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6 tips to avoid pickleball injuries
A new sports obsession has brought pleasure to Americans across the country — and injuries to more than a few. Here's how to stay safe on the court.
Forget “fad” or “trend.” Over the past few years, pickleball has become a phenomenon, winning fans like some Taylor Swift of leisure-time activity. A combination of tennis, badminton and ping-pong, it’s one of the fastest-growing sports in America: According to a report by the Association of Pickleball Professionals (APP), more than 48 million American adults — nearly 19% of the total population — have played pickleball at least once in the past 12 months. That’s up 35% since the APP’s previous report, which ran through the summer of 2022.
It’s easy to see why people are flocking to this racquet sport. Besides being addictively fun and easy to learn, pickleball delivers a quality aerobic workout, one that helps build speed, agility, balance and control. It’s also a great way to build social connections. And all these benefits are available no matter your age, says Ravi Vaswani, MD, a specialist in orthopedic surgery and sports medicine at the Northwell Health Orthopaedic Institute. “Pickleball requires less running than tennis or badminton, so it’s good for staying active and having fun,” says Dr. Vaswani.
But any activity more vigorous than knitting comes with risk, and pickleball is no exception. Indeed, says Nicholas Sgaglione, MD, senior vice president and executive director of the Orthopaedic Institute and chair of orthopedic surgery at the health system, Northwell practices have seen an increase in pickleball injuries over the past few years, especially in those over 65. “It’s a forgiving sport, so you can have fun at any level,” says Dr. Sgaglione, a pickleball fan himself. “That said, it still involves sudden acceleration, quick stops and lunging, so it can lead to injuries.”
Types of pickleball injuries
Pickleball players — or “picklers” — can suffer both acute pickleball injuries and the chronic kind that stem from overuse, says Dr. Vaswani. Falls on the court can produce cuts and bruises or even sprains and fractures; overuse injuries include rotator cuff strain and other shoulder issues, along with tendonitis affecting the Achilles tendon, hamstrings and elbow. (“Pickleball elbow” is very similar to tennis elbow.)
Fortunately, following a few easy rules can go a long way toward reducing your risk — and it’s worth paying attention so you can enjoy pickleball for years to come.
“Pickleball offers both physical and social benefits, so it’s good for your mind and body,” says Dr. Sgaglione, the Mauri-Martocci Professor of Orthopaedic Surgery, who practices at North Shore University Hospital. “It’s a great sport for your long-term health.”
So how can you make sure you stay injury-free on the hard court? Here are six steps that can help.
Ease into it
To lower your risk, start slow and don’t overdo it, especially if you haven’t been physically active for a while — try a weekly game at first, then ramp up to a twice-weekly pace if you’re feeling fine. If you have a preexisting condition, check with your doctor. “The most common problem I see is that pickleball can exacerbate a preexisting problem, like knee arthritis. Many people over age 65 do have some arthritis,” says Dr. Vaswani. “Most people can still play — and in fact staying active is helpful for arthritis. But it’s especially important to go slow and listen to your body.”
Don't forget to stretch
Spending a few minutes before and after games stretching your major muscle groups, plus your wrists and arms, has a number of payoffs, says Dr. Sgaglione. “Before you play, stretch and warm up,” he says. “After you play, stretch and cool down.” The prep makes your tendons more supple and pliable, so you can move fast and explosively without causing a tear, he says, while stretching after a game can reduce post-exercise stiffness.
Continue reading for six simple stretches to help prevent pickleball injuries.
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Build up your strength
Depending on how competitive you are, pickleball counts as moderate to vigorous intensity aerobic exercise, says Dr. Vaswani. (The National Institutes of Health’s guidelines recommend adults build up to at least 150 minutes to 300 minutes a week of moderate-intensity aerobic activity each week, or 75 minutes to 150 minutes a week of vigorous-intensity aerobic activity.) But it’s important to balance that with muscle-strengthening exercises two or more days a week, or as directed by your doctor. “Weight-bearing exercise can promote strong bones and tendon health,” explains Dr. Vaswani. “That can help slow the weakening of tendons that naturally occurs with age and raises the risk of injury.” Pay particular attention to your core, or midsection muscles. “Your core supports your upper and lower body, and if it’s weak, you’ll compensate with other muscles,” Dr. Vaswani says. “That will put you at higher risk of injury.” Good core exercises include pushups, abdominal crunches and floor or wall planks.
Wear the right gear
Pickleball may seem easy on the body, but it includes plenty of lateral movement, quick acceleration and sudden stops. To get the support you need, choose athletic shoes designed for court sports, since running shoes may not offer sufficient support, says Dr. Vaswani, and aren’t designed for lateral movement. Don’t limit your attention to shoes and paddle. The balls in the sport may be hollow and lightweight, but they’re made of a hard polymer and travel at a very high rate of speed. Choose shatter-resistant sunglasses or invest in a pair of goggles. If you suffer from wrist pain after playing or have arthritis or tendonitis, a wrist brace may help.
Stay alert
Sure, most of your attention will be trained on your opponents, and on teaming effectively with your partner. But to avoid injury, you also need situational awareness. For instance, one of the joys of the sport is that it can be played year-round — but it can be dangerous to play on a wet court. USA Pickleball suggests a simple court safety check: Press your toe down firmly on the court and make a twisting motion. If you leave an obvious wet spot, the surface is unsafe for play.
Hydrate, hydrate, hydrate
It’s easy to get caught up in the excitement of a match and forget to drink enough fluid. But staying hydrated can help you avoid dizziness, fatigue and lightheadedness, or even irregular heartbeat and fainting. Dr. Vaswani recommends stocking up on sports drinks, which supply electrolytes — just stay aware of the sugar content in some of those drinks. “If you don’t have enough electrolytes, that can lead to cramping and more stiffness in your joints,” he says.
6 stretches to prevent pickleball injuries
Target the muscles that are used most in pickleball to increase your flexibility, mobility and strength. Six stretches that work:
- Achilles tendon stretch: Face a wall, with hands on the wall at about eye level. Place one foot behind you, with your knee straight and heel on the floor. Lean your upper body toward the wall until you feel a stretch in your rear leg; hold for 30 seconds. Repeat with other leg.
- Standing shoulder stretch: While standing, raise one arm above your head and bend the elbow 90 degrees. Lean in the opposite direction while gently pulling on the bent elbow. Repeat with opposite arm.
- Hamstring stretch: Lie on your back with legs straight, then bring one knee to your chest. Hold under your bent knee while you straighten the leg as far as you can. Repeat with other leg.
- Plantar fascia stretch: While sitting, grip your toes as shown and pull them up toward your body until you feel a stretch in the arch. Repeat the motion, this time pushing your toes down until you feel a stretch at the top of the foot.
- Plantar fascia roll (myofascial release): While sitting, roll your affected barefoot back and forth from your heel to your mid-arch over a tennis ball or frozen water bottle.
- Butterfly stretch (groin): Sit with knees bent and feet together as shown. Press knees downward by leaning forward and pressing with your elbows, pulling your heels toward your body.
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