What You Can Do To Heal and Prevent Pickleball Injuries

Pickleball is America’s fastest-growing sport and has lately seen a sharp rise in participation in Singapore, particularly among older adults. Its appeal lies in its accessibility and the quick-paced nature of the game. However, as the number of pickleball players increases, so does the number of pickleball injuries.

UC Davis Health and USA Pickleball have noted a significant uptick in pickleball-related injuries presenting in emergency departments, especially lower extremity injuries like ankle sprains, knee injuries, and hip injuries. This guide discusses the most common pickleball injuries, how to heal, and crucial injury prevention strategies.

Common Pickleball Injuries

Due to the stop-and-go movements and sudden changes of direction on the court, overuse injuries and acute strains are frequent in pickleball. Injuries have surged alongside the sport’s popularity. Annual ER-treated pickleball injuries rose from just hundreds in the early 2000s to tens of thousands. Pickleball-related fractures rose 90 times from 2002 to 2022, and the number of cases doubled after 2020. Many injuries stem from falls onto outstretched hands (FOOSH), which is common in racquet sports.

Here are the most common injuries sustained by pickleball players.

Ankle Sprains

Strains and sprains are the most frequent injuries among pickleball players. For senior players (aged 60+), they account for around 33% of injuries. These injuries often result in ligament damage and swelling.

Achilles Tendinitis

Repetitive jumping and quick propulsion on the court place strain on the Achilles tendon, often causing inflammation and pain. Left untreated, it can escalate to Achilles tendon tears.

Plantar Fasciitis

Pickleball involves frequent heel strikes and changes in direction, which place stress on the plantar fascia. Plantar fasciitis causes stabbing pain under the heel, particularly during initial steps after rest.

Knee Pain and Meniscus Strain

Knee sprains and meniscus injuries are common due to twisting motions. The strain on ligaments and cartilage can limit mobility and may require extensive rehabilitation.

Hamstring or Calf Strain

Quick lunges and forward bursts can lead to muscle strains, particularly in the hamstrings and calves. These injuries can range from mild tightness to partial tears.

Lower Back Pain

Inadequate core strength or improper rotation when reaching for shots contributes to lower back discomfort. Prolonged or repetitive strain may lead to disc issues or muscle spasms.

Shoulder Impingement

Serving and overhead shots can cause compression in the shoulder joint, leading to inflammation and impingement symptoms. This injury is likely to occur in players lacking shoulder stability or strength.

Rotator Cuff Injury

A rotator cuff injury is another result of overhead strokes. Tears or tendinitis in these shoulder muscles can severely limit arm function.

Tennis Elbow / Lateral Epicondylitis

Often called pickleball elbow, this overuse injury stems from repeated paddle swings. It causes pain on the outer elbow, especially when gripping or lifting.

Wrist Sprain or Overuse

Wrist injuries are common in racquet sports like pickleball. Repetitive flicking motions or bracing during a fall can lead to sprains, tendon inflammation, or even bone fractures in extreme cases.

Pickleball Injury Treatment

Recovering properly from pickleball-related injuries is crucial for returning to the court. While some injuries are mild and self-limiting, others require structured rehab, targeted therapy, and a cautious return to sport. Below is a breakdown of treatment strategies based on injury type and severity.

RICE Method (Rest, Ice, Compression, Elevation)

The RICE method remains a go-to first aid protocol for acute injuries like sprains, strains, and minor contusions.

• Rest reduces further stress on injured tissues.
• Ice helps limit swelling and numbs pain—recommended for 15–20 minute intervals, several times daily within the first 48 hours.
• Compression, using an elastic bandage, helps manage swelling and supports the area.
• Elevation encourages fluid drainage and reduces inflammation.

While effective for the first 48–72 hours post-injury, RICE is often just the beginning. Persistent symptoms may need targeted care.

Manual Therapy and Soft Tissue Mobilisation

For injuries involving muscle tension, joint stiffness, or movement restrictions, manual therapy offers hands-on relief. For example, soft tissue mobilisation can reduce muscle knots and scar tissue buildup. Meanwhile, joint mobilisations restore normal joint motion, particularly in the shoulder, hips, and spine.

These techniques are often used with stretching and movement retraining, especially for hamstring pulls, hip flexor strains, or stiff shoulders from repetitive overhead movements (like serving or smashing).

Physiotherapy for Range of Motion and Strength

Targeted physiotherapy addresses muscle imbalances and joint stiffness. For example, physiotherapy for knee pain helps improve function after knee sprains, while neck pain therapy may aid players with postural strain. Meanwhile, wrist pain physiotherapy focuses on restoring range of motion, grip strength, and fine motor control, especially important after falls or overuse from repetitive paddle strokes. It may include joint mobilisation, tendon gliding exercises, and gradual strengthening to prevent flare-ups during gameplay.

Taping or Bracing

Athletic tape or braces provide joint support and proprioception during recovery. They can be effective for wrist injuries, elbow injuries, and ankle injuries. For serious ligament injuries, a rigid brace may be recommended during return-to-play phases.

Pain Management Techniques (e.g., Ultrasound, TENS)

Modalities like ultrasound and transcutaneous electrical nerve stimulation (TENS) can help manage pain and stimulate tissue repair in overuse injuries.

• Ultrasound sends sound waves into the soft tissue, which boosts blood flow and speeds up the healing process.
• TENS (Transcutaneous Electrical Nerve Stimulation) can relieve pain by blocking pain signals and relaxing muscles.
• Cold laser therapy or shockwave therapy might also be offered by sports physios for chronic overuse injuries, like plantar fasciitis or Achilles tendinopathy.

These techniques support (but don’t replace) active rehabilitation. They’re recommended as part of a wider recovery plan.

Graded Return-to-Play Plan

One of the biggest mistakes athletes make is returning too early or doing too much too soon. A graded return-to-play plan is key. To do this:

• Start with low-impact drills (e.g., shadowing or paddle work without running).
• Gradually increase intensity and duration of play, with breaks for feedback and assessment.
• Monitor pain, swelling, or instability. These are signs you’re not ready to progress.

For injuries like fractures, rotator cuff tears, or severe sprains, this plan should be overseen by a sports medicine physician or physical therapist to ensure full recovery before full-court play.

Pickleball Injury Prevention

Given the popularity of pickleball and the rising number of injuries, it’s essential to be proactive. The right injury prevention strategies can reduce the likelihood of time off the court.

Proper Warm-up and Cool-down

Start with light cardio and dynamic movements to prepare the body. End sessions with stretching to improve recovery. Without proper warm-ups, you can increase the risk of muscle strains and joint injuries.

Stretching and Mobility Drills

Daily stretching, especially for calves, hamstrings, shoulders, and the lower back, keeps muscles supple and joints mobile. Incorporate foam rolling and hip mobility work.

Strength and Conditioning (Focus on Legs, Core, and Shoulders)

Building strength in key areas can reduce the likelihood of knee injuries, ankle sprains, and shoulder impingement. Core exercises support balance and protect the spine.

Footwear With Proper Support and Grip

Wear shoes designed for court sports. Good grip and lateral support help prevent ankle sprains and hip injuries. Avoid worn-out or running-style trainers.

Technique Coaching and Skill Development

Poor mechanics are often a risk factor for pickleball-related injuries. Get instruction from certified coaches to improve footwork, paddle handling, and swing efficiency.

Avoiding Overtraining and Ensuring Adequate Rest

Allowing the body time to recover is crucial. Playing too often, especially without cross-training, can lead to chronic overuse injuries like tennis elbow or plantar fasciitis.

Using Supportive Gear or Braces if Needed

Paddles with proper grip size, wrist guards, elbow straps, or ankle braces can help prevent further injury, especially for players returning to the court post-injury.

Conclusion

As pickleball continues its surge as one of the fastest-growing sports, the importance of injury prevention and recovery cannot be overstated. Many pickleball injuries are avoidable with the right approach to warm-up, conditioning, and technique. The most common pickleball injuries, from ankle sprains to rotator cuff issues, can be managed and prevented, keeping players healthy and active. Whether you’re new to the sport or a regular pickleball player, being informed can make all the difference in your longevity on the court.