Pickleball injuries: a prevention guide

Why does pickleball injure so many players who are new to the game?

Pickleball is easy to learn but asks for short, explosive movements that many new players have not done in years, and it is easy to go from one game a week to several hours a day. That combination of sudden effort and fast-rising court time is behind most injuries, not the sport itself.

Many players come to pickleball in their 50s, 60s and 70s, often after years away from any sport with quick changes of direction. Tendons and calf muscles that have only walked for a decade are suddenly asked to accelerate from a split step. Bones may be thinner, and balance reactions slower, which makes a fall more costly. None of that means older players should avoid the game; it means preparing the body for it.

Experienced players get hurt too, usually when court time jumps: a tournament weekend, a new league or a move from weekly to daily open play.

Which pickleball injuries happen most, and how do they start on court?

Lower-leg strains, ankle sprains, elbow and shoulder overuse, and fall-related wrist and hip injuries account for most of what players report. Each one tends to start with a recognizable movement, which is where prevention can focus.

How do I chase a lob without falling backward?

Turn and move, do not backpedal: pivot your hips toward the baseline, then shuffle or use crossover steps so your feet stay under you. Stepping straight backward while looking up is how most backward falls begin, because your heels catch and your balance has nowhere to go.

If you cannot reach a lob safely, let it go or call it for your partner. A lost point costs nothing; a backward fall can mean a broken wrist from catching yourself, a hip injury or a blow to the head. Players who take blood thinners should treat any knock to the head on court as a reason to get checked the same day.

Practising the turn-and-shuffle pattern slowly during warm-up makes it more automatic when a real lob goes up mid-game.

What warm-up should I do before open play?

Spend 5 to 10 minutes raising your heart rate and rehearsing the movements of the game before the first competitive point. Cold calves and stiff shoulders are most at risk in the first few games, especially on cool spring mornings on outdoor courts.

1. Two to three minutes of brisk walking or easy side shuffles along the baseline
2. Calf raises and gentle ankle bounces to wake the calf and Achilles
3. Walking lunges and side lunges to rehearse kitchen-line positions
4. Arm circles and light band rows for the shoulders
5. Easy dinking that gradually builds into drives and a few overheads
6. Two or three slow practice turns and shuffles back toward the baseline

How much court time can I add each week without getting hurt?

Increase playing time gradually, adding a session or an hour at a time and holding steady for a week or two before adding more. The jump from two games to a three-hour open play, or from weekly to daily, is where overuse problems in the elbow, shoulder and Achilles usually start.

Seasonal changes count as load changes too. Moving from indoor gym floors in winter to outdoor hard courts in spring changes the grip under your shoes and how hard your joints work; summer heat adds fatigue that makes late games riskier. Ease into each transition. Fit shoes matter: court shoes built for side-to-side movement give more lateral support than running shoes, which are designed mainly for forward motion.

Watch the second and third hours of open play most closely. Grip strength fades, footwork gets lazy and players start reaching instead of moving their feet, which is when elbows, shoulders and ankles are most exposed. Sitting out a game, drinking water and stretching your forearms between games costs little. If you play a tournament, schedule an easier day or two afterwards rather than heading straight back to daily open play, and notice whether any ache is still there the following morning.

What strength work makes a pickleball player harder to injure?

Calf, hip, shoulder and forearm strength, plus balance, cover most pickleball injuries, and two short sessions a week are enough to make a difference. Strong calves handle push-offs, strong hips control lunges, and strong forearms and rotator cuff tolerate hours of swinging.

Useful starting exercises include calf raises progressing to eccentric heel drops, side lunges and monster walks for the hips, banded external rotation for the shoulder, wrist extensor eccentrics for the elbow, and single-leg balance for ankle control.

When should a pickleball player see a physical therapist?

See one when pain returns every time you play, lasts more than two or three weeks, or makes you change how you move on court. Elbow pain that is ignored for months, for example, often takes much longer to settle than elbow pain addressed early.

A physical therapist can test the strength and movement behind the problem and adjust your playing load rather than simply telling you to stop. The page on physical therapy for pickleball players covers what that looks like. Indiana lets you see a physical therapist without a referral for up to 42 calendar days; start with the two-minute questionnaire and the matching team will propose an independent therapist in the network.