and return-to-play guidance
- Targeted strengthening programs
- Shockwave therapy to stimulate tendon regeneration
How Shockwave Therapy Helps Elbow Pain
Shockwave therapy uses acoustic energy to:
- Increase blood flow to the injured tendon
- Stimulate collagen repair
- Break down scar tissue
- Restart the body’s natural healing response
For many Houston pickleball and tennis players, this means:
- Reduced pain within weeks
- Improved grip strength
- Faster return to play
- Avoiding injections or surgery
Most patients benefit from 3–6 shockwave sessions, spaced about one week apart.
When to See a Sports Shockwave Specialist
If your elbow pain:
- Lasts longer than 4–6 weeks
- Returns every time you play
- Affects grip strength or daily activities
…it’s time for a sports medicine evaluation focused on tendon healing.
If you're dealing with pickleball or tennis elbow in Houston, working with Houston’s Sports Shockwave MD can help you heal faster and get back to the game you love.
Dr. Javier Rios MD is Houston's Nonsurgical Orthopedic & Sports MD.
