Take Steps to Avoid Injury and Keep the Fun in Pickleball

Pickleball, a once relatively unknown racket sport, has rapidly gained traction, and its appeal is not surprising given its many benefits. The sport enhances cardiovascular fitness, helping to keep the heart strong and healthy, and also plays a role in improving bone density and muscle strength—key factors in preventing osteoporosis and maintaining mobility, which are so important for postmenopausal women. Beyond the physical benefits, pickleball offers social perks. The smaller court size and doubles play format foster social interaction, which is vital for mental health, reducing feelings of isolation that can sometimes accompany aging.

However, as with any sport, pickleball comes with risks in terms of injury. Understanding these risks and taking steps to prevent them is key to safely playing the game.

Prepping for Pickleball

The smaller court size and specific movements in pickleball are associated with a unique set of injury patterns. Pickleball’s emphasis on pivoting and lateral movements puts stress on the joints and muscles, particularly in the legs and lower back. The rapid, frequent changes in direction required by the smaller court increase the risk of lower body injuries such as ankle sprains and knee strains. What’s more, the quicker strokes used in pickleball can lead to overuse injuries such as “pickleball elbow” (lateral epicondylitis), due to repetitive stress on the forearm muscles and tendons. “We’re seeing a lot of ankle injuries, Achilles tendon tears, lower back injuries, disc herniations, and lateral epicondylitis,” says Jaspal “Ricky” Singh, MD, assistant professor of clinical rehabilitation medicine and director of the Interventional Spine Program at Weill Cornell Medicine.

One of the most effective ways to reduce the risk of injury is by stretching prior to playing. “When you prepare for pickleball, start with dynamic stretching, and then move on to static stretching,” says Dr. Singh. Dynamic stretches are controlled movements that prepare your muscles, ligaments, and other soft tissues for performance and safety. This type of stretching improves speed, agility, and acceleration. Static stretching requires you to move a muscle as far as it can go without feeling any pain, and then holding that position for up to 45 seconds. Static stretches, which are an effective way to increase flexibility, should be repeated two to three times each.

Common Pickleball Injuries

Sprains and strains. Sprains (injuries to ligaments) and strains (injuries to muscles or tendons) are common in pickleball, in the ankles, knees, and shoulders. They tend to result from the quick changes in direction and sudden stops. Prevention: Warm up before playing, regularly perform stretching exercises, and wear supportive footwear designed for court sports.

Pickleball elbow (lateral epicondylitis). This overuse injury causes pain around the outside of the elbow and is common among pickleball players due to the repetitive nature of the sport. Prevention: Ensure that the paddle grip size is appropriate for your hand, and engage in strength training for your forearm muscles.

Fractures. Falls during pickleball can lead to fractures, with broken bones being a major concern for older women, particularly those with osteoporosis. Prevention: Regularly engage in exercises that improve balance, wear proper footwear with good traction, and consider the use of knee or elbow pads.

Lower back pain. The quick movements and pivoting in pickleball can strain back muscles and ligaments. Prevention: Maintain a strong core through regular exercise, use proper technique to avoid excessive twisting, and perform regular back stretches.

Steps to Take if Injured

If you are injured while playing pickleball, Dr. Singh says the most important thing to do is stop playing. “Ice the area and take an NSAID to reduce inflammation. In most cases, there will be gradual improvement with reduced pain over a few days. If you have a significant muscle or tendon strain, it could take a couple of weeks,” he says. “If the pain continues for more than two weeks, seek medical attention from a physical therapist or a sports medicine specialist.”

If you enjoy pickleball or are considering taking it up, make sure to use appropriate gear and stretch before playing. These preventive measures can help reduce the likelihood of injury and allow you to enjoy the game safely.

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