Pickleball Injuries: The Fastest Growing Sport

Pickleball has exploded in popularity, becoming the fastest-growing sport in North America. Its accessibility makes it appealing to players of all ages, but the quick movements and repetitive strokes can lead to injuries, particularly among older adults who make up a large portion of the player base. At M.O. Therapy in Markham, we help pickleball players prevent and recover from injuries to enjoy this exciting sport safely.

Understanding Pickleball Injuries

Pickleball injury patterns reflect the sport's unique demographics and demands:

• Lower extremity injuries account for approximately 50% of injuries
• Sprains and strains are most common (32%)
• Fractures occur in about 28% of injuries (often from falls)
• Older players face higher fracture risk
• Overuse injuries affect arms and shoulders
• Many injuries occur in players new to racquet sports

Common Pickleball Injuries

Pickleball Elbow (Lateral Epicondylitis)

Similar to tennis elbow, pickleball elbow involves pain on the outside of the elbow from repetitive wrist extension and gripping.

Causes:

• Repetitive backhand strokes
• Tight grip on paddle
• Poor stroke mechanics
• Sudden increase in playing frequency
• Paddle too heavy or wrong grip size

Symptoms:

• Pain on outside of elbow
• Weak grip strength
• Pain with wrist extension
• Difficulty with daily activities
• Pain that may radiate down forearm

Treatment:

• Rest from aggravating activities
• Ice after playing
• Counterforce brace
• Physical therapy exercises
• Gradual return to play

Prevention:

• Proper stroke technique
• Appropriate paddle weight and grip size
• Gradual increase in playing time
• Forearm strengthening exercises
• Warm-up before playing

Shoulder Injuries

Rotator Cuff Problems: The overhead serve and reaching for shots stress the shoulder.

Causes:

• Repetitive serving motion
• Reaching for wide shots
• Previous shoulder problems
• Weak rotator cuff muscles

Prevention:

• Rotator cuff strengthening
• Proper serving technique
• Adequate warm-up
• Not playing through shoulder pain

Shoulder Impingement: Pain when lifting arm, particularly during serves.

Treatment:

• Rest from aggravating movements
• Physical therapy
• Strengthening exercises
• Technique modification

Knee Injuries

The quick lateral movements and sudden stops in pickleball stress the knees.

Meniscus Tears:

• Often occur during pivoting
• May feel catching or locking
• Swelling after activity
• More common in older players

Patellofemoral Pain:

• Pain around or behind kneecap
• Worse with stairs and squatting
• Common with increased play

Ligament Strains:

• MCL and LCL strains from lateral movements
• May occur from awkward pivoting
• Can range from mild to severe

Prevention:

• Proper footwear with lateral support
• Leg strengthening exercises
• Adequate warm-up
• Playing on appropriate surfaces

Ankle Injuries

Ankle Sprains: The most common acute injury in pickleball, resulting from quick lateral movements.

Risk Factors:

• Previous ankle sprains
• Inadequate footwear
• Uneven court surfaces
• Fatigue

Prevention:

• Shoes designed for court sports
• Ankle strengthening exercises
• Balance training
• Awareness of court conditions

Treatment:

• RICE protocol initially
• Progressive rehabilitation
• Return to play when strength and stability restored
• Consider bracing for return

Achilles Tendon Injuries

Achilles Tendinopathy: Overuse injury from repetitive pushing off and pivoting.

Symptoms:

• Pain and stiffness in Achilles
• Worse after rest
• May improve with movement initially

Prevention:

• Calf stretching and strengthening
• Gradual training increases
• Proper footwear
• Adequate warm-up

Achilles Rupture: A serious injury more common in middle-aged players.

Warning Signs:

• Sudden pop or snap
• Severe pain
• Inability to push off
• Gap in tendon

This requires immediate medical attention and usually surgical repair.

Falls and Fractures

Falls are a significant concern in pickleball, particularly for older players.

Common Fall-Related Injuries:

• Wrist fractures (FOOSH injuries)
• Hip fractures
• Shoulder injuries
• Head injuries

Prevention:

• Proper footwear
• Awareness of court conditions
• Playing within ability
• Good court lighting
• Non-slip court surfaces

Age-Related Considerations

Players Over 50

Older players face unique challenges:

• Higher bone fracture risk
• Longer recovery times
• Pre-existing conditions may be aggravated
• Cardiovascular considerations
• Balance and reaction time changes

Recommendations:

• Medical clearance before starting
• Gradual progression of activity
• Focus on warm-up and stretching
• Appropriate footwear
• Playing within physical limits
• Staying hydrated
• Knowing when to stop

New Players

Those new to racquet sports face higher injury risk:

• Learning proper technique takes time
• Tendency to overplay initially
• May not recognize warning signs
• Equipment may not be optimal

Recommendations:

• Take lessons for proper technique
• Start with shorter sessions
• Progress playing time gradually
• Invest in appropriate equipment
• Listen to body signals

Prevention Strategies

Proper Equipment

Footwear:

• Court shoes with lateral support
• Proper cushioning
• Non-marking soles
• Replace when worn

Paddle Selection:

• Appropriate weight for your strength
• Correct grip size
• Quality paddle for your level

Protective Gear:

• Eyewear recommended
• Consider knee braces if needed
• Wrist support for history of problems

Warm-Up Protocol

Dynamic Warm-Up (10 minutes):

1. Light jogging or marching
2. Arm circles and shoulder rotations
3. Lateral shuffles
4. Leg swings
5. Wrist circles
6. Light rallying to start

Strength and Conditioning

Essential Exercises:

Lower Body:

• Squats or chair squats
• Lunges
• Calf raises
• Single-leg balance

Upper Body:

• Rotator cuff exercises
• Wrist curls
• Grip strengthening
• Shoulder blade squeezes

Core:

• Plank (modified if needed)
• Bird dogs
• Gentle rotation exercises

Playing Smart

• Warm up properly before playing
• Take breaks during long sessions
• Stay hydrated
• Know your limits
• Stop if pain develops
• Allow recovery between sessions

Treatment at M.O. Therapy

Physiotherapy

Our physiotherapists help pickleball players:

Services:

• Injury assessment and treatment
• Rehabilitation programs
• Return-to-play protocols
• Prevention strategies
• Equipment recommendations

Massage Therapy

Our RMTs support pickleball players:

• Recovery after intense play
• Address muscle tension
• Improve flexibility
• Maintenance treatments

Chiropractic Care

Chiropractic benefits pickleball players through:

• Joint assessment and treatment
• Mobility optimization
• Soft tissue therapy
• Movement enhancement

Frequently Asked Questions

What is pickleball elbow? Pickleball elbow is similar to tennis elbow—pain on the outside of the elbow caused by repetitive gripping and wrist extension. It responds well to rest, physical therapy exercises, and technique modification.

How can I prevent injuries as an older pickleball player? Key prevention strategies include proper warm-up, appropriate footwear, gradual progression of playing time, strength and balance exercises, staying within your physical limits, and listening to your body's warning signals.

Should I wear special shoes for pickleball? Yes, court shoes designed for lateral movement are strongly recommended. Running shoes don't provide adequate lateral support and increase ankle injury risk.

How long should I wait after an injury before playing again? Recovery time varies by injury. Generally, you should be pain-free with full range of motion and strength before returning. For significant injuries, professional evaluation helps determine safe return timing.

Book Your Assessment

If you're dealing with a pickleball injury or want to develop a prevention program, M.O. Therapy in Markham can help. Our team understands the unique demands of this growing sport.

Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.