Pickleball’s surge in popularity has brought joy to many, but it has also led to an increase in injuries, particularly among older adults. The sport’s dynamic movements and quick reflexes can strain muscles and joints, making injury prevention a crucial aspect of the game.
This guide delves into the most common pickleball related injuries, their causes, and practical strategies to minimise risks, ensuring a safe and enjoyable experience on the court.
Why Are Pickleball Injuries So Common?
Pickleball’s rapid growth in popularity has led to an increase in injuries, particularly among older adults. The sport’s combination of elements from tennis, badminton, and ping pong requires quick lateral movements and sudden stops, which can strain muscles and joints.
Injuries often result from overuse, poor technique, or inadequate preparation. For instance, “pickleball elbow,” similar to tennis elbow, is a common overuse injury due to repetitive motions. Additionally, falls are prevalent, especially when players attempt to brace themselves with an outstretched hand, which can lead to wrist fractures or sprains.
How Age Affects Pickleball Players
Age significantly influences the risk of injury in pickleball. As individuals age, factors such as decreased bone density, reduced flexibility, and slower reaction times increase their susceptibility to injuries.
Studies show that players aged 60-69 are at the highest risk, with men being twice as likely as women to suffer fractures. The most common injuries in this age group include fractures of the arm, wrist, and hand.
How Inadequate Preparation Increases Injury Risk
Proper preparation is crucial to prevent injuries in pickleball. Skipping warm-ups or using inappropriate footwear can lead to strains, sprains, or more severe injuries. A proper warm-up increases blood flow and flexibility, reducing the risk of injury. Additionally, wearing court-specific shoes provides better support and traction, minimising the chance of slips and falls.
How the Nature of Pickleball Contributes to Injuries
The dynamic nature of pickleball contributes to its injury rate. The sport involves rapid direction changes, quick reflexes, and close-quarter play, increasing the likelihood of collisions and falls.
The smaller court size and fast-paced rallies can lead to overexertion, especially among older players. Environmental factors, such as uneven or slippery court surfaces, further elevate the risk of injury.
Preventive Measures
To reduce the risk of injury:
- Warm-Up and Stretching: Engage in dynamic stretches before playing to prepare muscles and joints.
- Proper Footwear: Wear court-specific shoes that provide adequate support and traction.
- Technique and Conditioning: Learn proper playing techniques and maintain overall physical conditioning.
- Rest and Recovery: Allow adequate rest between sessions to prevent overuse injuries.
By understanding the factors contributing to injuries and implementing preventive measures, players can enjoy pickleball safely and effectively.
How Can I Avoid Pickleball Injuries?
Engaging in pickleball offers numerous health benefits, but it’s essential to adopt preventive measures to minimise the risk of injuries. Implementing a comprehensive approach encompassing warm-up routines, appropriate footwear, body awareness, and cross-training can significantly enhance safety and performance on the court.
1. Prioritise Warm-Up and Stretching
Initiate each session with a 5–to 10–minute dynamic warm-up to increase blood flow and prepare the muscles for activity. Incorporate movements such as arm circles, leg swings, lunges, and torso twists to activate key muscle groups and improve flexibility. Conclude with static stretching to aid in muscle recovery and maintain flexibility.
2. Choose Appropriate Footwear
Select court-specific shoes designed to provide lateral support, cushioning, and traction suitable for quick side-to-side movements. Avoid running shoes, as they may not offer the necessary stability for pickleball’s dynamic movements.
3. Listen to Your Body
Pay attention to any signs of fatigue, discomfort, or pain. If you experience any, take a break to prevent overuse injuries. Pushing through pain can lead to more severe issues, so it’s crucial to rest and recover as needed.
4. Incorporate Strength and Balance Training
Engage in exercises that enhance muscle strength and balance, such as squats, lunges, and single-leg stands. Strengthening the core, legs, and shoulders can improve stability and reduce the risk of falls and strains.
5. Stay Hydrated and Maintain Nutrition
Proper hydration is essential for maintaining muscle function and promoting recovery. Ensure adequate fluid intake before, during, and after play. Additionally, consuming anti-inflammatory foods such as leafy greens, nuts, and omega-3-rich fish can support muscle health and help reduce inflammation.
6. Allow Time for Recovery
Incorporate rest days into your routine to allow muscles and joints to recover. Avoid playing to the point of exhaustion, as this increases the likelihood of injuries. Gradually increase the intensity and duration of play as your body adapts.
By adhering to these preventive strategies, players can enjoy pickleball while minimising the risk of injuries, ensuring a safe and enjoyable experience on the court.
What Are the Most Common Pickleball Related Injuries?
Pickleball, while an engaging sport, carries certain injury risks due to its fast-paced nature and dynamic movements. Understanding these common injuries and their causes can help prevent and promote safer play.
1. Wrist Injuries (FOOSH)
A frequent mechanism of injury in pickleball is the FOOSH (falling on an outstretched hand). This occurs when players trip or fall while attempting to brace for impact with their hands, leading to wrist fractures, sprains, or ligament tears.
2. Elbow Injuries
Overuse injuries like tennis elbow (lateral epicondylitis) are common due to repetitive gripping and swinging motions. Symptoms include pain on the outer elbow, weakness in the wrist and hand, and limited range of motion.
3. Shoulder Injuries
Repetitive overhead motions, such as serving and smashing, can lead to shoulder injuries, including rotator cuff strains and tendinitis. These injuries often result from overuse and can cause pain and limited mobility.
4. Hand and Finger Injuries
Direct trauma during play or falls can cause hand and finger injuries, including fractures and sprains. These injuries may also result from collisions with other players or the paddle.
5. Lower Extremity Injuries
Ankle sprains and Achilles tendonitis are common due to sudden changes in direction and quick movements. These injuries often occur when players change direction rapidly or land awkwardly after a shot.
Preventive Measures
- Warm-Up and Stretching: Engage in dynamic stretches before playing to prepare muscles and joints.
- Proper Technique: Learn and maintain correct form to reduce strain on joints and muscles.
- Gradual Progression: Increase intensity and duration of play gradually to avoid overuse injuries.
- Protective Gear: Use appropriate footwear and consider braces or stabilisers for added support.
- Cross-Training: Incorporate activities such as running, swimming, or cycling to enhance endurance and overall physical well-being.
By staying informed and proactive, players can enjoy pickleball while minimising the risk of injuries.
List Of Common Pickleball Injuries
| Injury | Signs & Symptoms |
| Achilles Tendinitis | Pain and stiffness along the Achilles tendon, especially in the morningPain that worsens with activitySwelling along the tendon Thickening of the tendonPain at the back of the heel when wearing shoes |
| Sprained Ankle | Pain, especially when bearing weight on the affected footTenderness when touching the ankleSwelling and bruisingRestricted range of motionInstability in the ankle Popping sensation or sound at the time of injury |
| Pickleball Elbow | Pain over the outside of the elbowDiscomfort that may radiate into the forearm and wrist Weak grip strengthPain exacerbated by repetitive wrist and arm movements |
| Rotator Cuff Injury | Dull ache deep in the shoulderDisturbed sleep due to shoulder discomfortDifficulty combing hair or reaching behind the back Arm weakness |
| Distal Radius Fracture | Pain and swelling in the forearm or wrist Visible deformity in the wristBruising around the wrist areaDifficulty or inability to use the hand or wrist normally |
| Knee Injuries | Pain in the knee, especially when pressure is applied or during movementSwelling, redness, and warmth around the knee Difficulty moving the kneeCatching or locking sensation in the kneeInability to fully straighten the knee |
| Shoulder Problems | Shoulder, arm, back, or neck painShoulder stiffnessWeakness in the armReduced range of motion |
| Lower Back Pain | Stiffness and difficulty moving or straightening the backPosture problems, such as standing crooked or bentPain that radiates down a legMuscle ache to a shooting, burning, or stabbing sensation |
| Muscle Strains | Pain in the affected muscle, worsening with movementStiffness or difficulty moving the affected limbSwelling or oedema around the injury siteTenderness to the touch Muscle weaknessBruising or discolouration near the injury |
| Tennis Elbow | Pain that may radiate from the outside of the elbow into the forearm and wristPain and weakness make it hard to shake hands, turn a doorknob, or hold a coffee cup |
| Elbow Injuries | Pain during or after using the elbow in activities like throwingDecreased mobility or strength in the elbow and armElbow stiffnessPain while making a fistVisible deformityNumbness or tingling in the elbow, arm, wrist, or hands |
| Hamstring Strains | Sudden, sharp pain in the back of the thighSwelling and tenderness within a few hoursBruising or a change in skin colour along the back of the legMuscle weakness or inability to put weight on the injured leg |
| Plantar Fasciitis | Stabbing pain in the bottom of the foot near the heelPain is worst with the first few steps after awakeningPain is triggered by long periods of standing or when getting up from sitting |
| Sprains and Strains | Pain and swelling in the affected area Bruising and limited ability to move the affected jointHearing or feeling a “pop” in the joint at the time of injury |
| Heel Bruising | Pain at the bottom of the heel bone, especially when walking or pressing on the heelRed or purple bruising on the outside of the heel |
| MCL Strain | Pain and swelling on the inner side of the kneeInstability or feeling that the knee is giving wayDifficulty bending or straightening the knee |
| Meniscus Tear | Pain, especially when twisting or rotating the kneeSwelling and stiffnessDifficulty extending the knee fullySensation of the knee locking or catching |
| Calf Injuries | Sudden pain in the calf muscleSwelling and bruising Difficulty standing on tiptoe or pushing off the footMuscle weakness in the calf |
| Wrist Injuries | Pain and swelling in the wristBruising and tenderness Difficulty moving the wrist or hand Numbness or tingling in the fingers |
| Tendinopathy | Pain and tenderness in the affected tendonStiffness, especially in the morning or after activity Swelling around the tendonReduced strength and movement in the affected area |
Comprehensive Guide to Common Pickleball Injuries: Causes and Prevention
1. Achilles Tendinitis
The worst pickleball injury is an Achilles tendon rupture, a severe condition where the tendon connecting the calf muscles to the heel tears completely or partially. This injury often results from sudden, forceful movements, such as quick direction changes or jumps, which are common in pickleball.
Symptoms include a sharp pain at the back of the ankle, a “pop” sound, and difficulty standing on tiptoe. Treatment typically involves surgery followed by a lengthy rehabilitation process, which may take several months.
Causes:
- Overuse from repetitive stress on the tendon.
- Tight calf muscles increase tendon strain.
- Sudden increase in physical activity.
Prevention:
- Regular calf stretching and strengthening exercises.
- Gradually increase activity intensity.
- Wear supportive footwear.
2. Sprained Ankle
A sprained ankle occurs when the ligaments that connect the bones in the ankle joint are overstretched or torn, typically from twisting or rolling the ankle. This injury is common in sports that involve sudden changes in direction, such as pickleball.
Symptoms include sudden pain, swelling, bruising, and difficulty bearing weight. Treatment usually involves rest, ice, compression, and elevation (RICE), and more severe cases may require medical evaluation and physical therapy.
Causes:
- Twisting or rolling the ankle during movement.
- Walking or exercising on uneven surfaces.
- Sudden falls or missteps.
Prevention:
- Strengthen ankle muscles and improve balance.
- Use ankle supports if you are prone to sprains.
- Ensure playing surfaces are safe and even.
3. Pickleball Elbow (Lateral Epicondylitis)
The worst pickleball injury is known as Pickleball Elbow, medically referred to as lateral epicondylitis. This condition arises from overuse of the forearm muscles, leading to inflammation and microtears in the tendons that attach to the outer elbow. It often results from repetitive motions, such as frequent backhand strokes or improper grip techniques.
Symptoms:
- Pain or burning sensation on the outer side of the elbow
- Weak grip strength
- Discomfort during wrist extension or gripping objects.
Prevention Tips:
- Maintain proper technique and form during play
- Avoid overuse by incorporating rest periods
- Use equipment that suits your playing style and physical capabilities.
Addressing Pickleball Elbow promptly can prevent long-term discomfort and ensure a quicker return to the game.
4. Rotator Cuff Injury
The worst pickleball injury is a rotator cuff tear, which involves damage to the group of muscles and tendons stabilising the shoulder. This injury often results from repetitive overhead motions or sudden forceful movements, leading to pain, weakness, and limited arm mobility. Symptoms include a deep, dull ache in the shoulder, difficulty lifting the arm, and possible grating sounds during movement.
Prevention Tips:
- Warm-Up Properly: Engage in shoulder-specific warm-up exercises before playing.
- Use Correct Technique: Ensure proper form during overhead shots to minimise strain.
- Strengthen Your Shoulder Muscles: Incorporate exercises that target the rotator cuff into your fitness routine.
- Avoid Overuse: Take regular breaks to prevent repetitive stress on the shoulder.
Addressing rotator cuff injuries promptly can prevent long-term damage and ensure a quicker return to the game.
5. Distal Radius Fracture
The worst pickleball injury is a distal radius fracture, commonly known as a broken wrist. This injury typically occurs when a player falls onto an outstretched hand, a common scenario in pickleball due to quick lateral movements and sudden stops. The distal radius is the larger of the two forearm bones and bears much of the load transmitted through the wrist.
Symptoms:
- Immediate sharp pain and tenderness at the wrist
- Swelling and bruising around the wrist
- Deformity or abnormal positioning of the wrist
- Limited range of motion or inability to move the wrist.
Recovery Timeline:
Healing time varies based on the severity of the fracture and the treatment approach. Generally, it takes about six weeks for the bone to heal sufficiently, followed by rehabilitation to restore strength and mobility. Full recovery can take several months, and some individuals may experience residual stiffness or discomfort during strenuous activities.
Prevention Tips:
- Strengthen wrist and forearm muscles to better absorb impacts
- Use proper technique and footwork to reduce the risk of falls
- Wear wrist guards or braces for added support during play
- Ensure the playing surface is even and free of hazards
Addressing a distal radius fracture promptly and following a structured rehabilitation program can help players return to the game safely and effectively.
6. Knee Injuries in Pickleball: Understanding and Prevention
Knee injuries are among the most prevalent concerns for pickleball players, especially those over 50. The sport’s quick lateral movements and sudden stops can lead to various knee issues.
Common Knee Injuries in Pickleball:
- Meniscus Tears: Damage to the cartilage that cushions the knee joint, often resulting from twisting motions. Symptoms include pain, swelling, and limited range of motion.
- MCL Sprains: Injury to the medial collateral ligament on the inner side of the knee, typically caused by sudden direction changes. This can lead to pain and instability.
- ACL Tears: A more severe injury involving the anterior cruciate ligament, often resulting from rapid deceleration or pivoting. Symptoms include a popping sound, swelling, and instability in the knee.
Prevention Strategies:
- Strengthening Exercises: Focus on the quadriceps, hamstrings, and hip muscles to support knee stability.
- Proper Footwear: Wear shoes with good lateral support and grip to prevent slips.
- Warm-Up and Cool-Down: Engage in dynamic stretches before playing and static stretches afterwards to maintain flexibility.
- Technique Training: Learn proper movement patterns to reduce undue stress on the knees.
By understanding the risks and implementing preventive measures, players can enjoy pickleball while minimising the risk of knee injuries.
7. Shoulder Problems: Overuse and Injury
Shoulder pain and stiffness often result from overuse or injury, affecting structures like tendons and muscles. Common conditions include rotator cuff tendinitis, bursitis, and shoulder impingement. Symptoms typically involve pain during movement, limited range of motion, and discomfort at night.
Causes:
- Tendon inflammation or tears.
- Instability or arthritis.
- Poor posture or repetitive motions.
Prevention:
- Regular shoulder strengthening exercises.
- Maintain good posture.
- Avoid repetitive overhead activities without rest.
8. Lower Back Pain
Lower back pain is a common condition affecting the lumbar region of the spine, often resulting from muscle or tendon injuries. It can manifest as a sudden or gradual ache, sometimes radiating down the legs (sciatica). Treatment typically includes rest, physical therapy, and medications; however, surgery may be necessary for severe cases.
Causes:
- Muscle or ligament strain from heavy lifting or sudden movements.
- Poor posture.
- Degenerative conditions like arthritis.
Prevention:
- Strengthen core muscles.
- Use proper lifting techniques.
- Maintain good posture during activities.
9. Muscle Strains
A muscle strain occurs when muscle fibres are overstretched or torn due to excessive force or improper movement. Common symptoms include sudden pain, swelling, bruising, and limited range of motion. Treatment typically involves rest, ice, compression, and elevation (RICE), as well as physical rehabilitation therapy.
Causes:
- Sudden heavy lifting.
- Overuse from repetitive motions.
- Fatigued or unconditioned muscles.
Prevention:
- Warm up before activities.
- Gradually increase activity intensity.
- Incorporate strength training into routines.
10. Tennis Elbow (Lateral Epicondylitis)
Tennis elbow is a painful condition caused by overuse of the forearm muscles and tendons, leading to inflammation and microtearing at the lateral epicondyle—the bony bump on the outside of the elbow. Despite its name, it affects individuals who engage in repetitive arm motions, such as gripping or twisting, common in activities like tennis, painting, or carpentry.
Symptoms include pain and tenderness on the outer elbow, which may radiate down the forearm and worsen with activities like shaking hands or turning a doorknob.
Causes:
- Repetitive wrist and arm motions.
- Overuse from activities like racket sports.
Prevention:
- Use proper techniques during activities.
- Strengthen forearm muscles.
- Take regular breaks to avoid overuse.
11. Elbow Injuries: Tendinitis & Ligament Sprains
Elbow injuries often involve tendinitis (inflammation of tendons) and ligament sprains (stretching or tearing of ligaments). Tendinitis, such as tennis elbow and golfer’s elbow, results from repetitive motions, leading to pain and swelling.
Ligament sprains, such as ulnar collateral ligament (UCL) injuries, commonly occur in throwing sports and can cause pain, instability, and reduced performance. Treatment typically includes rest, ice, anti-inflammatory medications, physical therapy, and in severe cases, surgery.
Preventive measures include proper technique, strengthening exercises, and avoiding overuse. Early intervention can lead to better outcomes and a quicker recovery.
Causes:
- Overuse from repetitive motions.
- Direct trauma or injury.
Prevention:
- Avoid repetitive strain without rest.
- Use protective gear during activities.
- Strengthen surrounding muscles.
12. Hamstring Strains
Hamstring strains are common injuries affecting the muscles at the back of the thigh, often resulting from overstretching or sudden movements. These injuries are prevalent in sports that involve sprinting, jumping, or rapid directional changes.
Symptoms include sharp pain, swelling, bruising, and difficulty moving the leg. Treatment typically involves rest, ice, compression, elevation (R.I.C.E.), and physical therapy. Recovery time varies based on the severity of the strain, ranging from a few days to several months.
Causes:
- Sudden acceleration or deceleration.
- Overstretching the hamstring muscles.
Prevention:
- Regular hamstring stretching and strengthening.
- Warm up before activities.
- Avoid sudden increases in activity intensity.
13. Plantar Fasciitis: Heel Pain Explained
Plantar fasciitis is a common cause of heel pain, resulting from inflammation or microtears in the plantar fascia—a thick band of tissue connecting the heel bone to the toes. This condition often causes sharp pain, especially with the first steps in the morning or after periods of rest.
Symptoms:
- Sharp pain at the bottom of the heel, particularly upon waking or after sitting
- Pain that worsens with prolonged standing or walking
- Stiffness and swelling in the heel area
Causes:
- Overuse from activities like running.
- Excessive strain on the foot arch.
- Obesity or sudden weight gain.
Prevention:
- Wear supportive footwear.
- Avoid excessive standing or running on hard surfaces.
- Maintain a healthy weight.
14. Sprains and Strains: Understanding Soft Tissue Injuries
Sprains and strains are common soft tissue injuries that affect ligaments, muscles, and tendons.
- Sprain: An injury to a ligament caused by overstretching or tearing, often due to sudden twists or impacts.
- Strain: An injury to a muscle or tendon resulting from overstretching or overuse.
Causes:
- Overstretching or twisting during activities.
- Not warming up before exercise.
- Fatigued muscles.
Prevention:
- Warm up before physical activities.
- Use proper techniques during movements.
- Ensure adequate rest and recovery.
15. Heel Bruising
A bruised heel involves damage to the fat pad located beneath the heel bone, resulting in pain and tenderness.
Causes:
- Landing hard on the heel from a jump or fall.
- Repetitive impact on hard surfaces.
- Wearing unsupportive or worn-out footwear.
Prevention:
- Use cushioned insoles or heel pads.
- Wear supportive shoes with adequate heel cushioning.
- Avoid prolonged activity on hard surfaces.
16. MCL Strain
An MCL (medial collateral ligament) strain is an injury to the ligament on the inner side of the knee, causing pain and instability.
Causes:
- Direct blow to the outside of the knee.
- Sudden twisting or pivoting movements.
- Overuse or repetitive stress on the knee.
Prevention:
- Strengthen thigh muscles, especially quadriceps and hamstrings.
- Use proper techniques during lateral movements.
- Wear knee supports if you are prone to knee injuries.
17. Meniscus Tear
A meniscus tear is a rupture in the cartilage that cushions the knee joint, leading to pain, swelling, and limited motion.
Causes:
- Twisting or turning quickly, often with the foot planted while the knee is bent.
- Degeneration due to ageing.
Prevention:
- Strengthen leg muscles to support knee stability.
- Avoid sudden, sharp pivots or turns.
- Use proper techniques during directional changes.
18. Calf Injuries
Calf injuries involve strains or tears in the muscles located at the back of the lower leg, resulting in pain and difficulty walking.
Causes:
- Sudden acceleration or changes in direction.
- Overuse without adequate rest.
- Insufficient warm-up before activity.
Prevention:
- Incorporate calf-strengthening and stretching exercises.
- Ensure proper warm-up before playing.
- Gradually increase activity intensity.
19. Wrist Injuries
Wrist injuries encompass sprains, strains, and fractures, leading to pain, swelling, and reduced mobility.
Causes:
- Falling onto an outstretched hand.
- Repetitive wrist motions, such as swinging a paddle.
- Overuse leads to tendonitis.
Prevention:
- Use wrist guards or supports during play to protect your wrists.
- Strengthen wrist and forearm muscles.
- Practice proper techniques to reduce strain.
20. Tendinopathy
Tendinopathy refers to the degeneration of tendon tissue, resulting in pain and impaired tendon function.
Causes:
- Repetitive overuse without adequate rest.
- Sudden increase in activity intensity.
- Age-related wear and tear.
Prevention:
- Incorporate rest periods into training schedules.
- Gradually increase activity levels.
- Engage in exercises that strengthen tendons and surrounding muscles.
21. Falling
Falls can lead to various injuries, including fractures, sprains, and head injuries.
Causes:
- Tripping over obstacles or uneven surfaces.
- Loss of balance during play.
- Inadequate lighting or poor footwear.
Prevention:
- Keep the playing area free of hazards.
- Use footwear with good grip and support.
- Engage in balance and strength training exercises to maintain a healthy balance of strength and flexibility.
22. Hydration
Proper hydration is essential for maintaining muscle function, lubricating joints, and enhancing overall performance.
Causes of Dehydration:
- Inadequate fluid intake before and during activity.
- Excessive sweating without replenishment.
- High temperatures and humidity.
Prevention:
- Drink water before, during, and after playing.
- Monitor signs of dehydration, such as dizziness or fatigue.
- Avoid excessive caffeine or alcohol before playing.
What Can Be Done to Reduce Injuries?
To minimise injuries in pickleball, players should focus on preventive measures and overall athletic conditioning. Most injuries result from collisions, sudden movements, and falls.
Key Prevention Strategies:
- Warm-Up and Stretching: Engage in dynamic stretches, such as arm circles and leg swings, before playing to prepare your muscles and joints.
- Gradual Exercise Progression: Start with lower-intensity workouts and gradually increase difficulty to avoid overexertion.
- Protective Gear: Use appropriate footwear and consider braces or stabilisers for added support.
- Cross-Training: Incorporate activities such as running, swimming, or cycling to enhance endurance and overall physical well-being.
By combining proper warm-up routines, gradual exercise progression, protective gear, and cross-training, players can significantly reduce the risk of injuries and enjoy the game more safely.
Final Thought
Pickleball offers a delightful blend of exercise, social interaction, and fun, making it an excellent choice for individuals of all ages, especially older adults. However, to fully enjoy the game and minimise the risk of injuries, it’s crucial to approach it with preparation and mindfulness.
Incorporating proper warm-up routines, using appropriate footwear, listening to your body, and gradually increasing activity levels can significantly reduce the likelihood of injuries. By staying informed and proactive, you can ensure that your pickleball experience remains safe, enjoyable, and beneficial for years to come.
