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Three Racquets, Three Different Wrists. Here’s Which One Is Hurting You.
Most elbow and wrist pain from tennis, badminton or squash is tendon overload, not a tear. Tennis and squash load the outer elbow; badminton loads the wrist and forearm. Caught early, most settle within 6 to 12 weeks while you keep playing at lower volume, as long as pain stays at 3 out of 10 or below and is gone by the next morning.
A few things are NOT overload and need checking this week: a snap on the little-finger side of the wrist, a fall onto the hand with pain at the base of the thumb, or numbness in the fingers.
Three racquets, three different wrists.
- Tennis loads the elbow, and the wrist takes the impact of a heavy ball.
- Badminton is almost entirely a wrist and forearm sport played at speed with a light racquet.
- Squash sits between them, with the added problem of a wall two feet from your swinging arm.
Knowing which of those you play narrows the diagnosis considerably, because the same wrist ache means different things in each.
Play through the wrong one for a season and a 6-week tendon problem turns into a 6-month one. Or a scaphoid fracture you called a sprain stops healing altogether. Rest the wrong one completely and the tendon you were trying to protect gets weaker, not better.
Tennis: elbow and wrist injuries
- Outer elbow pain, worst on the backhand and gripping: tennis elbow. Late backhands and a grip that is too small are the usual contributors. The fix is loading the tendon, not resting it.
- Inner elbow pain, worst on serve and forehand: golfer’s elbow. Commoner in players with heavy topspin forehands.
- Little-finger-side wrist pain on the two-handed backhand or heavy topspin: ECU tendinopathy, the classic tennis wrist injury, and it can progress to the tendon snapping out of its groove.
- Deep wrist pain on rotation, worse turning a doorknob: TFCC injury.
Badminton: why the wrist hurts, not the elbow
A light racquet moved very fast, with extreme wrist and forearm rotation on almost every shot. The elbow gets blamed and the wrist is usually the problem.
- Back-of-wrist and forearm pain from repeated fast rotation: often intersection syndrome or an extensor overload. Sometimes you can feel a creak, like walking on fresh snow, when you move the wrist.
- Thumb-side wrist pain, particularly with a backhand grip and the thumb pressed up the handle: De Quervain’s.
- Little-finger-side pain on smashes: ulnar impaction, where the two bones on that side load against each other at end range.
- Finger injuries from net play and falls: a jammed finger is usually a sprain, but not always. A fingertip that won’t bend or won’t straighten afterwards is a tendon injury, not a sprain.
Squash: the wall and the volume
- The same elbow and wrist tendon picture as tennis, with more volume because rallies are longer.
- Wrist and hand impact injuries from the wall. A hand or racquet hitting the side wall at speed produces finger fractures and metacarpal fractures that get dismissed as a knock.
- Falls onto the outstretched hand on a slick court: think scaphoid fracture before sprain if the hollow at the base of the thumb is tender.
In tennis the ball hits the racquet. In badminton the wrist hits the shuttle. Same sport family, different tissue paying for it.
How long before I can play again?
Tendon overload runs on a window. While it’s OPEN, the tendon is irritated and a few weeks of smarter loading fixes it. Keep playing hard through pain that no longer settles overnight, and that window closes into a thickened, sensitive tendon that takes months. Where you are in that window decides the timeline, more than the diagnosis does.
Weeks 0 to 2: calm it down, don’t shut it down
- Cut volume by about half. Shorter sessions, no tournaments.
- Drop the shot that hurts. Backhands for tennis elbow, smashes for little-finger-side wrist pain, net kills if the thumb side is sore.
- Start isometrics (below). Keep everything else moving.
Weeks 2 to 6: build the tendon back up
- Progress to slow loading exercises, daily.
- Rallying and groundstrokes, 30 to 45 minutes, if pain stays at 3 out of 10 or below and is back to baseline the next morning.
- A counterforce strap worn on the forearm during play can help tennis elbow. See tennis elbow counterforce strap.
Weeks 6 to 12: back to matches
- Serves, smashes and full matches come back in that order.
- Most players with overload caught early are back to normal volume here. Stubborn tennis elbow can take 3 to 6 months to fully settle, sometimes longer.
Injuries with their own timelines
- ECU tendon snapping out of its groove (acute): often a cast or splint for around 6 weeks, then a gradual return. Recurring snapping may need surgery.
- Broken finger: 6 to 12 weeks to heal, with at least 6 to 8 weeks protected. Playing with buddy tape or a splint before that is your surgeon’s call. See playing in splints and casts.
- Scaphoid fracture: 8 to 12 weeks or more to heal, and no racquet until it has.
What exercises help racquet elbow and wrist pain?
Pain during these should stay at 3 out of 10 or below.
- Isometric wrist extension (outer elbow). Forearm on a table, palm down, push the back of your hand up into your other hand without moving. Hold 30 to 45 seconds, 5 times, 2 to 3 times a day.
- Slow wrist lowering (outer elbow). Light weight, lift with the other hand, lower over 3 to 4 seconds. 3 sets of 15, once a day. Add weight when 3 sets feel easy.
- Slow wrist curls palm up (inner elbow). Same idea, palm facing up. 3 sets of 15, once a day.
- Forearm rotation with a hammer held near the head (badminton wrists). Turn palm up, palm down, slowly. 3 sets of 10. Move your hand further down the handle as it gets easier.
- Grip squeezes with putty or a soft ball, 3 sets of 10, once the elbow tolerates the above.
Equipment changes worth making
- Grip size. Too small is the commonest equipment error and makes you squeeze harder for the same control. Too large restricts wrist movement. Get it measured rather than guessed.
- String tension. Lower tension transmits less shock to the arm. Dropping a few pounds costs less control than people fear.
- Racquet weight and balance. Head-heavy racquets increase the load through the elbow on every shot.
- Replace strings and grips on schedule. Dead strings transmit more shock; slippery grips make you hold tighter.
Why now? Volume and technique
Most racquet arm injuries appear within weeks of a change:
- a new racquet,
- a coaching change,
- a jump from twice to four times a week, or
- a tournament block.
If your pain started in the last two months, look at what changed in the two months before it.
Late backhands, hitting behind the body, and leading with the elbow all shift load from the trunk to the arm. Those are coaching fixes, not medical ones, and they outlast any brace. (Even Federer had a coach.)
If you also play pickleball, the pattern there is different again: pickleball hand, wrist and elbow injuries. And for the glass walls and bandeja, see padel injuries.
Stop playing and get it checked this week if
- A snap or clunk felt on the little-finger side of the wrist during a shot.
- Pain after a fall, especially with tenderness at the base of the thumb.
- A finger that will not fully straighten, or that crosses its neighbor in a loose fist.
- Any numbness or tingling in the hand.
Get it checked if
- Pain that has stopped settling between sessions.
- No improvement after 6 weeks of reduced volume and loading.
- Pain at night or at rest.
The racquet decides which tissue takes the load. Your volume decides whether it copes.
Related: table tennis elbow and wrist pain
Written by Nigel Chua, hand occupational therapist in practice since 2005. Thousands of hands, wrists and elbows assessed and treated. My credentials are here. This article explains; it doesn’t examine. A wrist that snapped mid-rally deserves a look before the next match, not after it.
Part of: Hand, wrist and elbow pain by job, sport and hobby
Every article on this site is written using the Closing Window Method: name the window your condition runs on, find where you are in it, and act while it’s still open.