pickleball injuries

Pickleball Injuries: What to Watch Out For Houston

In Sports Injury and Pain by Brad Rickert

Pickleball injuries on the rise.

When we first read that headline, we weren’t surprised. After all, we treat pickleball related injuries in our clinics.

The study noted that the most common injuries were lower extremity sprains, strains, and fractures. We’ve seen lower back, rotator cuff, and elbow related pains, too. In fact, most pickleball injuries look like tennis related injuries.

Pickleball injuries disproportionately affect the 50+ year old crowd.

According to the Journal of Emergency Medicine, “patients 50 years or older accounted for 90.9% of the patients”.

In a 2010-2019 non-fatal senior pickleball and tennis-related injury study, women were over three-and-a-half times more likely to suffer a fracture compared to men and nine times more likely to suffer a wrist fracture.

Because pickleball seems easier to play, older players have flocked to the sport. Injuries often occur when players aren’t in shape, make incorrect movements, or use improper techniques.

Remember, “When you’re young, you play to get in shape. When you’re older, you need to get in shape to play”. This discipline helps you to play safely and lessen your chances for injury.

We suspect actual pickleball injury numbers are probably higher.

The study estimated the total nationwide injuries based on 300 emergency room visits.

In our experience, it’s not unusual for people with less serious strains and sprains to avoid E.R. visits. Instead, they rely on a physical therapist, physician, or administer self care.

Exactly, what is pickle ball and how is the game played?

The USA Pickleball organization describes the sport as “a fun sport that combines many elements of tennis, badminton and ping-pong”.

You play on a badminton sized court, indoors or out, using a paddle and plastic ball with holes.

Big name celebrities such as Mark Cuban, LeBron James, and Tom Brady are involved in increasing the legitimacy of pickleball as a professional sport.

In October ’22, Houston hosted a national pickleball tournament.

Instead of additional descriptions, we’ll show you:


What about pickleball as exercise?

As we age, it’s always better to be active vs. sedentary. Pickleball can

  • promote aerobic exercise
  • improve a players cardio-vascular endurance
  • develop muscular endurance
  • enhance your agility
  • maintain and enhance hand-eye coordination

Not to mention, retired people and widowed participants can get the socialization and competitive spirit which helps with mental health.

However, there is always some inherent risk of injury associated with any physical activity. As we are about to discuss, pickleball injuries are on the rise.

Most common pickleball injuries

Your lower back

Pickleball often requires long periods of time spent in spinal flexion and requires frequent spinal/trunk rotation. If you’re not appropriately prepared, this places your lower back at increased risk for injury.

If your core, obliques, and spinal extensors are not prepared for the increase in demand and stability, you can experience soreness and potential joint/nerve pain. In turn, you could significantly limit your function and mobility.

Pickleball related knee injuries

Due to the quick reaction and movement required in a condensed space like a pickleball court, as well as the multiple planes of movement required, your knees are at increased risk for injury.

With any twisting activity, you are at risk for meniscus and MCL injuries. Given the need to push off and land on one or each leg, any quad/hamstring weakness could lead to buckling and potential ligamentous damage.

If you suffer with knee arthritis, playing pickleball can exacerbate knee pain.

Also, as you age, your meniscus becomes more brittle and, under stress situations, prone to injury.

Your feet 

Rapid directional changes on a hard pickleball court can leave a player with painful blisters on their feet.

Another problem could be “Turf Toe” or spraining the ligaments of the big toe joint from forceful repetitive pushing off of the foot.

A similar condition, but in the arch of the foot is called Plantar Fasciitis.

It’s important to have properly fitted court shoes with an arch support to fit your needs. We recommend going to a specialized sports shoe store to get fitted for the specific shoe for you. Wearing a thin sock covered by a thicker sock may help prevent blisters.

Your ankles

Similar to tennis and other sports that involve rapid and frequent change in directions, a lateral or high ankle sprain would be a very common injury. Proper footwear and support (taping, bracing) to the ankles can help as potential prevention tactics. Even better, increasing the strength through your ankle musculature and entire lower extremity kinetic chain allows for avoidance of these injuries with continued participation.

Pickleball wrist pains

Due to the smaller court size and lighter ball, pickleball requires increased wrist engagement and “snapping”. This places more strain on the wrist, even for experienced tennis athletes. This can lead to painful tendon damage.

Falling onto an outstretched arm and hand can cause a “Colles Fracture”. A break of the distal radius and ulnar bones may require surgical intervention.

Shoulder injuries

Fortunately, pickleball does not have the same high demand of overhead activity as tennis.

Regardless, pickleball places increased demand on your rotator cuff. Any repetitive and quick-twitch movements without appropriate rotator cuff strengthening and engagement can result in rotator cuff strains and tears.

Pickleball elbow pain

Given the similar mechanism of the sport to tennis, it is not shocking that tennis elbow is a very common pathology in pickleball players. Especially, when participants quickly “ramp up” their playing time. This puts tendons at increased risk if not appropriately warmed up or prepared for the level of quick, “snapping” movements.

Tennis elbow happens when the tendons on the outside of the elbow become overloaded and inflamed.  It is a painful condition with most activities making it difficult to grip and lift. If this occurs, you will be sidelined off the pickleball court for 6-8 weeks.

Pickleball hip injuries

Just like low back injuries, the hips are at risk from the stooping forward while moving in unplanned movement patterns to the ball. The hip joint has a deeper socket than the shoulder which stabilizes your hip. Your hip does have soft cartilage called the labrum. Similar to the meniscus, the labrum can become brittle and tear from rotational movements.

Other injuries

Pickleball is often played with 2 people (doubles) on each side of the small court. Because of close proximity, there can be player-to-player collisions. Also, contact with the paddle to your partner’s body can cause contusions, sprains, or fractures. We strongly advise the use of eye protection to prevent eye injuries from a paddle, the ball or a partners hand.

How can I avoid pickleball injuries?

Be cognizant with your initial participation. Avoid playing for too long in your first few times out. This helps you avoid overuse injuries for tendons and muscles that are not used to pickleball movement patterns.

Next, be sure to warm up appropriately. Warm up prepares your soft tissues (muscles, tendons, ligaments) for the stress and movements required in the game. Lastly, as you increase your playing frequency, specific training of your shoulder, elbow, wrists, low back, hips, knees and ankle/foot can help to minimize injury.

What is the best way to warm up before playing pickleball?

Before any dynamic, sporting activity, a more active warm-up helps prevent soft-tissue injury. To prepare your heart and lungs for the the games fast pace, make sure you are able to complete some light-moderate intensity cardiovascular exercise. Also, make sure to stretch your arms, back, and legs to allow for appropriate blood flow through these tissues to avoid injury.

What should I do to cool down after playing pickleball?

A light jog or walk helps your heart rate and blood pressure to safely decrease to normal levels. Light stretching can help prevent significant soreness after sport participation.

What should I do immediately if I injure myself playing pickleball?

If you suspect a fracture of some sort, reach out to your doctor immediately. With any other pains, apply ice to reduce swelling. Then, reach out to a physical therapist and a doctor to rehabilitate your injury.

Ready to give pickleball a try?

Where to find Houston area pickleball courts


Friendswood https://www.facebook.com/groups/1513531952276188/

River Oaks https://www.places2play.org/place?id=10504

If you develop a pain, strain, or musculoskeletal injury, we’re here to help you.

Don’t suffer with your musculoskeletal pain or injury. Get treatment in 24-36 hours. Call  Friendswood (281) 482-7380 or River Oaks (832) 409-6390