Fixing Tennis Elbow and Pickleball Elbow: How PEAK Recovery Helps You Get Back in the Game

Tennis elbow and pickleball elbow are two names for a very common problem: pain on the outside of the elbow caused by irritation, overload, and poor healing of the tendons that attach the wrist and forearm muscles to the outer elbow. The medical name is lateral epicondylitis, though in many chronic cases it is more accurately described as a tendinopathy.

Despite the name, you do not have to play tennis to get it. Pickleball players, golfers, weightlifters, contractors, desk workers, and anyone who repeatedly grips, lifts, swings, types, or twists the wrist can develop the same painful pattern.

At PEAK Recovery in San Clemente, our goal is not just to calm down pain temporarily. Our goal is to help the irritated tendon recover, improve the way the elbow and upper extremity move, and help you return to the activities you love with less pain and more confidence.

Below is how the therapies at PEAK Recovery can work together to help people dealing with tennis elbow or pickleball elbow.

What Causes Tennis Elbow and Pickleball Elbow?

Tennis elbow and pickleball elbow usually develop when the forearm muscles and tendons are exposed to more load than they can tolerate. Over time, repetitive gripping, backhands, paddle control, poor swing mechanics, heavy lifting, or prolonged computer work can create microtrauma in the common extensor tendon near the outside of the elbow.

Common symptoms include:

• Pain on the outside of the elbow

• Pain with gripping, lifting, shaking hands, or opening jars

• Pain during tennis, pickleball, golf, or weight training

• Weakness when holding a racquet, paddle, dumbbell, coffee mug, or bag

• Morning stiffness or tenderness around the outside of the elbow

• Pain that improves with rest but returns when activity increases again

The frustrating part is that tendons often heal slowly. Rest may calm symptoms, but if the tendon does not become healthier and more load-tolerant, the pain often comes back as soon as you return to play.

That is why PEAK Recovery uses a multi-therapy approach.

1. Shockwave Therapy: Stimulating Tendon Healing Where the Pain Starts

Shockwave therapy is often one of the most important tools for stubborn tennis elbow or pickleball elbow because it targets the injured tendon directly.

Shockwave therapy uses acoustic wave energy to stimulate a healing response in irritated or chronically painful tissue. For tendon problems, this can be especially helpful because chronic tendinopathy is not always a simple inflammation problem. In many cases, the tendon has become disorganized, under-healed, and hypersensitive.

Shockwave therapy may help by:

• Increasing local blood flow

• Stimulating tissue repair activity

• Helping restart a stalled healing process

• Reducing pain sensitivity

• Improving tendon tolerance over time

• Supporting improved function with gripping and lifting

For tennis elbow and pickleball elbow, shockwave is typically applied around the common extensor tendon and surrounding forearm tissues. Many people feel tenderness during treatment because the therapy is targeting the irritated area, but sessions are usually quick and do not require downtime.

Shockwave therapy is especially valuable for people who have already tried rest, braces, ice, stretching, massage, or injections but still feel like the elbow will not fully heal.

2. Hyperbaric Oxygen Therapy: Supporting Tissue Repair From the Inside Out

Hyperbaric oxygen therapy, also known as HBOT, is designed to increase the amount of oxygen available to the body’s tissues. During a session, you relax in a pressurized chamber while breathing oxygen. The goal is to increase oxygen delivery throughout the body, including areas that may be struggling to heal efficiently.

Why does this matter for tennis elbow?

Tendon healing requires oxygen, blood flow, cellular repair, collagen remodeling, and control of excessive inflammation. Tendons naturally have a more limited blood supply than many other tissues, which is one reason elbow tendinopathies can linger for months.

HBOT may help support the recovery environment by:

• Increasing oxygen availability

• Supporting cellular repair processes

• Promoting circulation and tissue oxygenation

• Helping the body manage inflammation

• Supporting collagen formation and remodeling

• Creating a better internal environment for healing

For an athlete or active adult, HBOT can be a powerful adjunct therapy. It does not replace strengthening, movement correction, or direct tendon treatment, but it can help support the body’s healing capacity while other therapies are working locally at the elbow.

3. High Power PEMF: Calming Pain and Supporting Cellular Recovery

High Power PEMF stands for pulsed electromagnetic field therapy. This therapy uses electromagnetic energy to stimulate tissues and support recovery at a cellular level.

For tennis elbow and pickleball elbow, PEMF can be useful when the elbow is painful, irritated, stiff, or slow to recover between activities. It may be applied around the elbow, forearm, shoulder, or other related areas depending on the person’s pain pattern and movement findings.

High Power PEMF may help by:

• Reducing pain

• Improving local circulation

• Supporting cellular energy and tissue repair

• Helping calm irritated soft tissue

• Reducing muscle guarding around the elbow and forearm

• Improving comfort so patients can better tolerate rehab and strengthening

One of the advantages of PEMF is that it is non-invasive and comfortable for many patients. It can pair well with shockwave therapy because shockwave provides a focused mechanical stimulus to the tendon, while PEMF supports a broader recovery response in the surrounding tissue.

For pickleball and tennis players who feel like their elbow is constantly “angry,” PEMF can be a helpful tool for decreasing sensitivity while the tendon is being rebuilt.

4. Red Light Therapy: Improving Cellular Energy and Recovery

Red light therapy, also called photobiomodulation, uses specific wavelengths of red and near-infrared light to support cellular function. At PEAK Recovery, whole body red light therapy allows the body to receive a broader systemic recovery stimulus rather than treating only a small local area.

For elbow tendinopathy, red light therapy may help support:

• Cellular energy production

• Circulation

• Inflammatory balance

• Muscle recovery

• Tendon and soft tissue repair

• Faster recovery between workouts, matches, and therapy sessions

When tissue is irritated or chronically overloaded, the goal is to improve the body’s ability to recover and adapt. Red light therapy can be a useful part of that process because it supports the cellular machinery involved in repair.

For tennis and pickleball players, this can be especially helpful when the elbow issue is not happening in isolation. Many players also have shoulder tightness, wrist stiffness, neck tension, general soreness, or recovery issues from playing several times per week. Whole body red light therapy can help support overall recovery while the elbow-specific therapies target the main pain generator.

5. Sports Chiropractic: Finding the Bigger Reason the Elbow Is Overloaded

The elbow is often where the pain shows up, but it is not always where the problem starts.

Tennis elbow and pickleball elbow can be influenced by the entire kinetic chain: neck, shoulder, thoracic spine, elbow, wrist, grip mechanics, paddle position, racquet control, posture, and training volume.

Sports chiropractic care at PEAK Recovery focuses on evaluating how the body moves and identifying factors that may be placing extra stress on the elbow.

A sports chiropractic approach may include:

• Assessing elbow, wrist, shoulder, and neck mobility

• Improving joint motion where movement is restricted

• Soft tissue work for the forearm, upper arm, shoulder, and neck

• Identifying grip, posture, or swing-related stressors

• Helping restore better mechanics through the upper extremity

• Guiding progressive strengthening and return-to-play strategies

• Reducing compensations that keep irritating the tendon

This is an important part of long-term recovery. If the shoulder is not rotating well, the wrist is stiff, the neck is contributing to nerve irritation, or the forearm is doing too much work during every swing, the elbow may continue to flare up even after pain improves.

Sports chiropractic helps connect the dots so treatment is not just about chasing symptoms.

Why Combining Therapies Can Work Better Than One Treatment Alone

Tennis elbow and pickleball elbow are rarely solved by one magic treatment. The best results usually come from combining strategies that address different parts of the problem.

At PEAK Recovery, the therapies can complement each other:

Shockwave therapy targets the painful tendon and stimulates local healing.

Hyperbaric oxygen therapy supports oxygen delivery and the body’s internal repair environment.

High Power PEMF helps reduce pain and supports cellular recovery.

Red light therapy promotes cellular energy, circulation, and whole-body recovery.

Sports chiropractic improves movement, mechanics, and the bigger picture of why the elbow became overloaded in the first place.

Together, these therapies can help reduce pain, improve function, and support a smarter return to tennis, pickleball, golf, lifting, work, and everyday life.

When Should You Get Help?

You should consider getting evaluated if:

• Elbow pain has lasted more than two to three weeks

• Pain returns every time you play

• You have weakness with gripping

• You are relying on braces, tape, or anti-inflammatories to get through activity

• Rest helps temporarily but the pain keeps coming back

• You have numbness, tingling, or pain traveling into the hand

• You are avoiding sports, workouts, or work tasks because of elbow pain

The sooner you address the underlying problem, the easier it is to prevent a short-term irritation from becoming a long-term tendinopathy.

Get Back to Tennis, Pickleball, and Life Without Constant Elbow Pain

Tennis elbow and pickleball elbow can be incredibly frustrating, especially when they keep you away from the sports and activities you enjoy. But chronic elbow pain does not have to be something you just live with.

At PEAK Recovery in San Clemente, we use advanced therapies like Shockwave Therapy, Hyperbaric Oxygen Therapy, High Power PEMF, Red Light Therapy, and Sports Chiropractic to support healing, reduce pain, improve movement, and help you get back in the game.

If your elbow pain is keeping you from playing, lifting, working, or enjoying your normal routine, PEAK Recovery can help you build a plan that addresses both the painful tendon and the bigger movement patterns behind it.

Schedule a visit and take the next step toward getting your elbow — and your game — back.