5 Common Pickleball Injuries — and How to Avoid Them

If you’re one of the 8.9 million Americans who play pickleball, according to the Sports & Fitness Industry Association (SFIA), you know how fun — and challenging — the sport can be. As social and camaraderie-based as the sport is, it can also be tough on your body.

Pickleball is now the fastest growing-sport in America, according to SFIA’s 2023 report. Participation nearly doubled in 2022, increasing by 85.7 percent year over year, and it grew by a whopping 158.6 percent over three years.

However, while pickleball has gained popularity, so, too, have the injury rates of players, as a study published in 2020 in The Journal of Emergency Medicine points out. The study, which looked at pickleball-related injuries treated in emergency departments from 2001 to 2017, found that in 2013 there were 688 estimated injuries from pickleball, a figure that jumped to 6,072 in 2017. (As of January 1, 2019, membership in the United States of America Pickleball Association had increased 650 percent over the 2013 numbers.)

“As a sports specialist, it’s interesting to see the waves of activity trends. Pickleball seems more welcoming to a wider population, so you’re seeing a big range of age ranges coming in injured,” says physical therapist Leada Malek, DPT, a board-certified sports specialist in San Francisco.

While the sport is popular with older adults, the average age of a pickleball player is 35 years old; the age group with the most participants is 25 to 34, according to SIFA. The 18 to 24 and 65-plus age groups are tied for having the second-highest number of participants.

Injuries are far more likely to occur in pickleball players who are over 40, and they are even more likely among adults ages 50 and older, according to a review published in Apunts Sports Medicine in January 2023. In addition to their age, some new players come to the sport without adequate conditioning: “This is a demanding activity that requires strength training and endurance, and that’s often missed,” says Malek.

As a result, there are some common pickleball injuries worth having on your radar. Read on to know what to look out for — and how to prevent them, so you can keep playing the sport you love.

1. Sprains and Strains

Sprains (a stretched or torn ligament) and strains (a stretched or torn muscle or tendon, per the National Library of Medicine) account for one-third of pickleball injuries, according to a study published in Injury Epidemiology in 2021 that mostly focused on adults ages 60 and older. Malek sees hamstring and calf strains and ankle sprains the most often, and knee injuries have also been reported. The need to run, stop, plant your feet, and abruptly change direction can make strains and sprains more likely if your body isn’t ready for that type of movement, says Louisville-based sports medicine physical therapist Daryl Williams, DPT.

2. Low Back Pain

“There are many factors that contribute to stress on the lower back, including a lack of core strength,” says Williams. In addition, as you run forward and decelerate quickly, your quads have to engage to “put on your brakes,” and that movement can cause sudden flexion in the back, something that can cause strain if your back isn’t ready for it, says Malek. “Everything in your posterior chain has to be ready for a sudden stop in pickleball,” she says.

3. Fractures

A fracture is considered a type of traumatic injury, and it occurred in 28 percent of older adults playing pickleball, according to the 2021 study, and it affected 3.5 times as many women as men. The wrist was the area most vulnerable to fractures. One reason why? You can slip or trip and fall on the court with your wrist (literally) breaking your fall, says Malek. In fact, a study about upper body injuries in pickleball and paddleball, published in Cureus in 2023, backs this up, noting that the majority of upper body injuries were wrist fractures from a fall or dive; some even required surgery.

4. Upper Body Injuries

While upper body injuries are less common than lower body ones, according to the 2020 study, there’s still a risk. Pickleball requires similar motions as other racquet sports, and those mechanics predispose your upper body to injuries that are like what you’d see in tennis, says Malek.

In the Cureus study noted above, 18 percent of the injuries were located in the elbow, followed by 4 percent in the shoulder. Since most of the force to needed to hit the ball is generated by your wrist and elbow, you may experience pain in those areas. Swinging the paddle overhead (called an overhead smash) can also contribute to rotator cuff tendon tears, says Williams. Or you might simply experience soreness in your shoulder, wrist, or elbow due to overtraining, which means you’re putting too much stress on the joints during repeated play, without sufficient rest and recovery.

5. Bruises and Scrapes

It’s brutal out there! In an attempt to give your best effort on the court, you might fall and get a scrape, trip over a ball, or even run into a fence or wall. The result? A bruise or scrape, which affected about 1 in 10 pickleball players in the 2021 study. While these injuries don’t often sideline you, they are common.

How to Prevent Pickleball Injuries

You can’t stop every injury from happening, and you might get bruises and scrapes from time to time — but there are things you can do to decrease the risk of developing an injury that sidelines you:

Recover well. “Make sure that you have enough time between pickleball sessions or games to recover,” says Malek. Fit in a day of rest or recovery in between pickleball days, she recommends. And make sure that you’re also maintaining a balanced diet and getting adequate sleep, both of which aid in recovery.

Train outside of pickleball. Pickleball is a good workout, but you need other forms of training as well. Resistance training is crucial to build upper and lower body strength, as well as core and back stability, says Malek. “Strength training allows your body to be more prepared to handle the repetitive nature of running, bending forward, and changing directions in pickleball,” she says. Cardio exercise will also build the endurance needed to run around the court during games. The current Physical Activity Guidelines for Americans recommends that adults do at least 150 minutes of moderate-intensity aerobic activity per week, as well as muscle-strengthening activities of moderate (or greater) intensity on two or more days a week. Older adults should also include balance-training activities, such as walking heel to toe, practicing standing from a sitting position, and using a wobble board.

Know when to stop. “Pain is a signal from the brain; it’s your body trying to tell you something,” says Malek. It’s not always indicative of an injury, but it is a sign to slow down or stop altogether. If discomfort is limiting the way you move or is affecting your sleep, you should see a doctor to get it checked out. The sooner you do, the sooner you can get the treatment you need to get back out there to play the sport you love.

Make sure you warm up. Getting an adequate warm-up can help you prevent pickleball injuries and possibly improve your performance. Pickleball University recommends a few different pickleball warm-up drills, including at least one or two minutes of stretching your calves, back, and shoulders; dinking, where you and your partner (or opponent) line up on the non-volley zone line and “dink” the ball to each other with soft shots; and playing a pretend match using half the court, as well as other drills.