Get started
Menu
ExercisesConditionsGuidesToolsPricingFor physiotherapistsLog in Get started

Part of Padel injuries and how to keep playing

Common padel injuries

Padel injuries split cleanly into two groups, and the split is more useful than any single percentage. One group builds over weeks in the arm: the elbow first, then the shoulder, and mostly tendon problems that give you plenty of warning. The other arrives in a single moment in the leg, usually at the ankle or the knee, when a foot plants and the body carries on. In the Chilean survey that separated them, 85.7% of elbow and forearm injuries came on gradually while 64.7% of ankle and foot injuries came on suddenly. Almost every number on this page is a share of the injuries that people reported to a survey, not your risk of being one of them, because almost no padel study counted the hours anyone played; the few real per-hour rates are named as such where they appear.

Why the surveys disagree with each other

Four surveys, four different answers to the same question, and none of them is lying. A questionnaire handed to club players in Belgium counts what those players remembered about a year. A questionnaire handed to amateurs in Chile counts six months. One study asked only about the upper body. A systematic review then sets them side by side and reports ranges rather than one figure, because its authors judged that the differences in injury definition and design made pooling them impossible.

Then there is the missing bottom half of the fraction. A count of injuries becomes a risk only once somebody records the hours that everybody played, injured or not, and most padel studies never collected them. Where the hours were collected, the answer lands at 2.81 injuries per 1,000 hours of play in the Belgian survey, around 3 per 1,000 training hours in the systematic review, and 2.69 against 0.67 per 1,000 hours for amateur and professional women in the survey discussed in the questions below. Every other figure below is a slice of the injuries reported to a survey.

One more caution before the body parts. The systematic review listed its included studies and found most of them had been done in Spain, with injury definitions that varied from one to the next (Dahmen and colleagues, 2023, table 1); it scored their methodological quality at a mean of 7 out of 9 on the Joanna Briggs Institute tool. Ranges that look wide are usually telling you about the studies, not about the sport.

The elbow

The elbow is padel's signature complaint and the research agrees on that much. In the systematic review, every one of the five studies that reported individual joints put the elbow first, and one of those five could only ever have landed there, since it asked about the upper body and nothing else. The figures behind that run from 20.5% to 74.4% and do not measure the same thing: 20.5% is the elbow's share of the injuries in one study, while the top of the range is the percentage of players who named the elbow in another. A different set of five studies named a specific diagnosis, and the review says it could not extract one commonest diagnosis from them, though tendinopathy of the common extensor tendon, the thing usually called tennis elbow, was the one reported most often (Dahmen and colleagues, 2023, tables 3 and 4). In the Chilean survey the elbow and forearm accounted for 15.2% of the 184 injuries that named a body region (Belmar-Arriagada and colleagues, 2025, table 3), and 85.7% of those had come on gradually.

Why the elbow rather than the shoulder is a fair question and an unanswered one. The racket is shorter than a tennis racket (LTA), its hitting surface has no strings and is perforated with cylindrical holes (Federación Internacional de Pádel), the hand sits close to the impact, and the forearm muscles work to hold the wrist steady against a ball coming off a wall at an angle you did not plan for. That is a mechanism worth considering and nobody has measured it in padel players. The padel elbow page takes the equipment and the playing week apart, and tennis elbow is the loading program itself.

The shoulder, and where the overheads actually come from

A padel serve is underarm by rule: you bounce the ball on the ground first, then strike it at or below waist level with at least one foot touching the ground, having started with a foot behind the service line (Federación Internacional de Pádel, rule 6). So the serve is not what wears a padel shoulder out, which surprises most people arriving from tennis.

The overhead work lives somewhere else: the bandeja, the vibora, the smash. In 20 World Padel Tour matches covering 3,239 points, bandejas were played in 44% to 66% of points and flat smashes in 20% to 33%, across both sexes and all three sets (Martín-Miguel and colleagues, 2024, tables 3 and 4), and in 6 matches of the Italian men's second division 20% of all shots were struck above head height (Ungureanu and colleagues, 2022, table 2). Those are competitive players, not club players, so read them as the shape of the demand and not as your own count.

The shoulder then shows up second or third on every injury list: 15.2% of the 184 in the Chilean survey, a third of the 482 injured players in the 12-country questionnaire, and behind the elbow and knee in the systematic review (Belmar-Arriagada 2025, table 3; Muñoz 2022, table 4; Dahmen 2023, table 3). A painful shoulder that objects to the arm-up position belongs with rotator cuff tendinopathy, and shoulder pain when lifting your arm works through the alternatives if you are not sure that is what you have.

The knee

Knees sit high on the padel lists without ever leading them: second behind the elbow in the systematic review, fourth at 13.6% of the 184 in the Chilean survey (Dahmen 2023, table 3; Belmar-Arriagada 2025, table 3). No padel study has broken those knees down into diagnoses, so what follows is clinical reasoning rather than padel evidence.

Two patterns turn up in clinic. An ache at the front of the knee that builds over a few weeks, worse on stairs and after sitting, usually follows a lot of low volleys and deep positions at the net, and that is a loading problem treated by loading, which is the patellofemoral pain program. A twist on a planted foot that leaves the knee swollen, catching or locking is a mechanical problem and belongs with meniscus tear. An assessment separates them quickly, and the programs are not interchangeable.

Ankles and the Achilles

This is where the injuries arrive without warning. In the Chilean survey the ankle and foot was the single largest region, at 34 of the 184 injuries that named one, or 18.5% (Belmar-Arriagada and colleagues, 2025, table 3), and an exploratory analysis of onset put 64.7% of those as sudden, with ligament injuries sudden in 70% of cases. Anyone who has chased a lob into the back corner and stopped against the glass can supply the mechanism themselves.

A rolled ankle has its own staged program at ankle sprain, and the one thing worth knowing beforehand is when it needs an X-ray. The Ottawa ankle rules are a short checklist used in emergency departments for exactly that: an X-ray is needed if you could not take 4 steps immediately after the injury and still cannot, or if there is bone tenderness at the back edge or tip of either ankle bone.

A systematic review of 27 studies and 15,581 patients found the rules have a sensitivity close to 100% for excluding a fracture, with modest specificity, and that using them cuts unnecessary X-rays by 30% to 40% (Bachmann and colleagues, 2003). There is a matching pair of checks for the middle of the foot, and the ankle sprain page sets out both halves in full. They rule fractures out well. They are not a way to rule one in.

The calf and the Achilles are the quieter part of the same region and no padel study has reported them separately. A tendon that stiffens for the first few minutes each morning and eases as you move is behaving like Achilles tendinopathy, which is treated with graded loading rather than rest. A sudden snap or kicked feeling at the back of the ankle is a different event entirely, and the warning list sets out where to go with it and how fast.

The lower back

The lower back is on every list and near the bottom of most of them. In the systematic review the elbow comes first, and the back comes after the knee and the shoulder (Dahmen and colleagues, 2023, table 3). Nobody has studied padel and back pain directly, so no page can tell you the sport causes it or protects you from it.

What the game does ask for is plain enough. A smash arches and rotates the spine at speed, a bandeja does a smaller version of the same thing, and a low volley at the net asks you to hold a bent position while your arm works. Backs that have not done that before tend to complain the following morning, and most of the time that is a training story with a graded answer in the low back pain program. The exceptions are in the warning list, and the one that matters most is any change in bladder or bowel control or numbness around the saddle area.

The wrist, the hand, the face

Wrists and hands are a smaller group and a mostly gradual one: 81.8% of the wrist and hand injuries in the Chilean survey had built up instead of arriving (Belmar-Arriagada and colleagues, 2025). In the 12-country upper body questionnaire the wrist came third behind the elbow and shoulder, and that study found no association between sex and where an upper body injury landed (Muñoz and colleagues, 2022, table 4 and results). A fall onto an outstretched hand is the exception to the gradual rule, and the warning list covers the version of that which goes straight to an emergency department.

Faces and eyes have almost no padel research behind them. One Spanish survey inside the systematic review listed eye contusion at 1.7% of the injuries its players reported. Head and neck injuries together made up 10.2% by body part, and the neck alone 8.4% (Dahmen and colleagues, 2023, tables 3 and 4). Nobody has counted how often a ball off the glass, a partner's racket in a small court, or a run into a wall hits somebody in the head. Those entries are in the warning list because of what they cost if they are missed, not because anyone has shown they are common, and the honest position is that the frequency is unknown.

Two problems, two different answers

Everything above sorts into two piles. The arm pile is made of load: it builds over weeks, it warns you by making a full mug awkward or by stretching the morning stiffness a little longer each week, and it answers to graded loading plus a change in what you do on court before the problem settles in.

The leg pile is made of moments. A foot plants, the body keeps going, and there is nothing gradual about it. Nothing has been tested against that in padel players, so what physios suggest here is borrowed from other sports: being warm before the first point, having built strength rather than assumed it, and stopping when an ankle has turned over twice in a month instead of waiting for the third time.

Where the evidence behind any of that comes from other sports rather than from padel, the padel hub labels it as borrowed. That page also carries the exercises that cover the whole picture.

When to see a physio

One early appointment usually replaces three late ones. It is worth booking when something has held on for a fortnight, when you have started avoiding a shot without deciding to, or when you genuinely cannot tell whether the trouble is the shoulder, the neck or both. Book after an ankle gives way even if nothing broke, because the second one tends to follow the first.

What a clinician needs from you is the detail that separates one diagnosis from another: which shot sets it off, whether the morning after is worse than the evening, how many weeks it has been there, and what you have already tried. Expect to be watched before you are touched, and expect your playing week to be changed as much as your exercise list. Every line in the warning list below outranks all of this, at the timing each one gives, and none of them belongs to a physiotherapist first.

Related exercise programs

See a doctor promptly if

  • Emergency: if chest pain, pressure or tightness does not ease quickly when you rest, spreads to your arm, neck, jaw, stomach or back, or comes with sweating, feeling sick, feeling light-headed or being short of breath, call emergency services straight away, as this can be a heart attack. If it eases quickly and none of these happen, get medical advice the same day, and do not exercise again until you have been checked.
  • Emergency: after a fall or injury to the wrist, your hand is numb, tingles or has pins and needles, the wrist has changed shape or sits at an odd angle, or you heard a crack. The same applies to a bone showing through the skin or a cut that is bleeding heavily. Go to an emergency department or call emergency services straight away, and do not drive yourself. The wrist may be broken or out of place.
  • Emergency: your arm, hand or fingers turn cold, pale, blue or gray compared with the other side. Call emergency services or go to an emergency department straight away, and do not drive yourself. The blood supply to the arm may be blocked.
  • Emergency: the shoulder feels as if it has slipped out of place, looks a different shape or suddenly locks so you cannot move the arm, or the pain is severe after a fall or an injury. Go to an emergency department straight away, without driving yourself, and do not try to put the shoulder back in yourself.
  • Emergency: the knee became very swollen very quickly, within a few hours of a twist, fall or blow, or you felt a pop or snap. Go to an emergency department straight away. Do not drive yourself: ask someone to drive you or call an ambulance.
  • Emergency: the ankle or foot looks deformed or out of place, you heard a crack when you were injured, or the foot is numb, tingling, cold, pale or blue. Go to an emergency department straight away.
  • Emergency: pain, tingling, numbness or weakness in both legs, numbness or altered feeling around your genitals or bottom, or new trouble peeing or controlling your bladder or bowels. Call emergency services or go to an emergency department straight away. These can be signs of pressure on the nerves at the base of the spine (cauda equina syndrome).
  • Emergency: after a ball, a racket, a collision or a fall to the face, any change to your sight, severe pain in the eye, a headache or finding light hard to bear, feeling sick or being sick, an eye you cannot move or keep open, or blood or pus coming from the eye. The same applies if something has pierced the eye or hit it at high speed, or if a strong chemical has gone into it. Go to an emergency department or call emergency services straight away, and do not drive yourself.
  • Emergency: after a knock to the head, being very drowsy or finding it hard to keep your eyes open, confusion, a fit (seizure), new weakness or numbness anywhere in your body, new trouble understanding, speaking, walking or keeping your balance, new problems seeing or hearing, clear fluid coming from your ears or nose, bleeding from your ears or bruising behind them, a black eye when your eye was not hit, a dent in your head or a wound with something stuck in it, or a change in behavior. Call emergency services straight away. These can be signs of an injury to the brain.
  • Emergency: after a knock to the head, you were knocked out, even for a moment, you cannot remember what happened just before or after, you have had a headache ever since, or you are being sick (vomiting). The same applies, even if you feel fine, if you take medicine that thins your blood, other than aspirin on its own, have a bleeding or clotting condition, have had brain surgery in the past, or had been drinking alcohol or taking drugs when it happened. Go to an emergency department straight away, and do not drive yourself.
  • Same day: a sudden pop or snap at the back of your ankle or heel, a feeling that someone kicked you there, or sudden pain there after which you cannot push off or rise onto your toes on that leg. Stop, take the weight off that leg carefully and go to an urgent care center or emergency department the same day, even if you can still walk, as this can be a torn Achilles tendon.
  • Same day: you could not take 4 steps right after the injury and still cannot, or the back edge or tip of either ankle bone is tender to press. Get it checked for a fracture the same day. These are part of the Ottawa ankle rules, explained on this page.
  • Same day: a joint is hot, red and swollen, or you have joint pain with a high temperature or feel hot, cold or shivery. Get medical advice the same day, and go to an emergency department if you feel very unwell. This can be a sign of infection in the joint, which needs treatment quickly.
  • Same day: a calf or thigh that is newly swollen, warm, tender, red or darker than usual, has swollen veins that are sore to touch, or has a throbbing or cramping pain that does not fit your injury or condition, or that feels different from normal muscle soreness after exercise. This can be a sign of a blood clot (deep vein thrombosis), especially after surgery, an injury, time in a cast or boot, a long trip or a spell of being much less mobile than usual. Get medical advice the same day. If you are also short of breath or have chest pain, call emergency services.
  • Within a few days: the pain is there at night or at rest and keeps getting worse. See your doctor within a few days. If you have had cancer, now or in the past, or are losing weight without trying, see your doctor sooner, within a day or two, and mention it. This applies even if the pain is not getting worse. If you are being treated for cancer now, contact your cancer team the same day.

Common questions

What is the most common padel injury?

The elbow, in every survey that has looked at individual joints, and the usual diagnosis is the one called tennis elbow. The 2023 systematic review of 8 studies and 2,022 players found that all five of the studies reporting joints put the elbow first, at figures from 20.5% to 74.4% that are counting different things, some the elbow's share of the injuries reported and some the percentage of players who named it; one of those five asked only about the upper body, so it could not have found anything else. The review is explicit that it could not extract one most common diagnosis, though common extensor tendinopathy was the one reported most often across the studies (Dahmen and colleagues, 2023, tables 3 and 4). Surveys that group by region instead of by joint answer differently: the Chilean study of 364 amateurs put the ankle and foot first at 18.5%, with the shoulder and upper arm and the elbow and forearm tied at 15.2%, all three counted out of the 184 injuries that named a body region (Belmar-Arriagada and colleagues, 2025, table 3). Neither is wrong: they are counting different things, and both are counting injuries rather than players.

Do padel injuries come on suddenly or build up slowly?

Both, and which one you get depends mostly on where it is. The Chilean survey is the only one that reported onset by body region: 85.7% of elbow and forearm injuries and 81.8% of wrist and hand injuries came on gradually, while 64.7% of ankle and foot injuries were sudden; by tissue, 77.1% of tendon injuries were gradual and 70% of ligament injuries were sudden (Belmar-Arriagada and colleagues, 2025). That is one exploratory analysis inside one cross-sectional survey in one country, so hold it loosely. It matches what a physiotherapy clinic sees, though: arms complain for weeks before anyone books an appointment, and ankles book the appointment themselves.

Are women more likely to get injured playing padel?

The best recent evidence says no. Among 457 Belgian recreational players, female gender was not associated with a higher risk of injury, and the factors that were associated were age over 30, insomnia, less playing experience, playing on the right, doing a warm-up, using an overgrip and not playing another racket sport (Declève and colleagues, 2025). Two of those need reading, not acting on, because a retrospective survey cannot show which came first and the likeliest explanation is that the players who keep getting hurt are the ones who start warming up and who wrap the handle; nothing on this page treats either as advice. The Chilean survey found the same absence of a difference: 53.7% of women and 53.9% of men reported an injury in the previous six months (Belmar-Arriagada and colleagues, 2025, tables 1 and 3). A questionnaire of 950 amateur players from 12 countries tested the same thing for the upper body and found no association between sex and where the injury was, at p = 0.871, nor with what tissue was hurt, at p = 0.147 (Muñoz and colleagues, 2022, table 4 and results); the raw counts in that study put the wrist at 12.5% of the injured men against 6.8% of the injured women, which reads like a difference until you see that the test says it is not one.

Do professionals get injured more than club players?

It depends entirely on which measure you pick, and this is the clearest lesson in padel research. A survey of 80 elite professional and 147 amateur women reported a higher injury rate per hour in the amateurs, 2.69 against 0.67 per 1,000 hours, and a higher proportion of professionals reporting any injury at all, 61.1% against 40.1% (Escudero-Tena and colleagues, 2026). Those two facts are not in conflict. The likeliest explanation is that professionals play so many more hours that a lower rate per hour still adds up to more of them being hurt over a year, while amateurs pack more injuries into each hour on court. It is the same arithmetic that makes a per-hour figure the one worth asking for, and those figures are from the paper's abstract, since the full tables sit behind a paywall.

Is padel bad for your back?

The lower back appears on every list and never at the top of one. Among the sites reported in the systematic review, the elbow sits above it, and so do the knee and the shoulder (Dahmen and colleagues, 2023, table 3). No study has tested whether padel causes back pain, and given how common back pain is in people in their forties whatever they do at the weekend, that question is hard to answer without following players over years. What is reasonable to say is that the smash asks the spine to arch and rotate at speed, sometimes dozens of times an evening, and that a back unused to it will say so the next morning. The low back pain program is the graded version, and the warning list on this page covers the small number of back symptoms that are not a training problem.

References

  1. Dahmen J, Emanuel KS, Fontanellas-Fes A, Verhagen E, Kerkhoffs GMMJ, Pluim BM. Incidence, prevalence and nature of injuries in padel: a systematic review. BMJ Open Sport and Exercise Medicine. 2023;9(2):e001607. https://doi.org/10.1136/bmjsem-2023-001607
  2. Declève P, Nourissat G, Neyens D, Cools A, Borms D. Prevalence and injury profiles for recreational padel players: a cross-sectional survey-based study. Physical Therapy in Sport. 2025;75:8-14. https://doi.org/10.1016/j.ptsp.2025.07.002
  3. Belmar-Arriagada H, Gajardo-Burgos R, Armstrong R, Bascour-Sandoval C. Padel related injuries: prevalence and characteristics in Chilean amateur players, a cross sectional analytic study. BMC Sports Science, Medicine and Rehabilitation. 2025;17:173. https://doi.org/10.1186/s13102-025-01141-2
  4. Muñoz D, Coronado M, Robles-Gil MC, Martín M, Escudero-Tena A. Incidence of upper body injuries in amateur padel players. International Journal of Environmental Research and Public Health. 2022;19(24):16858. https://doi.org/10.3390/ijerph192416858
  5. Escudero-Tena A, Fernández-de-Osso AI, Ibáñez Godoy SJ, Conde-Ripoll R. Upper-body injury epidemiology in women's padel: impact of playing level, side of play, and racquet characteristics. Journal of Sports Sciences. 2026;44(16):2167-2179. https://doi.org/10.1080/02640414.2026.2711552
  6. Ungureanu AN, Lupo C, Brustio PR. Padel match analysis: notational and time-motion analysis during official Italian sub-elite competitions. International Journal of Environmental Research and Public Health. 2022;19(14):8386. https://doi.org/10.3390/ijerph19148386
  7. Martín-Miguel I, Almonacid B, Muñoz D, Sánchez-Alcaraz BJ, Courel-Ibáñez J. Game dynamics in professional padel: shots per point, point pace and technical actions. Sports. 2024;12(8):218. https://doi.org/10.3390/sports12080218
  8. Bachmann LM, Kolb E, Koller MT, Steurer J, ter Riet G. Accuracy of Ottawa ankle rules to exclude fractures of the ankle and mid-foot: systematic review. BMJ. 2003;326(7386):417. https://doi.org/10.1136/bmj.326.7386.417
  9. Federación Internacional de Pádel. Rules of Padel. Review of application 01.01.2026. Accessed 1 October 2026. https://www.padelfip.com/rules-of-padel/
  10. LTA. Padel rules. Accessed 1 October 2026. https://www.ltapadel.org.uk/play/how-to-get-started-playing-padel/rules/
  11. LTA. Padel vs tennis. Accessed 1 October 2026. https://www.ltapadel.org.uk/play/padel-vs-tennis/
  12. NHS. Chest pain. Page last reviewed 8 August 2023. https://www.nhs.uk/symptoms/chest-pain/
  13. NHS. Dislocated shoulder. Page last reviewed 16 September 2026. https://www.nhs.uk/conditions/dislocated-shoulder/
  14. NHS. Knee pain. Page last reviewed 21 December 2023. https://www.nhs.uk/symptoms/knee-pain/
  15. NHS. Tendonitis. Page last reviewed 9 June 2023. https://www.nhs.uk/conditions/tendonitis/
  16. NHS. Eye injuries. Page last reviewed 12 March 2026. https://www.nhs.uk/conditions/eye-injuries/
  17. NHS. Head injury and concussion. Page last reviewed 29 May 2025. https://www.nhs.uk/conditions/head-injury-and-concussion/
  18. NHS. DVT (deep vein thrombosis). Page last reviewed 30 April 2026. https://www.nhs.uk/conditions/deep-vein-thrombosis-dvt/

Written and checked by the PocketPhysio editorial team. Last updated 2026-10-01.

This page is general education, not a diagnosis or a personal treatment plan. See a physiotherapist or doctor for advice about your own situation.