Common pickleball injuries: causes, treatments, exercises

Pickleball has exploded in popularity over the past couple of years, and for good reason. It’s a fun and social way to stay active.

Like any sport, though, it comes with some risk of injury, especially as more people pick up a paddle. “While pickleball injuries are increasing along with participation, especially among older players, the rewards of playing are far greater than the risks,” says Sarah Melear, PT, DPT, a physical therapist at Hinge Health. 

Many common pickleball injuries are preventable and treatable with simple at-home strategies, such as targeted exercises and heat and cold therapy. Read on to learn more about some of the most common pickleball injuries, including what causes them and how to treat and prevent them, especially with exercises recommended by Hinge Health physical therapists.

Common pickleball injuries

Pickleball isn’t considered a high-risk sport, but like any physical activity, injuries can happen — especially with sudden movements or repetitive play. The most common injuries include strains, sprains, and stress fractures (and acute or traumatic fractures). Research suggests knees are often the most affected joint, followed by the thigh, leg, and foot (combined), shoulder, back, and elbow.

Common types of pickleball injuries include:

• Acute injuries. These happen suddenly — often from slips, trips, falls, or quick movements. Sprains and strains are most common, while fractures (usually in the wrist) are less frequent. Improving balance, strength, and awareness on the court can help reduce your risk.

• Overuse injuries. These develop gradually from repetitive motions or doing more activity than your body is prepared for. Common examples include tendonitis in the elbow, shoulder, wrist, or Achilles tendon. Bursitis and stress fractures are other types of overuse injuries that can happen. Gradually increasing activity and conditioning your body can help prevent these types of injuries.

• Knee injuries. Frequent pivoting, lateral movement, and quick stops can stress the knees. Injuries may be acute (such as a ligament or ACL injury) or overuse-related. Following a consistent strength training routine can help condition the muscles that support your knee, thereby protecting the soft tissues in and around it. 

Why pickleball injuries happen

Injuries usually come down to a mix of factors, including:

• Lack of preparation. “Pickleball looks easy and accessible, compared to some other sports, so people often jump in without the strength or mobility their bodies need to support those movements,” says Dr. Melear.

• Sudden movements and direction changes. Quick pivots, stops, and side-to-side motions can challenge your body — especially if you’re new to the sport. These abrupt stops and movements can sometimes lead to injuries if your body isn’t used to those demands. 

• Repetitive motions. Frequent swinging and quick footwork can strain your joints and muscles, particularly if your body isn’t conditioned for it.

• Overdoing it. Rapid increases in play time or intensity can overload muscles and joints — even for experienced players.

• Muscle imbalances. Weakness in one area can place extra strain elsewhere. “For example, Achilles tendonitis can be linked to weakness higher up in the legs,” says Dr. Melear.

• Age-related factors. Natural changes in strength, flexibility, and tissue resilience can increase injury risk — but smart training can offset this.

• Court hazards and falls. Slippery surfaces, debris, or collisions are common contributors to acute injuries.

How movement can help with pickleball injuries

It’s natural to think rest is best after an injury. But in most cases, unless your doctor has specifically prescribed rest for a given injury, gentle movement is key to recovery and prevention. Movement is medicine — it helps reduce stiffness, improve circulation, restore range of motion, and ease pain, says Dr. Melear.

Whether you’re recovering or trying to stay injury-free, targeted exercise can address underlying issues like muscle weakness, tightness, or poor balance. Over time, this helps your body better handle the demands of pickleball.

A physical therapist can guide you toward the right exercises for your needs, helping you recover and return to the court stronger and more confident.

These exercises help condition your body for pickleball to prevent injuries and support your recovery from common tweaks. The standing calf and standing hamstring stretches improve range of motion and reduce muscle tightness, which, in part, helps prevent strains and other muscle injuries. Forearm stretches and strengthening can support the muscles used for gripping the paddle, helping reduce elbow and wrist irritation from frequent play. The single leg stance and single leg balance build lower-body strength and can improve your balance. Finally, the banded rotation pull apart and shoulder rows help keep your upper back and shoulders strong and resilient.

The information contained in these videos is intended to be used for educational purposes only and does not constitute medical advice or treatment for any specific condition. Hinge Health is not your healthcare provider and is not responsible for any injury sustained or exacerbated by your use of or participation in these exercises. Please consult with your healthcare provider with any questions you may have about your medical condition or treatment.

Treatments for pickleball injuries

Most pickleball injuries improve with at-home treatments. Exercise therapy and physical therapy play a central role in recovery and long-term injury prevention. Other tools — like ice, heat, TENS, or over-the-counter medication — can help manage symptoms so you can stay active and continue your rehab. These simple approaches include:

• Try physical therapy and targeted exercises. Targeted exercises can help strengthen and stretch the muscles that support the joints you use when you play pickleball. You can do exercise therapy at home or work with a physical therapist who can guide you through movements tailored to your needs. You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

• The PEACE & LOVE method. This modern approach to injury recovery emphasizes movement and gradual loading instead of prolonged rest. It expands on the traditional RICE method by supporting healing while helping you stay active and rebuild strength.

• Stay active. Whether it’s walking, stretching, or other everyday activities, staying active increases blood flow and helps prevent muscle tightness and weakness, aiding recovery. Keep any activity at a comfortable level to avoid aggravating symptoms. Hinge Health physical therapists refer to this range as your movement sweet spot.

• Apply heat or cold therapy. Both can help you manage pickleball injuries. Ice can reduce swelling and pain, whereas heat helps loosen tight muscles and increase blood flow to promote healing. Alternate between the two, or stick to the method that brings you the most relief.

• Take over-the-counter (OTC) medication. Pain relievers such as ibuprofen (Advil, Motrin), naproxen (Aleve), and acetaminophen (Tylenol) can help ease pain so you can do your targeted exercises and stay active when you have pain from a pickleball injury. Other options are topical NSAIDs or pain relief creams. If you have a medical condition or take other medications, check in with your provider to make sure these OTC options are safe to take.

• Ask about TENS therapy. TENS, or transcutaneous electrical nerve stimulation, uses gentle pulses to quiet your pain response and help reduce pain. You can use TENS therapy before playing pickleball to help ease discomfort and prepare for activity, or afterward to manage soreness and help with recovery. One option is the wearable device Enso, available through Hinge Health. It’s small, wireless, and portable.

• Consider complementary treatments. Talk to your provider if you’re interested in trying alternative treatments for pickleball injuries, such as massage, acupuncture, and chiropractic care.

How to prevent pickleball injuries

You can’t prevent every injury, but many are avoidable with simple on- and off-the-court strategies. Building strength, improving balance, and being mindful of how you move on the court can go a long way in reducing your risk. Here’s what Hinge Health physical therapists recommend:

• Warm up. Take five to 10 minutes for a dynamic warm-up before you play. It helps increase blood flow, loosen muscles and joints, and prepare your body for movement.

• Train off the court. “Proper conditioning, which includes stretching, strengthening, and dynamic balance training, can help prevent injuries on the court,” says Dr. Melear. A physical therapist can design a personalized program.

• Build up gradually. Give your body time to adapt. Start with shorter sessions and increase intensity slowly. Taking active rest days (think: a light yoga session or leisurely walk) and breaks between games can help prevent overuse injuries.

• Wear the right gear. Choose court or tennis shoes for better support during quick, side-to-side movements. If needed, wear protective eyewear to reduce the risk of eye injuries.

• Be aware of your surroundings. Check the court for wet spots, cracks, or debris before playing. Communicate with your partner to avoid collisions. 

• Be cautious with backpedaling. Moving backward to hit the ball can increase fall risk. If you have balance issues, try to avoid backpedaling — it’s safer to turn and move forward or sideways.

• Take a lesson. Taking a lesson or working with a coach can help you avoid movement patterns that put unnecessary strain on your body and ensure your equipment fits you well. For example, a paddle that’s too heavy can cause wrist, elbow, or shoulder injuries.

• Cool down and recover. Stretching after a game can help reduce muscle tension and improve flexibility. Prioritizing rest, sleep, and stress management also plays a role in injury prevention.

• Listen to your body. If you feel pain or fatigue, take a break. Pushing through discomfort can increase your risk of injury.

Is pickleball safe for older adults? 

“Yes — pickleball can be safe for older adults, especially if they build up gradually,” says Dr. Melear. “I’ve seen so many people enjoy it and experience real benefits.”

Pickleball can improve cardiovascular fitness, balance, coordination, and overall strength. It also offers social and mental health benefits, helping boost mood, reduce stress, and even decrease feelings of loneliness.

While older adults make up a larger share of pickleball-related injuries, that’s largely because more people in this group are playing. With proper conditioning, strength and balance training, and a gradual ramping up of activity, many injuries can be avoided. Pacing yourself and giving your body time to adapt can help you stay active and enjoy the game safely.

When to see a doctor

Many pickleball injuries improve with simple at-home care and activity modification. But if your pain is severe, getting worse, or interfering with daily activities, it’s important to see a healthcare provider. You should also seek care if you have:

• Sudden, severe pain or swelling

• Inability to bear weight or move the affected area

• Visible deformity or joint instability

• Signs of a fracture (such as sharp pain after a fall or significant tenderness)

• A fall or collision that involves hitting your head

• Symptoms that don’t improve after several days of home care

• Recurrent injuries in the same area

PT tip: Stay focused on the court

“Injuries often happen when you’re distracted,” says Dr. Melear. Stay focused during play and save socializing for breaks between matches.

How Hinge Health can help you

If you have joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app when and where it works for you.

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.

References

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5. Stroesser, K., Mulcaster, A., & Andrews, D. M. (2024). Pickleball Participation and the Health and Well-Being of Adults—A Scoping Review. Journal of Physical Activity and Health, 21(9), 1–14. doi:10.1123/jpah.2024-0092

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