Top 7 Most Common Pickleball Injuries [+5 Injury Prevention Tips]

Pickleball is a rapidly growing sport, especially among older adults. In fact, it was the fastest-growing sport overall between 2019 and 2022. This cross between ping-pong, badminton, and tennis is an easy, fun way to keep yourself healthy and socialize with friends. 

Unfortunately, as the sport has grown, injuries from playing pickleball have increased as well. 

Although a wide range of people are discovering and enjoying pickleball, people over the age of 55 make up about half the pickleball players. And as you get older, you become more likely to develop a sprain, strain, or fracture (especially from physical activity). But anyone could develop an injury, regardless of age. 

Fortunately, there are ways to help prevent pickleball injuries. And if you end up with one of these injuries, a physical therapist can help you recover and get back on track. 

Here are the top 7 pickleball injuries, and how to help prevent them.

The Top 7 Pickleball Injuries 

The journal Injury Epidemiology reports that sprains, strains, and fractures are among the most common pickleball injuries. 

Here are the most common pickleball injuries at specific locations of the body:

Achilles tendinitis

Achilles tendinitis, also known as an Achilles tear, commonly occurs when playing pickleball due to the repetitive lower leg movements and sudden starting and stopping. The Achilles tendon is the body's largest tendon, and connects the calf muscles to the heel bone.

Symptoms of Achilles tendinitis include:

• Calf or heel pain
• Ankle or calf stiffness
• Achilles tendon swelling
• Pain when you move quickly

Lateral epicondylitis

This injury is also called forearm tendinitis or elbow tendinitis (as it affects the tendons that connect the elbow to the forearm). And since it commonly occurs when playing tennis or pickleball, it's also called "tennis elbow" or "pickleball elbow." 

Repeated stress of swinging a pickleball paddle can lead to elbow strain, especially if you don't use the proper form. And over time, this can lead to tearing of the tendon that connects the elbow to the forearm – elbow or forearm tendinitis.

Symptoms of lateral epicondylitis include:

• Pain in the outside part of the elbow
• Pain in the forearm 
• Pain when you grip something or extend your wrist
• Pain when moving your elbow or wrist
• Pain when you try to twist something, like a jar or doorknob
• Tendon swelling in the forearm
• Weakness in grip

Shoulder injuries

Playing pickleball requires a lot of repetitive motions using the shoulder, including slicing and sweeping. And when you reach overhead to hit the ball during pickleball, the rotator cuff in the shoulder does a lot of work, as it's key to helping you lift and rotate your arm. These factors put you at risk for a shoulder injury if you overextend or strain the shoulder. 

Although you could develop several different types of shoulder injuries, the most common one is a rotator cuff injury, or injury to the muscles and tendons that attach the humerus to the shoulder blade.

Symptoms of a rotator cuff injury include:

• Pain in the front, side, or back of the shoulder
• Pain that spreads to the neck, shoulder blade, or upper arm
• Inflammation in the shoulder
• Reduction in the range of shoulder and arm motion
• Pain when you raise or lower your arm
• Pain when you lie on the injured shoulder at night
• Weakness when you lift or rotate your arm
• Cracking sensation when you move your shoulder 

Sprained ankles

An ankle sprain is a twisting or overstretching of the ankle ligament. This could result if you fall in a way that twists or hits the ankle, land the wrong way, land on an uneven surface, or pivot suddenly while playing pickleball.

Symptoms of a sprained ankle include:

• Pain, bruising or swelling in the ankle
• Trouble moving the ankle
• Pain when you put all your weight on the ankle 
• Feeling of instability when you stand or move

MCL strains

The MCL, or medial collateral ligament, is a ligament that runs down the inside of your knee and holds the knee joint steady. It connects the thigh bone and the shin bone, and it is key in helping you move from side to side. Pickleball involves lots of quick turning, twisting, and pivoting movements that can put stress on the MCL, especially if you overextend it or aren't regularly physically active.

Symptoms of MCL strain include:

• Pain in the inside of the knee, directly over the ligament 
• Swelling, bruising, or pain in the area around the knee 
• Tenderness along the inside of the knee joint
• A "locking" or "catching" feeling when you move the knee
• Popping sensation in the knee
• Feeling like the knee will give way, or feeling like it can't hold your weight

Wrist or hip fractures

Although they occur at different parts of the body, wrist and hip fractures can both occur when you fall on the hard pickleball court. Hip fractures can result from taking the fall on your hip, and wrist fractures can occur if you try to catch yourself with your hand. If you have trouble balancing, or trouble reacting quickly to change directions on the court, you're at greater risk of falling (and greater risk of these fractures).

Symptoms of these fractures include:

• Swelling, tenderness, pain, and/or bruising in the affected area 
• Pain when moving the wrist, hand, or hip
• Visible misalignment of the wrist or hip

Physical Therapy for Pickleball Injuries 

In addition to properly resting the injured area of your body, and putting ice on the area, you should see a physical therapist if you experience a pickleball injury. 

A physical therapist can help you regain and improve your range of motion after a pickleball injury. They'll prescribe exercises to strengthen injured areas of your body, and help you optimize the way you move on the court to reduce the risk of future injuries. Depending on the injury, they might also prescribe a brace or splint to support the injured area. As you continue your treatment, they'll let you know when it's safe to return to the sport you love.

If you haven't started playing pickleball yet (or have just started), and you're an older adult, it's also recommended that you see a physical therapist before starting to play pickleball. The same goes if you're new to the sport and have done limited physical activity recently. Working with a physical therapist will promote overall wellness and  reduce your risk of an injury. 

Noe Sariban, PT, DPT, a physical therapist who plays pickleball professionally, recommends: "Older people, especially, who more likely have impairments and limitations, should be assessed” before they play pickleball. “People… play [pickleball] four or five days a week for multiple hours at a time. That can be a recipe for causing problems with the body over time.There are definitely things we can address prior to people stepping on the court. We look at how they hit the ball, how they move on the court, and if they have a sense of what their body is doing."

Trust PeteHealth for pickleball injury treatment

Looking for a physical therapist to help you get back to playing pickleball, or to help you optimize your movement on the court and avoid injury? PeteHealth is the trusted physical therapy solution that you can access on your schedule, bringing you the care you need wherever you need it – including your home or office. Our licensed physical therapists are at the top of their profession, and we accept most insurance carriers.

PeteHealth makes tailored care even easier for patients with PeteDME, which offers custom fit durable medical equipment (DME) prescribed by your PeteHealth home health or outpatient therapist to address your unique needs.

Finally – the all-in-one, professional, convenient approach to physical therapy that you deserve with PeteHealth and PeteDME. 

5 Tips for Preventing Pickleball Injuries

In addition to eating a healthy diet and maintaining good hydration, these tips can help you reduce your likelihood of a future pickleball injury. 

1. Exercise regularly

Many pickleball injuries occur in people who jumped into the sport when they previously hadn't exercised regularly. Routine exercise makes you less likely to develop an injury, so move your body regularly (whether that's playing pickleball, walking, or doing other exercises). Exercises that help you with balance are also beneficial for lessening your risk of falls.

2. Warm up before you start playing pickleball

Proper warm-up stretches help you prevent straining on your muscles and help your body achieve a full range of motion. Warm-ups should last 5-10 minutes. Be sure to warm up all of your muscle groups before starting to play. Walking or jogging is a great place to start, followed by arm and leg stretches. You might also warm up with some light hitting.

3. Use proper form

Don't just use your upper body and arms when hitting the ball. The right form involves bringing up energy from your lower body and core – specifically, the legs, trunk, and hips. This will both help you generate more power and help you prevent injuries (particularly rotator cuff injuries). You might consider taking some lessons to help you develop the right form and footwork.

4. Use the right equipment

When you're playing pickleball, court shoes (shoes designed for tennis or pickleball) are a better option than running shoes. That's because tennis shoes help you get better traction on the pickleball court, and have better support on the sides. Be sure to also choose shoes that fit properly and have support features. This reduces your risk of Achilles tendinitis and sprained ankles.

You should also make sure that your paddle has the right size handle for your needs, to lessen the risk of elbow and wrist injury. A high-quality paddle can also lessen the impact on your elbow, and a lighter paddle can reduce the strain in your forearms.

5. Cool down after play

Once you've finished playing, cool down with several minutes of walking and stationary stretches. These cool-downs will help you lessen muscle soreness. 

Cooling down also involves listening to your body and taking rest days if you need them. Even if you don't need a full day of rest, be sure to take breaks to fully recover for your next round of pickleball.

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All health-related content on this website is for informational purposes only and does not create a doctor-patient relationship.

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