Physio Hub:

Evidence-Based Article

Pickleball Injuries: What Players Need to Know

Why they happen — and how to prevent them

Pickleball isn’t just growing — it’s exploding. Participation rose 51.8% in one year and 223.5% over three years, making it the fastest-growing sport in America for the third year in a row. It’s fun, social, and accessible to players of all ages, which explains its popularity among both young adults and older adults.

But with rapid growth comes a sharp rise in injuries. According to the American Academy of Orthopedic Surgeons (2024), fractures among players in their 60s have increased almost 90-fold in the past five years. Quick lateral movements, rapid pivots, and long playing sessions can place unexpected stress on the body — especially for people who jump into the sport without preparation.

Below is a practical physiotherapist-guided breakdown of the most common Pickleball injuries, why they happen, and what you can do to prevent them.

Common Pickleball Injuries

Even though Pickleball is considered “low impact,” the sport demands fast changes of direction, repeated swinging, sudden stops, and quick accelerations. These movements commonly affect the shoulder, elbow, knee, Achilles tendon, wrist, and groin.

1. Rotator Cuff Strain

Frequent overhead shots and rapid arm swings place heavy stress on the rotator cuff.
Most older players already have age-related tendon degeneration, making them more vulnerable to:

rotator cuff tears
biceps tendinitis
shoulder impingement

2. Tennis Elbow (“Pickle Elbow”)

Repetitive wrist extension and gripping can overload the tendons on the outside of the elbow.
Common symptoms:

pain when gripping the paddle
reduced wrist mobility
tenderness on the lateral elbow

3. Knee Injuries

Pickleball requires constant side-to-side movement and abrupt directional changes.
Common knee injuries include:

meniscus irritation
patellar tendinopathy
MCL strains
osteoarthritis flare-ups

Strength and proprioception deficits make these knee issues more likely.

4. Achilles Tendonitis

Achilles injuries are increasing sharply — especially in players over 55.
Fast forward movements, sudden deceleration, and repeated ankle dorsiflexion place high stress on the tendon.

A 2024 study reported 43 Achilles ruptures linked to Pickleball between 2013–2023, with a spike in recent years.

5. Wrist Sprains

Frequent wrist adjustments during paddle swings can overstretch or irritate wrist ligaments.
Falls are also a major contributor.

6. Adductor Magnus (“Mini Hamstring”) Strain

Rapid side movements can strain the inner thigh, particularly during lunges or unexpected lateral reaches.
This injury is becoming more common as Pickleball intensity increases.

7. Slips, Trips, and Falls

Many players are new to quick-reaction sports.
Falls often happen due to:

poor court traction
improper footwear
abrupt “kitchen line” stops
lack of balance training

These injuries can involve the wrist, hip, knee, or even lead to fractures.

How Physiotherapy Helps

Physiotherapy management depends on whether the injury is acute (sudden) or chronic (developed over time).
Chronic Pickleball injuries often involve:

tissue degeneration (tendinosis)
joint stiffness
reduced mobility
muscle guarding

A physiotherapist will tailor treatment to your needs, but common components include:

Strength Training

Rotator cuff training
Wrist and forearm strengthening
Quadriceps, hamstring, and calf strengthening
Hip abductors and glute stability exercises

Flexibility + Mobility

Hip flexor and quadriceps stretching
Calf and Achilles mobility
Spinal and thoracic rotation mobility

Balance and Proprioception

Single-leg balance
Wobble board work
Tandem walking
Dynamic balance drills

Agility + Plyometrics

Pickleball requires quick, precise movements.
Controlled plyometrics and directional drills can reduce injury risk and improve performance.

Core + Shoulder Stability

Programs like the “Thrower’s Ten” are extremely helpful for shoulder resilience.
Core exercises help control rotational movements and improve power transfer.

How to Prevent Pickleball Injuries

1. Warm Up Properly

Spend 10–15 minutes preparing your body:

dynamic stretches
light jogging
arm circles
mini lunges / side steps

Cold muscles tear easily.

2. Use Proper Footwear

Court shoes > running shoes.
Why?
Running shoes are built for forward motion, not lateral movement.

3. Build Strength Gradually

Especially important for:

rotator cuff
wrist/forearm
glutes
calves/Achilles

4. Learn Proper Technique

Avoid unnecessary lunging, reaching, or twisting under fatigue.

5. Manage Load

Fatigue = poor mechanics = higher injury risk.
Increase playtime progressively — don’t jump into hours-long matches as a beginner.

6. Protect Your Eyes

Ball strikes to the eye are increasing with higher ball speeds.
Protective eyewear is recommended for frequent players.

7. Consider Prehabilitation

Older players benefit greatly from seeing a physiotherapist before starting Pickleball to screen for:

mobility limitations
balance deficits
strength asymmetries

Prehab reduces injury risk dramatically.

Conclusion

Pickleball is fun, social, and accessible — but like all sports, it carries injury risks.
With proper warm-up, strength training, technique, and load management, players of all ages can stay active, healthy, and competitive.

< Recommendation by Our Experts>

Warm Up & Cool Down
Spend 10–15 minutes preparing the body before playing, and cool down afterward to reduce stiffness.

Use Proper Shoes & Grip
Wear court shoes with good traction and a paddle grip that reduces strain on your wrist and elbow.

Play Smart & Avoid Fatigue
Hydrate well, pace your matches, and listen to early warning signs of pain. Gradually increase playtime and intensity.

Strong Athletes Still Get Injured — Here’s Why

by Physio Hub | Fitness

Does BlazePod Training Actually Improve Athletic Performance?