Advice from a Certified Hand Therapist: Pickleball Wrist Pain: What’s All the ‘Racket’?

Do you experience a dull and aching pain or soreness in your wrist during or after playing racket or paddle sports? Does your wrist feel stiff when reaching for low balls or flicking your wrist for those difficult and awkward shots? If you answered yes and your symptoms are located on the “pinky” side of your paddle wrist, then you have ulnar sided wrist pain. Pain in this region can be anything from wrist arthritis, tendon irritation, joint instability, or triangular fibrocartilage (TFCC) injury.

Ulnar sided wrist pain can be uncomfortable and persist if left untreated, but early treatment can significantly reduce pain and discomfort. Common athlete complaints include: stiffness, clicking or snapping sensation, local swelling, and pain. Typically, symptoms increase when gripping a racket/paddle, twisting your wrist, and rotating your forearm. There are several structures, including ligaments, nerves, and tendons, especially on the small finger side of your wrist that can be injured from repetitive use in awkward positions, or from direct trauma, such as a fall onto the hand. Early diagnosis is critical to assess which structures are involved to provide athletes with the optimal course of treatment. Your physician will assess your pain symptoms, joints/ligaments and stability via clinical exam, X-rays and/or MRI. Medical management varies depending on severity, structures injured and other medical history concerns.

Often, with recreational and novice tennis and Pickleball athletes, there is evidence of muscular weakness in the shoulder blade, shoulder rotator cuff, upper arm muscles, and forearm. Weakness in these areas often lead to using your wrist and hand in less stable positions causing increased force through the ulnar side of the wrist.

I have these symptoms, now what?
If you find you have wrist pain while playing sports or completing daily activities, an evaluation by a physician is necessary to rule out any underlying medical conditions. From there, a proper course of treatment could help to address your symptoms.

How will hand therapy help me?
Referral to a Certified Hand Therapist (CHT) can assist in the assessment of your core strength/posture, shoulder/elbow/forearm/wrist flexibility and strength. Using a variety of special tests and assessment techniques, your hand therapist can prescribe neuromuscular exercises, proper splints to support your wrist, core strengthening, flexibility exercises, and joint protection strategies to reduce pain and get you back on the court safely and efficiently.