5 Common Pickleball Injuries and How to Prevent Them

Pickleball looks simple enough.

The court is smaller than a tennis court, the rallies can be social, and you do not have to be a professional athlete to play.

Then someone hits a short ball.

You sprint forward, plant your foot, reach for the shot, and suddenly your ankle, knee, shoulder, or elbow reminds you that pickleball can demand a lot from your body.

As participation has grown, pickleball injuries have become increasingly common as well. A 2026 review found that falls, rapid changes of direction, and forward lunging are major injury mechanisms, with sprains, strains, fractures, and Achilles injuries frequently reported.

The good news is that you can prepare your body for many of the demands of the sport.

Here are five common pickleball injuries and practical ways to reduce your risk.

1. Ankle Sprains

Pickleball requires constant small adjustments.

You shuffle laterally, move forward for a dink, backpedal for a lob, and quickly change direction when the ball goes somewhere unexpected.

That creates plenty of opportunities to roll an ankle.

Ankle sprains are especially likely during quick direction changes, awkward landings, or when a player’s foot turns inward unexpectedly.

A previous ankle sprain can also leave behind deficits in strength, balance, or confidence that make the ankle feel less stable later.

How to Reduce Your Risk

Your ankle needs more than flexibility.

Strengthening exercises such as calf raises, resisted ankle movements, single-leg balance, and eventually hopping or lateral drills can help prepare the ankle for the unpredictable movements of pickleball.

Footwear also matters. A shoe designed for court sports generally provides better lateral support than a shoe designed primarily for straight-line walking or running.

Research on pickleball injuries also highlights sport-specific footwear and proprioceptive training as practical prevention strategies.

2. Achilles Tendon and Calf Injuries

That short ball near the kitchen can be trouble.

You suddenly accelerate forward, push hard through your foot, and ask your calf and Achilles tendon to produce a large amount of force very quickly.

For someone who plays once or twice a week but does little strength or sprint training outside of pickleball, that demand can be a major jump from normal daily activity.

Achilles tendon injuries have been repeatedly reported in pickleball research, particularly among middle-aged and older players.

How to Reduce Your Risk

Calf strength should be part of your preparation.

Both straight-knee and bent-knee calf raises can help build strength through different parts of the calf.

However, strength is only one piece.

Your body also needs gradual exposure to faster movement.

If you have not played for months, jumping directly into three competitive games is very different from gradually rebuilding your court time.

Increase playing frequency, intensity, and duration progressively instead of changing everything at once.

A dynamic warm-up before playing can also help prepare your calves and ankles for faster movement.

3. Knee Injuries

Pickleball repeatedly places the knee in positions involving bending, stopping, lunging, and changing direction.

For some players, this leads to irritation rather than one major injury.

For others, an awkward twist or fall can result in a more significant knee problem.

Research from a sports medicine center has reported meniscus injuries among the knee problems seen in pickleball players.

You may notice pain while lunging, difficulty pushing out of a deep position, swelling after playing, or discomfort when changing direction.

How to Reduce Your Risk

Strong legs give you more options.

Exercises such as squats, split squats, step-downs, and single-leg strengthening can help prepare your quadriceps and hips for repeated court movement.

However, your training should eventually become more specific.

If all of your strengthening happens slowly in a straight line, you may still be unprepared for rapid lateral movement.

As your strength improves, consider gradually introducing side-to-side movement, controlled deceleration, and change-of-direction drills.

The goal is to prepare your knee for what pickleball actually demands.

4. Shoulder Injuries

Pickleball may not require the same serving motion as tennis, but your shoulder still performs hundreds of repetitive swings.

Overhead shots can be particularly demanding.

Rotator cuff problems are among the shoulder conditions reported in pickleball players, especially when playing volume increases faster than the shoulder is prepared to tolerate.

You may notice soreness after playing, discomfort reaching overhead, weakness during harder shots, or pain when sleeping on the affected shoulder.

How to Reduce Your Risk

Do not focus only on the shoulder joint itself.

Your rotator cuff and shoulder blade muscles help control the arm during repeated strokes.

Exercises such as rows, external rotations, controlled pressing, and other shoulder-strengthening movements can help build capacity.

Thoracic mobility can also be relevant because your upper back contributes to reaching and rotation.

Most importantly, avoid making dramatic increases in playing volume.

Going from one casual game per week to playing five days in a row can create a workload your shoulder has not had time to adapt to.

5. Wrist and Hand Injuries From Falls

One of the most important pickleball injury risks has nothing to do with swinging the paddle.

It is falling.

Falls are one of the leading mechanisms of injury in pickleball, particularly among older adults. Wrist fractures are also frequently reported because players instinctively reach out with a hand when trying to stop a fall.

A fracture is not something you can prevent with one specific wrist exercise.

Instead, prevention should focus on reducing the likelihood of falling in the first place.

How to Reduce Your Risk

Balance, lower-body strength, and footwork matter.

Single-leg exercises, balance training, lateral stepping, and controlled change-of-direction drills can help you become more comfortable moving around the court.

Also pay attention to the environment.

Make sure the playing surface is dry and clear. Wear appropriate court shoes. Avoid backpedaling aggressively when turning and moving forward may be safer.

A 2026 systematic review specifically recommended dynamic warm-ups, proprioceptive training, appropriate footwear, and attention to court surfaces as part of injury-prevention efforts.

Why Pickleball Injuries Often Happen to Active Adults

One reason pickleball is so popular is that you can start playing without years of training.

That is also part of the problem.

Your skill level can improve faster than your physical capacity.

You may learn how to place shots, rally, and compete before your calves, knees, shoulders, and balance have adapted to several hours of repeated play.

This becomes especially important for players returning to sports after years away.

A recent analysis of emergency department visits found that pickleball injuries disproportionately involved older players, with more than half of the injured pickleball participants in that dataset being 65 or older. Falls were the leading mechanism.

Age does not mean you should stop playing.

It simply makes preparation more important.

Your Warm-Up Should Look Like Pickleball

Standing next to the court and holding a calf stretch for 30 seconds is not much preparation for sprinting, stopping, rotating, and reaching.

Instead, your warm-up should gradually increase your heart rate and expose your body to the movements you are about to perform.

You might include brisk walking or light jogging, calf raises, squats, lateral steps, controlled lunges, shoulder movements, and a few easy practice rallies before playing at full intensity.

The purpose is simple:

Do not make the first hard movement of the day happen during the first competitive point.

Strength Training Can Help You Stay on the Court

Playing pickleball is physical activity, but playing alone does not necessarily address every physical quality you need.

A separate strength program can help develop the muscles that support your ankles, knees, hips, shoulders, and trunk.

That becomes even more important if you play several days per week.

Think of strength training as preparation for your sport rather than something separate from it.

Your gym program does not need to be complicated.

A few well-selected lower-body, upper-body, balance, and core exercises performed consistently can go a long way toward building greater capacity.

What If You Already Have Pain?

Do not automatically assume you have to stop playing forever.

Minor symptoms may respond to temporary changes in playing frequency, intensity, or duration while you address strength and mobility.

However, repeatedly playing through worsening pain is different.

Consider getting evaluated if pain continues to increase, changes the way you move, causes recurring swelling, limits normal daily activity, or keeps returning every time you play.

Seek prompt medical attention after a significant fall or injury if you cannot bear weight, notice substantial swelling or deformity, experience severe weakness, or suspect a fracture or tendon rupture.

Pickleball Physical Therapy at Physiopros

The best way to prevent pickleball injuries is not to avoid the sport.

It is to prepare your body for it.

At Physiopros Performance Rehab in Parsippany, NJ, we work with athletes and active adults, including pickleball players, who want to recover from injuries and return to activity. Physiopros currently includes pickleball among the sports supported through its sports physical therapy and Return To Sport Testing programs.

Depending on your needs, rehabilitation may include strength training, mobility work, balance, jumping and landing, change-of-direction drills, sport-specific movement, and objective return-to-sport testing.

Whether you are dealing with a current injury or want to feel more prepared before increasing your playing schedule, your program should match the demands you face on the court.

If pain is keeping you from playing comfortably, schedule an evaluation and find out what your body needs to get back on the court.

Call Physiopros Performance Rehab at (973) 265-8621 or request an appointment by clicking here.

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