The silent dangers of padel (yes, you still have to warm up)

Padel has done something most public-health campaigns only dream of. It has got people off the sofa.

Britain has gone from about 15,000 players in 2019 to a million adults and juniors who have picked up a racket, according to the LTA in May 2026, on 1,825 courts across 551 venues. Clubs are full on a Tuesday night. Offices have a WhatsApp group called “Padel??” with three question marks, which is how you know it is serious. Families who had not exercised together since a disastrous holiday in 2014 are now booking a court after school. Coaches, club managers, stringers, physios, coffee vans and people who sell very expensive bottles of water have all found a living in it. That part deserves a round of applause. Preferably after you have warmed up.

Then there is the other part.

Because padel feels friendly. The court is small. The ball does not travel at 120 mph. You can be useless and still have a laugh. So a lot of players treat preparation the way they treat the terms and conditions: skip, accept, hope for the best. The match is not Wimbledon. The opponent is Dave from accounts. Surely Dave from accounts cannot injure you.

Dave can. Or rather, you can, with Dave as an accomplice.

A 2023 systematic review in BMJ Open Sport & Exercise Medicine put the injury rate at about 3 injuries per 1,000 hours of training and 8 per 1,000 matches. Prevalence in the studies they pooled ran from 40% to 95%. The elbow was the most common site, ahead of the knee, shoulder and lower back. Tendon and muscle injuries dominated. Tennis elbow — common extensor tendinopathy, if you want the name that appears on the invoice — was the diagnosis that kept showing up. A 2026 scoping review found the same pattern up top: elbow first, then shoulder, with the extensor carpi radialis brevis tendon doing a lot of the suffering. Lower down, knee and ankle ligaments lead. Achilles tendinopathy and Achilles rupture are on the list too. They are not the headline injury. They are the one that ends your year if you ignore the niggle.

None of this is a mystery of biomechanics. Padel asks for repeated deceleration, split-steps, lunges into the glass, and a lot of wristy, late swings because the walls forgive a bad position. If the grip is wrong, the smash is all arm, and the warm-up was “a few knock-ups while discussing the traffic on the A3”, the tendon takes the load the muscle was supposed to share. Tendons do not send a formal complaint in week one. They send a polite email. Then they send it again. Then they stop answering and you cannot lift the kettle.

The excuse is always the same. The standard is not that high, so the risk cannot be either. That is how you build a chronic problem in instalments. It does not feel catastrophic, so it does not feel urgent. I have a client with tennis elbow on a loop. We settle it. He goes back to five matches a week, no warm-up, same grip, same “I’ll be fine”. I have shown him the warm-up. He is not short of instructions. He is short of the eight minutes between parking the car and wanting to be already winning. People are stubborn. Courts are booked. The beer is scheduled.

A tendon does not check your date of birth. It checks whether you went from nothing to four nights a week.

Two other things get skipped because they are boring.

One is a warm-up that actually matches the sport: pulse up, hips and ankles through the ranges you are about to use, shoulders and forearms switched on, a few progressive swings before the first smash. A general loosen-up is better than nothing. It is not the same as preparing the tissues you are about to load. UK physio guidance on padel injuries makes the same dull point: warm up before the match, not during the first two games.

The other is strength. Padel is not a substitute for having legs, hips and shoulders that can tolerate the work. The German data behind that physio advice points to technique and muscle strength as the practical levers. The diary objection is familiar. Work, coffee, padel, beer. Strength training does not fit between the flat white and the pint. The tendon does not care about the diary.

None of this is an argument for quitting. The sport is a gift. It has dragged people into clubs, into new businesses, and, in my own clients, back into the same postcode as their families. The silent bit is the assumption that a friendly game does not need the boring basics.

Next piece: how to avoid the lot of it, without turning your Tuesday night into a military operation.

References:

• Dahmen et al., BMJ Open Sport & Exercise Medicine, 2023. https://bmjopensem.bmj.com/content/9/2/e001607

• Epidemiology, incidence, prevalence and treatment of injuries in padel: a scoping review. Applied Sciences, 2026. https://www.mdpi.com/2076-3417/16/6/2680

• LTA, 15 May 2026. https://www.ltapadel.org.uk/news/2026/may/1000000-padel-players-in-britain/

• White House Clinic. Common padel injuries, and what to do about them. https://www.whitehouse-clinic.co.uk/articles-and-advice/common-padel-injuries-and-what-to-do-about-them