As the popularity of pickleball rises, with more than 8.9 million players in the U.S., a corresponding trend in the increase of injuries has developed. For example, more than 17,400 pickleball-related injuries required emergency room visits in 2022, according to data from a University of Arkansas study. And while the average age of a player is 35, those over 50 experienced more injuries than any other age group. This article will explore the risks of pickleball injuries and provide helpful strategies to prevent them.

What are the most common pickleball injuries?

People of all ages and fitness levels can enjoy pickleball because it is less strenuous than similar games like tennis and racquetball. Data from the University of Arkansas study suggests the age of a pickleball player is a good predictor of the likelihood of an injury. The cause of the injury also corresponds to the age of the participant:

Less than 26 years old — misuse of sports equipment

Age 26 to 50 — excessive physical activity

Players older than 50 account for over 87% of all pickleball injuries that required emergency room visits, according to the study. They also are more likely to have serious injuries, such as cardiac arrest, the study found. The fact that pickleball seems more popular among the elderly might account for some of their overrepresentation in the amount of injuries.

Chronic injuries

Pickleball-related injuries range from minor to severe. The University of Arkansas data shows that about 17% of them impact the upper trunk, 10% affect the head and 10% occur in the lower trunk. Injuries due to strain and overuse of the joints seem to be the most common. When you already have joint discomfort or arthritis, the strain of trying out a new activity can make it worse. Here are some of the most common wear and tear injuries.

• Tennis elbow, also known as pickleball elbow, is a common injury resulting from repetitive arm movements during gameplay, causing pain and discomfort in the outer part of the elbow.
• Shoulder injuries can occur due to the overhead swinging motion required in pickleball, leading to strains, sprains and even rotator cuff tears.
• Lower back pain may develop from sudden twisting or bending movements during play, impacting the lumbar spine and surrounding muscles.
• Achilles tendonitis, often caused by quick and repetitive footwork on the court, can result in inflammation and pain in the Achilles tendon, affecting mobility and comfort.

Fractures and sprains

Wrist injuries, ranging from sprains to fractures, are common in pickleball. In the Arkansas study, about 30% of all pickleball injuries requiring emergency room visits are fractures and 17% are sprains. They often happen when a person trips or falls and tries to brace the fall with an extended hand. Nearly half of all injuries in the elderly population are due to tripping or falling.

• Fractures can occur from falls or collisions on the pickleball court, resulting in broken bones that require medical attention.
• A sprained ankle, often caused by sudden twists or turns while running or pivoting, can lead to pain, swelling and instability.
• Knee strains and meniscus injuries can occur from sudden movements, as well as the repetitive bending and motion involved in pickleball, causing pain and loss of mobility.
• Hamstring strains can develop from overstretching or sudden movements during gameplay, resulting in pain, stiffness and weakness in the back of the thigh.
• Wrist sprains can happen from falls or impacts on the court, causing ligament tears, pain with wrist movement and reduced grip strength and dexterity.

Avoiding pickleball injuries

Several risk factors can increase a person’s susceptibility to pickleball injuries. For example, underlying musculoskeletal issues make individuals more prone to injury. For many people, physical therapy can address these concerns, providing targeted exercises to strengthen vulnerable areas and improve flexibility.

Recognizing that you can take proactive steps to avoid pickleball injuries is key to playing the game safely and having fun. Let’s look at some of the ways you can safeguard yourself against some of the risks inherent in sports.

Importance of warming up and cooling down

A complete warm-up is necessary to get your muscles and joints ready for movement before you hit the court. Stretches and light cardio can help increase blood flow and flexibility, reducing the risk of strains and sprains. Similarly, incorporating cooldown exercises at the end of your session can help alleviate muscle tension and promote recovery.

Maintaining hydration and nutrition

To prevent overuse injuries and promote prevention, be sure to drink plenty of water before, during and after your games to prevent dehydration and maintain electrolyte balance. Fueling your body with nutritious foods rich in carbohydrates, protein and vitamins supports higher energy levels and muscle recovery, further aiding in injury prevention on the pickleball court.

Strength and agility training for injury prevention

To improve pain management and avoid problems like ligament injuries, focus on exercises that target key muscle groups involved in pickleball movements, such as the legs, core, shoulders and wrists. Incorporating balance and coordination drills will improve your agility and stability, enhancing your ability to react quickly and safely during gameplay.

Proper equipment and techniques

To play pickleball safely, you need a good set of shoes, paddles and protective gear. Check the fit and quality of your gear to make sure it will provide enough support and protection. Consider wearing eyewear to protect your vision while playing.

It’s also important to build up your skills so you can swing, move and position yourself on the court properly. For example, some players often fall while back-pedaling to reach an overhead lob shot. The correct technique is to turn around and run to the back of the court to get into the best position. When you get good at reading the court and anticipating shots, you won’t have to dive for the ball or make clumsy strokes. Your performance and enjoyment of the game will improve, too.

Treatment for pickleball injuries

Sports medicine often recommends the RICE method (rest, ice, compression and elevation) for managing common injuries. It decreases swelling, eases discomfort and speeds up the healing process. In the early phases of an injury, resting and using compression treatments help stabilize the region, reduce movement and avoid more damage.

At Florida Medical Clinic, our Family Medicine providers are your first line of defense when it comes to staying healthy and active, both on and off the pickleball court. Whether you’re managing a chronic condition, recovering from a minor injury, or just need a wellness check-up, our team is here to help. We provide personalized, whole-person care to patients of all ages, and can guide you through injury prevention, treatment, and recovery, so you can get back to the game you love with confidence.

About Dr. Walker

Dr. Walker earned his medical degree from Chicago Medical School at Rosalind Franklin University in North Chicago, IL. He is board certified in Family Medicine by the American Board of Family Medicine.

Dr. Walker fosters a collaborative relationship with his patients through shared decisions and education. He offers family medicine care to all ages, providing services such as joint and trigger point injections, dermatological procedures, diabetes management, and laceration repair.

When not treating his patients, Dr. Walker enjoys spending time with family, the outdoors, and watching sports.