Pickleball Injuries: Causes, Prevention & Recovery Guide

A comprehensive guide to understanding and preventing pickleball injuries

It seems like everyone is playing pickleball these days. It's officially the nation's fastest-growing sport, with participation jumping by 158.6% between 2020 and 2022 alone. It’s a great mix of social fun and physical activity, drawing in players of all ages. But there's a catch to this sudden popularity: a sharp, and frankly, alarming rise in injuries. From 2013 to 2022, emergency room visits related to the sport shot up 22-fold. This guide will help you understand the risks. We'll dig into the latest data to show you the most common injuries, explain the main risk factors, and give you practical strategies to stay on the court and out of the doctor's office.

A look at the data behind pickleball injuries

While pickleball is often called a low-impact sport, its fast-paced nature can be deceiving. The game requires quick pivots, sudden stops, and explosive side-to-side movements that can put a lot of stress on the body. A closer look at the injury data shows some clear trends and highlights who is most at risk.

A big part of the story is the sport's popularity with older adults. Players aged 50 and over are involved in an estimated 91% of injuries, with the 65-80 age group making up 61% of those cases.

When we look at the specific diagnoses from a 10-year analysis of emergency department visits, two categories really stand out:

1. Fractures: Making up 32.7% of all injuries.
2. Strains/Sprains: Accounting for 30.8% of all injuries.

These injuries typically fall into two buckets. Acute injuries are the ones that happen in an instant, usually from a trip, fall, or awkward movement, like a wrist fracture or an ankle sprain. On the other hand, overuse injuries build up slowly over time from repeating the same motions, leading to problems like rotator cuff tendinitis or the dreaded "pickleball elbow."

The most common types of pickleball injuries

While you can get hurt playing any sport, the specific demands of pickleball make certain parts of the body more vulnerable. The data consistently points to the wrist, lower back, and lower leg as the top three trouble spots, each with its own common set of problems.

Common lower body injuries

Your lower body, including your hips, knees, and ankles, takes the brunt of the force in pickleball. The game is all about constant lateral movement, quick footwork, and sudden changes in direction, which puts a ton of pressure on these areas.

• Ankle Sprains and Achilles Tendon Injuries: Those quick side-to-side shuffles and lunges for the ball can easily lead to a rolled ankle. Ankle sprains are especially common in younger players (18 to 34). A much more serious, and unfortunately frequent, injury is an Achilles tendon rupture. It's often called the "worst pickleball injury" because the recovery is long and difficult, often keeping players off the court for months.
• Knee Strains and Tears: The constant starting and stopping needed to chase down shots can strain the ligaments in your knee or even cause a tear in the meniscus, which is the cartilage that acts as a cushion. For players who already have issues like osteoarthritis, the repetitive stress from pickleball can make their symptoms worse, leading to more pain and inflammation.
• Hip and Muscle Strains: The lower trunk, which covers the hip and pelvis, is another common injury site, particularly for players in the 65-80 age group. Slips and falls are a big problem here. Nearly 7% of players who go to the emergency room for a pickleball injury are admitted to the hospital, and these admissions are most often for hip fractures after a fall.

Common upper body injuries

From the power behind your swing to the reflex to catch yourself during a fall, your upper body is always involved in a pickleball match. This makes it a prime target for both sudden injuries and nagging overuse conditions that develop over time.

• Wrist Fractures and Sprains: The wrist has the unfortunate distinction of being the single most injured body part in pickleball, responsible for 12.7% of all reported injuries. Wrist fractures are particularly common, making up almost a third of all fracture cases. There's also a gender gap here, as women experience nearly 70% of all fractures. This often happens from a FOOSH injury, which is a natural reaction when you try to break a fall.
• "Pickleball Elbow" (Lateral Epicondylitis): If you've been around the courts long enough, you've likely heard someone complain about elbow pain. This classic overuse injury, also known as tennis elbow, comes from the repetitive gripping of the paddle and the impact of hitting the ball. It causes inflammation in the tendons on the outside of the elbow, resulting in pain and tenderness.
• Shoulder Problems: The overhead motion of a serve or a big smash puts a lot of strain on the shoulder joint. This can lead to rotator cuff tendinitis (inflammation) or even tears in the rotator cuff tendons. The problem is so widespread that one study named rotator cuff issues as the single most common diagnosis among injured pickleball players, which shows just how much work the joint does during a game.

Key risk factors for pickleball injuries

Understanding what causes these injuries is the first step to preventing them. While every situation is different, the data points to a few recurring reasons for the high rate of pickleball injuries.

The major role of falls

More than any other single factor, falls are the main culprit. According to one major study, falls are behind an estimated 65.5% of all injuries that send players to the emergency room. The risk gets much higher for older players; falls are responsible for a whopping 96% of injuries in those 81 and older. These sudden tumbles are the primary cause of the most serious acute injuries, like fractures of the wrist, hip, and shoulder.

Overuse and poor mechanics

Let's face it, pickleball is addictive. The short games and social vibe make it easy to play for hours, day after day. But this can lead players to do too much, too soon. Playing for long stretches without enough rest or using poor form puts repetitive stress on your tendons, ligaments, and joints. Bad swing mechanics, for example, can directly lead to chronic overuse problems in the elbow, shoulder, and lower back. When that nagging pain starts to interfere with your game, a non-surgical approach can be very effective. A physiatrist, a specialist in Physical Medicine and Rehabilitation, can find the source of the pain and create a recovery plan that doesn't involve surgery. This patient-first philosophy is a cornerstone at practices like Sobel Spine and Sports.

Lack of conditioning

Many new players are so eager to start that they jump right in without the physical foundation to handle the game's explosive demands. Pickleball isn't just a casual paddle game; it requires agility, balance, and core strength, and endurance. As sports medicine experts often say, new players should start slowly and build up. Your body needs a chance to adapt to the new movements. Going from zero to playing multiple long matches several days a week is just asking for an injury.

A proactive approach to injury prevention

The good news is that you have a lot of control over these risks. By focusing on proper preparation, off-court conditioning, and smart recovery, you can significantly reduce your chances of being sidelined.

Preparation before you play

What you do in the 10 minutes before a match can make a huge difference.

• Warm-Up Properly: Skip the old-school static stretching before you play. Instead, spend 5-10 minutes on a dynamic warm-up. Things like light jogging, high knees, arm circles, and walking lunges get your body ready by increasing blood flow to your muscles and waking up your nervous system.
• Use the Right Gear: Your shoes are your most important piece of equipment. Running shoes won't cut it, as they're built for forward motion and lack side-to-side stability. Wear proper court shoes or tennis shoes. They give you the lateral support needed to prevent your ankle from rolling during quick changes in direction.
• Check Your Environment: A quick scan of the court can prevent a serious fall. Make sure there are no stray balls, water bottles, or other hazards. Be extra careful on outdoor courts and try to avoid playing on wet surfaces where it's easy to slip.

Building off-court fitness

One of the best ways to defend against pickleball injuries is to build a strong, resilient body away from the court. A balanced fitness routine will prepare you for the specific demands of the game.

• Strength Training: Don't skip the gym. Focus on strengthening your core, which provides stability for your whole body. Strong leg muscles (quads, hamstrings, and glutes) help absorb impact and protect your knees, while specific exercises for your rotator cuff can help prevent shoulder problems.
• Balance and Agility: Since falls are the number one cause of injury, balance exercises are a must. Simple drills like standing on one foot can make a big difference in your stability. Agility work, like side shuffles or ladder drills, will train your body to handle the game's quick movements more efficiently.
• Flexibility and Mobility: Save the long, static stretches for after you play. When your muscles are warm, holding stretches for at least 30 seconds can improve your overall flexibility, reduce soreness, and help with recovery.

A well-rounded fitness routine is your best defense against injury. For a practical demonstration of exercises designed specifically for pickleball players, check out the video below. It covers key movements to build strength and stability, helping you stay safe on the court.

Professional Physical Therapy demonstrates ten essential exercises to help pickleball players build strength and prevent common injuries.

What to do when an injury occurs

Even with the best preparation, injuries can still occur. Knowing how to react is key.

• Minor Injuries: For minor strains and sprains, the classic RICE method is your first move. For the first 48 hours, focus on Rest, Ice (20 minutes at a time), Compression (with a bandage), and Elevation to manage swelling and pain.

• When to See a Specialist: It’s important to listen to your body and not try to play through serious pain. You should get professional medical help if you have severe pain or swelling, hear or feel a "pop" when the injury happens, can't put weight on a limb, or have pain that doesn't get better after a few days of self-care. Ignoring these signals can turn a simple injury into a chronic problem.

Staying in the game safely

Pickleball is a fantastic sport that offers a great mix of exercise, strategy, and social fun. But its fast-paced nature comes with real injury risks. The data doesn't lie: falls are the leading cause of serious injuries like fractures, and older players are the most at risk.

However, an injury doesn't have to be the end of your pickleball career, and the risk shouldn't keep you away from a sport you enjoy. By making smart choices, like warming up, wearing the right shoes, building your fitness, and knowing when to rest, you can drastically lower your chances of getting hurt. And if pain does pop up, getting an accurate diagnosis and a personalized treatment plan from an expert is the quickest way back to the court.

If a pickleball injury is keeping you on the sidelines, seeking professional medical advice is a crucial step toward recovery. A specialist like Dr. Jerry Sobel at Sobel Spine and Sports, a board-certified physiatrist with extensive experience in non-surgical sports medicine, can provide a comprehensive diagnosis. They can create custom treatment plans for common pickleball injuries, including rotator cuff tendinitis, "pickleball elbow," sciatica, and back pain. Getting expert care helps ensure you can return to the game safely and confidently.

Frequently asked questions

What are the most common types of pickleball injuries? The most common pickleball injuries include ankle sprains, Achilles tendon issues, knee strains, wrist fractures (often from falls), and overuse conditions like "pickleball elbow" (lateral epicondylitis) and rotator cuff tendinitis.

How can I reduce my risk of pickleball injuries? You can significantly lower your risk by performing a dynamic warm-up before playing, wearing proper court shoes with lateral support, strength training to support your joints (especially your core and legs), and practicing balance exercises to help prevent falls.

Are older players more susceptible to pickleball injuries? Yes, the data shows that players over 50 account for the vast majority of pickleball injuries. This is largely due to a higher risk of falls, which can lead to more serious injuries like hip or wrist fractures.

What is the single biggest cause of serious pickleball injuries? Falls are the leading cause of serious, acute pickleball injuries. A fall on an outstretched hand is a primary cause of wrist fractures, and falls are also responsible for many hip and shoulder injuries seen in players.

When should I see a doctor for pickleball injuries? You should see a doctor if you experience severe pain or swelling, hear a "pop" at the time of injury, cannot bear weight on the affected limb, or if the pain doesn't improve after a few days of rest, ice, and elevation. Pushing through significant pain can lead to a more severe, chronic issue.

Can poor technique lead to pickleball injuries? Absolutely. Improper swing mechanics or footwork can place repetitive stress on your joints and tendons, leading to overuse pickleball injuries like pickleball elbow, shoulder tendinitis, and lower back pain over time.