Pickleball is one of the fastest-growing sports in the United States, beloved for its fun, social nature, and accessibility to players of all ages. However, as its popularity has soared, so have the rates of sports-related injuries among recreational and competitive Pickleball athletes. According to a 2023 report by UBS, Pickleball injuries are estimated to cost Americans up to $500 million per year in health care expenses, with more than 67,000 emergency room visits, 366,000 outpatient visits, and 8,800 outpatient surgeries attributed to Pickleball-related injuries annually among U.S. adults aged 60 and older. Understanding why these injuries occur, how to recognize them, and—most importantly—how to prevent them is vital for anyone wanting to enjoy the sport safely and long-term.
Why Are Pickleball Injuries So Common?
At first glance, Pickleball may appear to be a low-impact sport, especially compared to tennis or squash. The court is smaller, and the game can be less physically demanding. However, the reality is that the rapid, multi-directional movements required in Pickleball often place significant stress on muscles, ligaments, and joints. Unlike tennis, Pickleball frequently demands quick sprints, abrupt stopping, lateral (side-to-side) movements, and rapid changes of direction—all within a confined space. This combination puts many body parts at heightened risk of injury.
Several key factors contribute to the high incidence of injury among Pickleball players:
-
Inadequate Warm-Up: Many players jump directly into games without properly warming up, leaving muscles less flexible and more prone to strain or tears.
-
Lack of Pre- and Post-Exercise Stretching: Without regular stretching, muscles and tendons can become tight, reducing range of motion and increasing the likelihood of injury.
-
Sudden, Explosive Movements: Short bursts of intense activity, such as lunging or quick shuffling, place significant force on the lower limbs and core.
-
Improper Footwear: Playing in shoes not designed for court sports can lead to poor traction and insufficient support, increasing the risk of slips, trips, and falls.
-
Weak Core and Balance Issues: Core strength provides stability for all body movements. Weakness in the trunk muscles can result in poor posture and mechanics, raising the chance of both acute and overuse injuries.
-
Balance Deficiencies: Older adults, in particular, may have difficulty with balance, making falls and resultant injuries more likely during fast changes in movement.
Most Common Injuries in Pickleball
Pickleball injuries can affect almost every area of the body. Some of the most frequent injuries I encounter in my sports medicine practice include:
-
Achilles Tendonitis or Rupture: Inflammation or even tearing of the large tendon at the back of the ankle, typically resulting from explosive starts or sudden pivots.
-
Shoulder Injuries: Such as rotator cuff tendonitis, bursitis, impingement, or even tears. These often develop from repeated overhead shots or awkward reaches.
-
Patellar Tendonitis (Jumper’s Knee): Pain and swelling just below the kneecap, which can progress to partial tears with overuse or improper landing from jumps.
-
Tennis Elbow (Lateral Epicondylitis) or Golfer’s Elbow (Medial Epicondylitis): Inflammation of the tendons around the elbow joint due to repetitive swinging or improper technique.
-
Lower Back Pain: Often caused by twisting, bending, or poor court movement mechanics.
-
Ankle Sprains and Instability: Quick shifts and changes in direction can over-stress the ligaments around the ankle.
Treatment Options
The good news is that most Pickleball injuries can be effectively treated with conservative measures. The mainstays of initial management include:
-
Rest: Allow time for inflamed or injured tissues to recover and avoid activities that provoke pain.
-
Ice: Applying ice to the injured area can help reduce pain and swelling, especially in the first 48 to 72 hours.
-
NSAIDs: Nonsteroidal anti-inflammatory drugs (like ibuprofen) may help control pain and inflammation when used appropriately.
-
Activity Modification: Gradually returning to play, adjusting playing style, or limiting certain types of movement until fully recovered.
-
Physical Therapy: A structured rehabilitation program can restore strength, flexibility, and balance, as well as address biomechanical issues that contributed to injury.
-
Injections: In some cases, corticosteroid or platelet-rich plasma (PRP) injections may be used for persistent inflammation or pain.
- Advanced Biologic Therapeutics: Stem cell or exosome-based treatments may be considered for patients experiencing persistent inflammation or pain, offering a regenerative approach aimed at supporting tissue repair and functional recovery.
-
Surgical Repair: While rare, some injuries (like full tendon ruptures or severe tears) may require surgical intervention followed by a period of rehabilitation.
Preventing Pickleball Injuries
The best approach to Pickleball injuries is prevention. Here are several practical tips to help athletes of all ages minimize their risk:
-
Always warm up with light aerobic activity, dynamic stretching, and movement drills before playing.
-
Stretch regularly, focusing on the shoulders, calves, hamstrings, and lower back.
-
Strengthen your core and lower body through targeted exercises, enhancing stability and shock absorption.
-
Wear proper footwear specifically designed for court sports.
-
Work on balance drills to improve movement efficiency and stability, especially for older players.
-
Listen to your body: Don’t ignore nagging pains—early intervention is key.
Conclusion
Pickleball is a fantastic way to stay active and socialize, but, like any sport, it carries certain injury risks. By understanding the causes and types of injuries, recognizing the importance of proper training and preparation, and knowing when to seek treatment, you can maximize your enjoyment of the game and stay safely on the court for years to come.
If you’re experiencing pain or injury related to Pickleball or any other sport, don’t hesitate to consult with a sports medicine specialist for assessment and guidance.
CBS News: “Pickleball injuries could cost Americans up to $500 million this year …”
https://www.cbsnews.com/news/pickleball-injuries-will-cost-americans-up-to-500-million-this-year/
Advisory.com: “The estimated cost of pickleball injuries? Nearly $400M.”
https://www.advisory.com/daily-briefing/2023/06/29/pickleball
Dr. Drew Stein is an orthopedic sports medicine specialist with decades of experience treating athletes of all ages and abilities. For more information or to schedule a consultation, contact us.
