You do not need to play tennis to end up with tennis elbow. Ask around any pickleball court on a Saturday morning, or among neighbors who just finished a big fall cleanup, and you will likely find someone rubbing the outside of their elbow and wondering why lifting a coffee mug suddenly hurts.
Tennis elbow is one of the most common overuse problems in active adults, and two popular pastimes, pickleball and yard work, are frequent culprits. This article explains what the condition is, why these activities tend to bring it on, what people usually try first, and where shockwave therapy fits for elbow pain that will not settle down.
What Tennis Elbow Actually Is
The medical name is lateral epicondylitis. It involves the tendons that connect the muscles of the forearm to a bony bump on the outer side of the elbow, called the lateral epicondyle. Those forearm muscles extend the wrist and fingers and help stabilize the wrist whenever you grip something.
The condition usually develops from overuse rather than a single injury. Repeating the same gripping and wrist motions over and over places stress on the tendons where they attach to the bone. Natural wear in the tendons over time, or a direct injury, can also play a role. The result is pain on the outside of the elbow that often worsens when you grip or lift.
Why Pickleball Brings It On
Pickleball has drawn in huge numbers of new players, many of them adults who had not played a racquet sport in years. That enthusiasm is great for fitness, but it often means a sudden jump from little activity to several games a week.
Each shot asks the forearm muscles to grip the paddle and hold the wrist steady at contact. Backhand shots, in particular, load the muscles on the back of the forearm that attach near the outer elbow. Add long sessions, back-to-back games, and the temptation to play through soreness, and the tendons may not get the recovery time they need.
Equipment and technique can matter too. A paddle grip that does not fit your hand well, squeezing the handle too tightly, or relying on the wrist instead of the shoulder and body to generate power may all add strain.
The Yard Work Connection
Yard work rarely gets blamed for elbow pain, but it involves many of the same motions. Pruning with hand shears, pulling weeds, raking leaves, and running a string trimmer or hedge trimmer all require sustained gripping and repeated wrist movement.
Timing is part of the problem. Many people tackle yard projects in bursts, such as a weekend of spring pruning or a full day of clearing fall leaves. In parts of the Sacramento region, including Carmichael, where large trees and long growing seasons keep gardeners busy, those bursts can add up. Hours of continuous gripping after weeks of lighter activity is the kind of sudden load that tendons handle poorly.
Early Signs Worth Paying Attention To
Tennis elbow often starts as a mild ache that is easy to dismiss. Over days or weeks, it may become more noticeable during everyday tasks that involve gripping or lifting, such as:
- Picking up a cup, a jug of milk, or a full bag
- Shaking hands or turning a doorknob
- Holding a paddle, a tool, or a steering wheel
- Typing or using a computer mouse for long periods
The pain is usually centered on the outside of the elbow and may spread down the forearm. Some people also notice that their grip feels weaker than usual. If you have numbness, tingling, or pain that started with a fall or a pop, those are reasons to have the elbow checked promptly, since they may point to a different problem.
First Steps Most People Try
For many people, tennis elbow improves with time and sensible changes. Common first steps include resting the arm from the activities that aggravate it, adjusting equipment or technique, using cold packs for pain, and wearing a properly fitted brace to reduce strain on the tendon. Exercises and therapy aimed at restoring strength and range of motion are often part of the plan.
Changing how you play or work can make a real difference. That might mean shorter pickleball sessions with rest days in between, lessons to improve stroke mechanics, or splitting a big yard project across several days.
When symptoms persist despite these measures, other options may be considered. Injections are sometimes used, and surgery is generally reserved for cases where other treatments have not helped. Shockwave therapy is one of the non-invasive options that falls between those two ends.
Where Shockwave Therapy Fits
Shockwave therapy uses acoustic sound waves, delivered through a handheld device placed on the skin, to target an irritated tendon. The waves are intended to increase circulation in the area and stimulate the body’s own repair processes. There are no incisions, needles, or medications involved.
It is most often considered for tendon problems that have lasted for months rather than days, typically after rest and other conservative steps have not been enough. For tennis elbow, that often describes the player who has taken weeks off, tried a brace, and still feels pain every time they pick up a paddle.
Research on shockwave therapy for tennis elbow has produced mixed results. Some studies report meaningful short-term improvement with few side effects, while others have found smaller benefits. That is why it is best viewed as one option within a broader plan, chosen after an evaluation, rather than a guaranteed fix.
What Treatment Typically Involves
Sessions are short, often under ten minutes, and are usually repeated over several weeks. Mild tenderness during treatment is common, and most people return to their normal routine the same day. A provider will typically recommend continuing to modify the activities that caused the problem while treatment is underway, since returning to full play too soon can stall progress.
How Chiropractic Care Fits Alongside It
An elbow problem is rarely only about the elbow. How you use your wrist, shoulder, upper back, and even your neck affects how much load reaches the forearm tendons. A stiff shoulder, for example, may cause a player to rely more heavily on the wrist and forearm during each swing.
This is where chiropractic care can complement treatment aimed directly at the tendon. A holistic chiropractor looks at how the whole arm and upper body are moving, not just the painful spot. Depending on the evaluation, chiropractic therapy might be paired with shockwave treatment, massage for tight forearm muscles, or other supportive care. For people looking for one place to explore these options, a Chiropractic wellness clinic that offers several services under one roof can make it easier to coordinate care.
Practical Adjustments for Players and Gardeners
A few habits can lower the strain on your forearm tendons, whether you are recovering or trying to avoid a first episode.
Warm up before you play or work. Gentle arm circles and light wrist movement before a game or a gardening session prepare the muscles for heavier use.
Loosen your grip. Holding a paddle or tool only as tightly as needed reduces constant tension in the forearm.
Check your equipment. A paddle grip that fits your hand, and garden tools with padded or larger handles, can make each grip less demanding.
Pace yourself. Spread big yard projects across several days, and build up pickleball time gradually rather than jumping from occasional play to daily matches.
Switch tasks and hands when possible. Alternating between activities that use different motions gives the tendons short breaks throughout the day.
Keep up with prescribed exercises. If a provider has given you forearm or grip exercises, do them consistently, even after the pain eases. Stronger supporting muscles can help the tendons tolerate the next long match or weekend of yard work.
Listen to early warning signs. A mild ache after play is a signal to scale back for a few days, not to push harder. Catching irritation early usually makes it easier to settle.
Getting Back to the Court and the Garden
Tennis elbow can be stubborn, but it is a well-understood condition with a range of non-surgical options. Most people start with rest, smarter technique, and better equipment. For pain that lingers for months despite those changes, shockwave therapy may be worth discussing with a provider who can evaluate the whole arm. The goal is the same either way: getting back to the games and the yard you enjoy without that familiar ache on the outside of your elbow.
About Baratta Holistic Center
Dr. Tony Baratta leads Baratta Holistic Center, a chiropractic office in Carmichael, California, that combines chiropractic adjustments with shockwave therapy, massage therapy, cold laser therapy, and spinal decompression. Each patient’s care starts with an individual evaluation. The office can be reached at (916) 979-0716, and you can Get directions through Google Maps.
