Exercises for tennis and padel: a warm-up, shoulder and elbow care, and footwork training

Racket sports go with a longer life

In 80,306 British adults, people who played racket sports had a 47% lower risk of dying during the study. It's an association: social contact and better health may explain part of it.

Sources 1, 2

Padel's weak spot is the elbow

The elbow, usually tennis elbow, was the most reported injury site in every padel study that named joints. Padel players report about 3 injuries per 1,000 hours of play.

Sources 3, 4

An app didn't prevent tennis injuries

In 579 adult club players, the only trial of a tennis prevention programme found no difference: 37% against 38% had an injury problem at any one time.

Source 5

Shoulder programmes work in handball

A shoulder routine of about 10 to 15 minutes cut shoulder problems in handball players, even when it was done only once or twice a week. Nobody has tested it in tennis or padel.

Sources 6, 7

Power and agility training helps your game

In 23 trials, mostly in young competitive players, plyometric, core and strength training twice a week raised serve speed, sprint speed and agility.

Source 8

Protect your eyes

Most racket-sport eye injuries happen without eyewear, and eyewear made to a recognised standard protects. Padel became the leading cause of sport eye injuries in one Swedish county.

Sources 9, 10

Stop-start effort

Short sprints, stops and changes of direction, with recoveries between points. The UK's National Health Service (NHS) counts doubles tennis as moderate activity, and our calories calculator uses 6.8 metabolic equivalents (METs) for tennis, 7.3 for squash and 5.5 for social badminton. Sprint speed, change-of-direction speed and leg power are the qualities trials have trained most.

Sources 11, 8, 12

The main movements

The split step and side shuffle, lunging and recovering, groundstrokes with a trunk turn, and the serve and smash, which are overhead throwing actions. Padel adds many overhead and wall shots with a solid racket that has no strings; the authors of a padel review suggest this may explain its elbow problems.

Source 3

Where the load falls

The sites the studies point to:

• Legs: thigh, ankle and knee injuries were among the commonest in professional women, and ankle (17%) and knee (13%) injuries in Portuguese padel players.
• The hitting shoulder: professional players with past shoulder pain had less inward rotation in both shoulders.
• The forearm and elbow: the commonest injury site in padel.
• The wrist on the little-finger side: lab studies link the two-handed backhand with strain on the non-dominant wrist.
• The calf: tennis leg, a tear of the inner calf muscle, typically between the ages of 35 and 50.

Sources 13, 4, 14, 3, 15, 16

What to train (our reading)

Repeated accelerations and stops, single-leg landing control, rotational power, shoulder control through overhead strokes, and forearm endurance.

How often players get hurtEmerging evidence

Tennis injuries mostly affect the legs, then the arms, then the trunk. The numbers:

• Tennis: up to about 3 injuries per 1,000 hours of play. In 579 Dutch club players reporting every 2 weeks for 16 weeks, 37% to 38% had an injury problem at any one time, and 11% to 12% a substantial one.
• Professional women: 56.6 injuries per 1,000 hours of match play, 12.8 of them causing time out (52 players over a season).
• Padel: 2.75 injuries per 1,000 hours of training and 8.44 per 1,000 matches in one Spanish federation study; 3.4 per 1,000 hours in Portuguese players.
• Padel over a career: 60% to 95% of players report an injury, and 85% of 113 Spanish recreational players had had one.
• Women's padel: amateurs had more upper-body injuries per hour than professionals (2.69 against 0.67 per 1,000 hours).

Sources 5, 17, 13, 3, 4, 18, 19

Tennis elbowEmerging evidence

The commonest padel injury site in all 5 studies that named joints: tennis elbow (lateral epicondylitis) was 20.5% of diagnoses in the largest Spanish survey, and the elbow 18% of injuries in Portugal. In 532 tennis players, it became more common with age and with more hours played a day, and in older players with larger grips (1979). In one padel survey, players coached by an instructor warmed up more and had fewer elbow injuries, an association. Our tennis elbow guide covers treatment.

Sources 3, 4, 20

The shoulderEmerging evidence

Shoulder and elbow tendon problems were the main upper-body injuries in women's padel, and rotator cuff problems 7.4% of Spanish padel diagnoses. Professional tennis players with past shoulder pain had less inward rotation in both shoulders, not a bigger difference between sides. Long play, fatigue, technique and shoulder-blade control are suspected risk factors, from low to moderate quality studies. See our shoulder pain and shoulder impingement guides.

Sources 19, 3, 14, 15

Ankle sprainsEmerging evidence

7.8% of Spanish padel diagnoses, 17% of injuries in Portuguese players, and among the commonest in professional women. As our ankle sprain guide explains, a previous sprain raises the risk of another, and a balance programme cuts repeats.

Sources 3, 4, 13

Knees, calves and feetEmerging evidence

Knee injuries were 13% in Portugal; jumper's knee (patellar tendinitis) was 5.6%, plantar fasciitis 8.4% and partial calf tears 6.8% of Spanish padel diagnoses. In a study of senior padel players, tennis leg was among the commonest injuries, reported by 22%, and the International Tennis Federation (ITF) describes it as typical between 35 and 50. See our knee pain, jumper's knee, calf pain and plantar fasciitis guides.

Sources 4, 3, 16

Eye injuriesEmerging evidence

Padel caused 20% of sport eye injuries in one Swedish county from 2017 to 2021, the most of any sport by 2021, almost all from the ball. In a survey of 583 Italian padel players, 10% had had an eye injury and a tenth of those needed surgery; the risk rose with more matches a week. Squash and badminton cause serious eye injuries too.

Sources 10, 21, 9

Older playersEmerging evidence

In US emergency departments from 2000 to 2023, falls caused 36.5% of racket and paddle sport injuries. For players over 64, a medical event was the cause of a quarter of visits, and they were about 6 times as likely to be admitted to hospital as younger players.

Source 22

The only tennis prevention trial: no effectStrong evidence

579 adult recreational players in the Netherlands were randomised to TennisReady or their usual routine. TennisReady was an unsupervised smartphone app: an on-court and an off-court warm-up of about 10 minutes each, twice a week for 12 weeks, getting harder each week, with cardiovascular routines, 52 balance, strength and range exercises, tennis circuits and warm-up games.

Injury problems at any one time: 37% against 38%; substantial ones, 11% against 12%. Only 8% kept to it well, and even they did no significantly better. The authors concluded that an unsupervised app like this shouldn't be rolled out.

Sources 5, 23

The Oslo shoulder programme: trialled in handball, untested in racket sportsEmerging evidence

The Oslo Sports Trauma Research Center (OSTRC) programme was tested in 45 elite Norwegian handball teams (660 players) over a 7-month season. It has five exercises, each with easier and harder versions, to increase the shoulder's inward rotation, strengthen its outward rotation and train shoulder-blade control, plus whole-body and upper-back mobility work: about 10 minutes, 3 times a week as part of the warm-up before throwing. The exact exercises are in an appendix we couldn't open; our shoulder mobility and stability routine is built on its four parts.

Shoulder problems at any one time: 17% against 23%, 28% lower odds (odds ratio 0.72; 95% confidence interval 0.52 to 0.98). Substantial problems fell from 8% to 5%, but that difference wasn't significant (odds ratio 0.78; 0.53 to 1.16). Teams did it 1.6 times a week on average, about half of what was asked, and 7% never did it.

Source 6

Shoulder Control: trialled in handball, untested in racket sportsEmerging evidence

Tested in 18 Swedish secondary schools specialising in handball, in players aged 15 to 19, over a year. Players chose one exercise from each of five groups, at a level that was challenging with good technique, and moved up a level when it got easy. Each set lasted 30 seconds, moving 1 to 2 seconds each way: 3 times a week with 3 sets of each from June to August, and 2 sets of each in the normal warm-up during the season, about 10 to 15 minutes.

Shoulder injuries were cut by more than half (hazard rate ratio 0.44; 95% confidence interval 0.29 to 0.68): treating 9 players prevented one injury. Players did it 1.3 times a week on average, and schools ran it 1.8 times a week in season.

• Shoulder strength 1: a Y-raise against a band anchored low in front; then archer draws with a trunk turn; then band rotations with the arm out at 90 degrees and the elbow bent; then slowly lowering the arm from a throwing position against a band.
• Shoulder strength 2: a push-up plus on knees and forearms; then an overhead band pull-apart; then a forearm plank to push-up position and back; then walking the feet out from a push-up position.
• Upper-body mobility: rotations lying on your back, then threading one arm under and opening from a forearm plank on the knees, on the toes, and from a push-up position.
• One-arm diver: stand on one leg, one arm overhead, and hinge forward to a T and back; bodyweight, then holding a ball, a band or a dumbbell.
• Trunk rotation: band trunk turns with straight arms; then a diagonal chop in a lunge; then turns with the arm in a throwing position; then a throwing motion against a band.

Source 7

Other overhead sportsEmerging evidence

In 237 youth baseball players aged 9 to 11, a warm-up of stretching, mobility and balance exercises for 12 months cut shoulder and elbow injuries from 3.1 to 1.7 per 1,000 practices and games. In 44 college swimmers, 6 weeks of band strengthening with stretches didn't change shoulder strength or movement (injuries weren't measured). Before the handball trials, a review found little evidence for any shoulder prevention measure in overhead sports. The serve and smash are throwing actions, but none of these has been tested in tennis or padel (our reasoning).

Sources 24, 25, 26

A governing-body routine

The Lawn Tennis Association (LTA) Tennis Wales injury prevention routine lists 12 exercises for 3 to 7 days a week, mostly 2 sets of 6 to 10: single-leg balance and hops, bridges, side-lying leg raises and clamshells, band shoulder rotations and pull-aparts, upper-back rotations, dead bugs and a side plank with a band row. It hasn't been tested in a trial; our injury prevention routine borrows its band rotation, hop, balance and clamshell doses.

Source 27

Ankle sprains: prevent the second one

After a sprain, our ankle sprain guide's home balance programme (3 sessions a week for 8 weeks) cut repeat sprains from 33% to 22% in a trial of 522 athletes, and a brace for sport through the next season is advised. Preventing a first sprain with balance training is unproven.

Tennis elbow: no prevention trialMixed evidence

In the 1979 survey, players said technique and racket changes helped stop it coming back, and rated braces the least successful; lab studies of grips and strings haven't been tested in players. Build your playing time gradually and keep your forearms strong (our suggestion), and if it starts, follow our tennis elbow guide.

Sources 20, 15

Eye protectionEmerging evidence

Across squash, racketball, tennis and badminton, a median of 93% of eye injuries happened without eyewear. Prescription glasses, contact lenses and industrial glasses could make injuries worse, lensless eye guards failed in squash, and only eyewear meeting a recognised sports standard was linked with no eye injuries. Only 10% of Italian padel players strongly supported wearing goggles.

Sources 9, 21

What doesn't work, or isn't shownMixed evidence

None of these has good evidence behind it:

• Unsupervised app-based warm-ups: no effect in the one trial.
• Stretching to prevent injury: not effective, as our warm-up guide explains; the ITF's tennis leg advice to warm up and stretch is advice, not evidence.
• Straps or braces to prevent tennis elbow: not shown; our tennis elbow guide uses them for relief while worn.
• Changing racket, strings or grip size to prevent elbow pain: untested in players.
• The sleeper stretch for everyone: our shoulder guides keep it for a clear loss of inward rotation on one side, and a swimmers' programme that included it changed nothing measured.

Sources 5, 16, 20, 15, 25

Power, agility and speedEmerging evidence

In 23 trials of 743 players, neuromuscular training (plyometrics, core, strength and agility work) improved serve speed and leg power by moderate amounts and agility, sprint speed and strength by smaller to moderate amounts against usual training, but not serve accuracy. Players over 18 gained more serve speed and power, twice a week did as well as three times for sprinting, and more than 12 weeks added nothing for agility or sprinting. Plyometrics helped serve speed, sprinting and power most, core training agility, and strength training strength.

In 12 studies of players aged 12 to 25, plyometrics for 3 to 9 weeks raised serve speed, sprint speed, leg power and agility. The certainty of all this is low, and nearly every trial was in young competitive players, not adult club players.

Sources 8, 28, 29

Footwork drillsEmerging evidence

In 31 boys aged 16, 8 weeks of sprint and change-of-direction training improved speed, agility and jumping with or without a racket, and more without one. The LTA suggests on-court shuttles and an X drill before play.

Sources 12, 30

Strength

Strength training gave the biggest strength gains in the tennis trials. Our editorial plan: whole-body strength twice a week, which also meets the NHS advice of strength work on 2 days, with single-leg work for court movement and shoulder and forearm work for your hitting arm.

Sources 8, 11

Conditioning

Racket sports are stop-start. High-intensity interval training (HIIT) once or twice a week and easier zone 2 work cover it; our HIIT and zone 2 guides explain both.

Mobility

Professionals with past shoulder pain had less inward rotation in both shoulders. Our shoulder guides start with the cross-body stretch and keep the sleeper stretch for a clear loss on one side.

Source 14

Fitting it around your tennis or padel

Our editorial plan, built on the trials:

• Build: 2 sessions a week of power, agility and strength for 6 to 12 weeks; twice a week was enough in the trials, and more than 12 weeks added little for agility.
• In season: 1 or 2 short sessions a week, and no hard plyometrics or heavy leg work the day before a match.
• The shoulder programme: 3 times a week as part of your warm-up, as trialled in handball, knowing that teams managed 1.3 to 1.6 and still benefited.

Sources 8, 6, 7

Most tennis elbow isn't from tennis

Most people with tennis elbow don't play tennis, and about 9 in 10 are much better within a year, as our tennis elbow guide explains. In players, it's a load problem in the tendons on the outside of the elbow.

Why padel players get itEmerging evidence

The authors of the padel review suggest the many overhead shots, the solid, stringless racket, and the near absence of two-handed backhands may load the elbow tendons. It's their explanation, not a tested one.

Source 3

Keep playing within the pain rule

Our elbow guides keep discomfort to about 3 to 4 out of 10, settling within an hour and no worse the next morning, and stop for tingling. Cut back the shots that hurt, often serves, smashes or backhands, rather than stopping everything (our suggestion).

Straps and racketsMixed evidence

A strap can ease pain while you wear it, with no proven long-term benefit, as our tennis elbow guide says. Changing racket, strings or grip size is untested in players; in one 1979 survey, players felt technique and racket changes helped more than braces.

Sources 20, 15

The same body, different balls

The movement demands and most of the advice on this page carry over: the warm-up, the shoulder and forearm work, and the footwork training. Badminton went with 6.2 extra years of life in the Copenhagen study, again an association.

Source 2

Eyes in squash and badmintonEmerging evidence

Squash balls and shuttlecocks cause serious eye injuries. Eyewear made to a recognised sports standard is the only protection that worked; lensless guards failed in squash.

Source 9

Pickleball and older playersEmerging evidence

Pickleball caused 13% of racket and paddle sport visits to US emergency departments, and its injuries led to hospital admission about 2.6 times as often as those in other racket sports, with older players and pickleball driving a rise in admissions. Falls were the commonest cause, so the landing and balance work on this page matters.

Source 22

Everyone: seven questions

The PAR-Q+ (Physical Activity Readiness Questionnaire for Everyone) asks about a heart condition or high blood pressure, chest pain, dizziness or fainting, other long-term conditions and their medicines, a bone or joint problem that activity could make worse, and being told to exercise only under supervision. If you answer yes to any, check with your GP or a qualified exercise professional first. If you're over 45 and not used to hard exercise, ask a qualified exercise professional before the power and agility work, and delay if you're ill.

Source 31

Heart disease, or over 64 and new to the sport

A medical event was the cause of a quarter of emergency visits by racket players over 64. Check with your GP first, and consider doubles before singles: the NHS counts doubles tennis as moderate activity.

Sources 22, 11

After an ankle sprain

Keep a balance routine going 3 times a week for 8 weeks once you're back on court, and wear a brace for the season, as our ankle sprain guide sets out.

Tennis elbow or shoulder pain now

Follow our tennis elbow guide's stages, keeping discomfort to about 3 to 4 out of 10. Our shoulder guides allow up to about 5 out of 10 during exercise if it settles by your next session.

Padel, squash and badminton players

Wear eyewear made to a recognised sports standard, not everyday glasses.

Sources 9, 10, 21

Pregnant

The NHS advises against sports with a risk of falling or of being hit on the bump. Talk to your midwife or GP about whether to keep playing and how; gentler doubles or hitting practice may suit (our suggestion). Our pregnancy guide has more.

Sources 32, 31

Call 999 for chest pain

The NHS says to call 999 if:

• You get sudden pain or discomfort in your chest that doesn't go away; it can feel like squeezing or pressure, burning or indigestion.
• The pain spreads to your left or right arm, or your neck, jaw, stomach or back.
• You have chest pain and feel sweaty, sick, light-headed or short of breath.

Source 33

An eye hit by the ball

Go to A&E or call 999 if something hit your eye at high speed, your sight has changed, you have severe pain in the eye, a headache or sensitivity to light, you feel or are sick, you can't move your eye or keep it open, or blood or pus is coming from it. Ask for an urgent GP appointment or contact NHS 111 if it isn't getting better after 24 hours.

Source 34

A sudden pain in the calf

Tennis leg feels like a sudden, sharp or burning pain in the calf, sometimes with a sound, and most players can't carry on. Stop playing, keep weight off it, and use ice, a compression bandage and raising the leg, as the ITF advises; see a doctor if it's severe or you're unsure. A snap at the back of the ankle with difficulty walking needs the checks in our calf pain and Achilles guides.

Source 16

Ankle or knee injuries

Call 999 or go to A&E if you heard a crack, the joint has changed shape or points at an odd angle, it's numb or tingling, or the skin has turned blue or grey or is cold. Get help from NHS 111 or an urgent treatment centre if you can't put any weight on it or walk more than a few steps, or it's very painful or swelling a lot.

Source 35

Collisions with walls, rackets or partners

Call 999 if someone hit their head and was knocked out and hasn't woken, can't stay awake, has a fit, has problems with their vision or hearing, has clear fluid from their ears or nose, has new numbness or weakness, has problems walking, speaking or understanding, or their behaviour has changed.

With suspected concussion, stop playing: 'If in doubt, sit them out'. The UK grassroots guidance says no sport for at least 24 hours, contact NHS 111 within 24 hours, and no return to competition before 21 days.

Sources 36, 37

Heat

Heat exhaustion should improve within 30 minutes of resting somewhere cool, cooling down and drinking. Call 999 if it doesn't, or for a very high temperature, hot skin that isn't sweating, fast breathing, confusion, a fit or loss of consciousness.

Source 38

"Tennis elbow comes from tennis"Strong evidence

Most people with tennis elbow don't play tennis, as our tennis elbow guide says. In players, it rose with age and hours played.

Source 20

"A strap prevents tennis elbow"Mixed evidence

Straps ease pain while you wear them, with no proven long-term benefit, and players in a 1979 survey rated braces the least successful way to stop it coming back.

Source 20

"A new racket or softer strings will fix your elbow"Mixed evidence

Untested in players; the evidence is lab measurements and one 1979 survey.

Sources 15, 20

"Tennis adds 10 years to your life"Emerging evidence

That's an association in one Copenhagen study, where the most sociable sports did best and cause wasn't shown. British data also show lower death rates in racket players.

Sources 2, 1

"Padel is gentle, so it doesn't cause injuries"Emerging evidence

Padel injury rates per hour are in the same range as tennis, and the elbow is the most reported site.

Sources 3, 4

"My glasses protect my eyes"Emerging evidence

Everyday glasses, contact lenses and lensless guards can fail or make injuries worse. Eyewear made to a recognised sports standard protects.

Source 9

"An injury prevention app will keep you injury-free"Strong evidence

The only trial, in 579 players, found no effect.

Source 5