How to treat tennis wrist pain, according to physical therapists
Tennis wrist pain and injuries can strike seasoned players and beginners. Here's how to treat tennis wrist issues so you can feel (and play) better.
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Playing tennis (or pickleball) is great for you. It improves cardiovascular health, strengthens muscles, and enhances flexibility and coordination — all while promoting joint health by improving balance and mobility. It’s a great full-body workout that helps build endurance, agility, and overall fitness. But sometimes playing tennis can lead to wrist pain or injuries. Repetitive movements — hitting the ball with your racket (forehands, backhands, volleys, serves, over and over) — can strain the muscles in your wrist. “Wrist pain crops up frequently among tennis players, but it’s very treatable,” says Alec Martinez, PT, DPT, a physical therapist at Hinge Health.
Even though most cases of tennis pain are mild and resolve on their own with conservative measures such as exercise and physical therapy, it’s important to address tennis wrist pain proactively. Wrist pain can make everyday activities, such as washing the dishes or carrying groceries, challenging and even painful. Fortunately, you can alleviate tennis wrist pain through gentle stretches and strengthening movements.
Here, learn more about what causes tennis wrist pain and how to treat it, especially with tips and exercises from Hinge Health physical therapists.
Revisado por nuestros expertos clínicos y médicos
Alec Martinez, PT, DPT
Christynne Helfrich, PT, DPT
Causes of tennis wrist pain
Tennis wrist pain can happen to anyone who plays tennis, but may be more likely in certain situations.
Overuse. “The most common reason I see patients with tennis wrist pain is because they’ve increased their time on the court too quickly,” explains Dr. Martinez. “Your wrist muscles need time to acclimate.” If you ramp up too fast (intensity or duration on the court), you may be more likely to have wrist pain afterward.
Equipment changes. You can think of trying a new racket like breaking in a new pair of shoes — it can take your body some time to get used to this change. “If you change something about your racket, whether it’s the tension of your strings or the size of your grip, you may develop tennis wrist pain,” says Dr. Martinez. “These changes may seem small, but they can impact how much force is placed on your arm and wrist.”
Your technique. The culprit behind your tennis wrist pain may be your grip, or how you hit the ball, says Dr. Martinez. In fact, one 2019 review found that having a very tight grip on the racket increases pressure on your wrist by about 20%. It's common for tennis players to adjust their strokes and serve to improve their technique. But if you're having pain after, it may mean that your wrist needs some time to adjust. “If you’re not used to a particular type of serve but start to practice it, you can develop a wrist sprain or strain,” explains Dr. Martinez.
Common tennis wrist injuries
Sometimes wrist pain after tennis can be due to an injury in your tissues. Here are the three common ones.
Tendonitis. This is the most common tennis wrist pain injury, says Dr. Martinez. “There are two main groups of tendons in your wrist: wrist flexors, which help you close your hand around your racket, and wrist extensors, which you use to bend your wrist back and up when you play backhand,” says Dr. Martinez. These tendons run through narrow tunnels known as sheaths, which protect and support them. If you overuse your wrist, the sheaths can become inflamed, contributing to tennis wrist pain.
Wrist sprains. While these are a less common reason for tennis wrist pain than tendonitis, they can happen, especially if you make a sudden move where you have to hyperextend your wrist joint, says Dr. Martinez. When you sprain your wrist, it means your ligaments have stretched too much and, in some cases, may partially tear. That’s why sprains can be painful and cause weakness.
Carpal tunnel syndrome. Carpal tunnel syndrome is when the median nerve — one of the main nerves in your hand — becomes swollen and inflamed. While it doesn’t usually directly cause tennis wrist pain, if you already have carpal tunnel symptoms, playing tennis may cause an uptick in pain. “I see it in patients who do a lot of desk work but also play tennis — overuse from both activities can worsen symptoms like pain, tingling and numbness in your wrists,” says Dr. Martinez. Research suggests that about half of elite tennis players have symptoms of carpal tunnel syndrome.
Symptoms of wrist pain after tennis
An occasional ache or pain after a vigorous tennis match is okay. But if symptoms persist or start happening often, it may be a good idea to see a provider. Watch out for:
Pain and soreness. You’ll often experience this at the crease of your wrist, either in the front or the back.
Wrist swelling.
Wrist stiffness. “You may find it hard to bend or extend your wrist,” says Dr. Martinez.
Hand weakness. “Since a lot of your wrist muscles extend into your fingers, you may notice weakness when you use them for everyday activities like writing or buttoning your shirt, for example,” explains Dr. Martinez. You may also notice decreased grip strength when you hold onto your racquet, too.
Exercises for tennis wrist pain
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- Resisted Wrist Flexion
- Wrist Extensor Stretch
- Wrist Flexor Stretch
- Towel Wringing
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
The above exercises are recommended by Hinge Health physical therapists to treat and prevent tennis wrist pain. When your wrist is sore or stiff, stretching it can help increase flexibility and increase its range of motion. Subsequently, strengthening the tendons and ligaments in your wrist can help improve their stability and support, so you can swing your racket with power.
The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.
Treatments for tennis wrist pain
Tennis wrist pain is very treatable and usually can be managed at home with some simple self-care measures, says Dr. Martinez. Here’s how to deal with wrist pain.
Exercises and physical therapy. Wrist exercises are important to help manage your discomfort. The wrist stretches and exercises listed above are a good place to start. “Most causes of tennis wrist pain are due to increased strain on wrist muscles,” explains Dr. Martinez. If you strengthen them, you’ll be less likely to develop a chronic problem. But if your tennis wrist pain doesn’t improve, or the symptoms return, Dr. Martinez recommends trying physical therapy. A physical therapist can tailor an exercise plan for your needs and help you make other adjustments in your routine (both on and off the court) to reduce wrist pain. Note: You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.
Massage. You can use a massage gun, a massage ball, or even your hands to massage your wrist area. “There’s no one perfect technique — you may want to try two or three of these options before you settle on the one that feels right for you,” says Dr. Martinez. You can use whichever method feels best when you need relief and before or after playing tennis. “When you stimulate your wrist muscles, you help to activate them for exercise,” explains Dr. Martinez. “After your game, massaging can relax tight muscles and boost circulation to help the area repair itself.”
Compression sleeve. If you have swelling, wearing a compressive accessory can help in the early stages of tennis wrist pain. “Swelling itself is important, because it brings valuable nutrients to the area to help your wrist heal,” says Dr. Martinez. “But a compression sleeve can help reduce swelling enough to keep you comfortable.” A tool like this is a short-term fix — keeping up with your stretches and exercises will help address the root problem.
Ice or heat. In the first 48-72 hours of a wrist injury, try using ice to numb pain and reduce swelling. After that, you can switch to heat to help bring blood to tight, stiff muscles, advises Dr. Martinez. After the first three days, you can opt for either ice or heat if you have a preference, as they’re both effective.
How to prevent tennis wrist pain
No one wants to be sidelined by tennis wrist pain. Hinge Health physical therapists recommend these tips to prevent aches and pains.
Work your arms. It’s important to develop a strength and conditioning program for your arms, including your wrists, says Dr. Martinez. If you notice some discomfort when you lift weights, start with light resistance bands or small weights to help strengthen those muscles. You can use stress balls to strengthen your grip, too.
Listen to your body. To prevent pain during activities, “you want to find your movement sweet spot,” says Dr. Martinez. Your sweet spot is based on how you feel. Aim to find an intensity that allows you to feel challenged, but not overextended. Start out easier and progress as you feel ready. Either way, consider being mindful of any initial discomfort, as that could be a sign you’re pushing your body too much.
Get expert advice. Need a new racket? Try researching tips from trusted organizations, such as the United States Tennis Association (USTA), or getting help from an expert at a sporting goods store or specialty tennis shop. “They can help you pick the right grip size and set the right amount of tension to reduce tennis wrist pain,” says Dr. Martinez. If you have access to a tennis coach, ask them to weigh in. “They may have feedback that can help to reduce wrist strain,” says Dr. Martinez.
PT tip: Don’t fear discomfort
“Pain is your body’s way of communicating with you,” says Dr. Martinez. If you develop some discomfort after playing tennis, there’s no need to panic. Instead, take action by consulting with a physical therapist so the pain doesn’t begin to interfere with your daily life.
How Hinge Health can help you
If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
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References
Gil, J. A., & Kakar, S. (2019). Hand and Wrist Injuries in Tennis Players. Current Reviews in Musculoskeletal Medicine, 12(2), 87–97. doi:10.1007/s12178-019-09550-w
Logli, A. L., Loushin, S. R., Orlando, A. F., Tetzloff, S., Kaufman, K. R., & Kakar, S. (2022). Ulnar Wrist Pain in a Tennis Player: Case Review and Discussion. JBJS Reviews, 10(4). doi:10.2106/jbjs.rvw.21.00158
Kaiser, P., Stock, K., Benedikt, S., Ellenbecker, T., Kastenberger, T., Schmidle, G., & Arora, R. (2021). Acute Tennis Injuries in the Recreational Tennis Player. Orthopaedic Journal of Sports Medicine, 9(1), 232596712097367. doi:10.1177/2325967120973672
Chrissian, S. A., Apostle, T., & Gluzman, A. (2005). Prevalence of Median Nerve Entrapment (Carpal Tunnel Syndrome) in the Dominant Hand of Competitive. Archives of Physical Medicine and Rehabilitation, 86(9), e22. doi:10.1016/j.apmr.2005.07.119