Common Pickleball Injuries and How to Prevent Them

This article is general information, not medical advice. For any persistent pain, swelling, or injury, see a doctor or physical therapist.

Part of our pickleball resource hub.

Pickleball is easy on the body compared to many sports, but its quick side-to-side movement and stop-start bursts — often in players over 50 — do cause a predictable set of injuries. The good news: most are very preventable. Here are the common ones and how to avoid them.

The most common pickleball injuries

• Pickleball elbow (lateral epicondylitis) — overuse pain on the outside of the elbow from repetitive gripping and swinging. See our full pickleball elbow guide.
• Ankle sprains — rolling an ankle on a quick lateral move or stop.
• Calf strains and Achilles injuries — the sudden push-off can strain or even tear the calf or Achilles (players often describe a “pop”).
• Shoulder issues — rotator cuff irritation from overhead shots and serves.
• Knee pain — from twisting, squatting low for dinks, and quick direction changes.
• Falls and wrist fractures — often from backpedaling for a lob and losing balance.
• Lower back strain — from bending and rotating repeatedly.

Why pickleball injuries happen

Three factors combine: the game demands fast lateral movement and sudden stops, many players are older and newly active, and a lot of people skip warming up and play for hours. Add worn-out or wrong shoes and it’s a recipe for the injuries above.

How to prevent pickleball injuries

• Warm up first. A few minutes of dynamic movement dramatically cuts strains — see our warm-up routine.
• Wear real court shoes. Not running shoes — you need lateral support. See the best pickleball shoes.
• Never backpedal for a lob. Turn, run, and set up — backpedaling is the #1 cause of falls and wrist fractures.
• Build strength and mobility. Basic leg, core, and shoulder work makes you far more resilient.
• Don’t overplay. Overuse injuries come from too much, too soon — build up gradually.
• Use good technique. A controlled swing and clean footwork strain the body far less than muscling shots.
• Listen to your body. Sharp or lingering pain means stop and rest — playing through it turns a small issue into a long one.

First response: what to do in the first 48 hours

How you handle the first two days often decides the next two months. For sprains and strains (ankle rolls, pulled calves): the modern protocol is PEACE — Protect it, Elevate, Avoid anti-inflammatories in the first day or two (they may slow early healing), Compress, and Educate yourself on load — followed by gradual movement rather than total rest. For a suspected Achilles rupture (a pop, feeling kicked, can’t push off): don’t walk it off — immobilize and get imaged same-week; early treatment dramatically changes outcomes. For falls with wrist impact: if there’s point tenderness, swelling, and gripping hurts, get an X-ray — wrist fractures masquerade as sprains constantly, and a missed scaphoid fracture is a genuinely bad outcome. When in doubt: 48 hours of honest assessment beats six months of wishing you had.

Returning to play without the sequel

Most re-injuries happen because “feeling better” arrives weeks before “being healed.” A return protocol that works for nearly everything: (1) pain-free in daily life first — stairs, carrying groceries, a brisk 20-minute walk; (2) then sport movements without a ball — shuffles, split-steps, easy direction changes; (3) then controlled play — 30 minutes of dinking and half-court games, no tournaments, no chasing lobs; (4) then full play with one rule for two weeks: you don’t chase the unreachable ball. Add one session of strength work per week for the injured area permanently — the ankle you rolled and the calf you strained are now the strongest-monitored parts of your body or the next injury’s address, your choice.

Strength work that prevents the big four

Ten minutes, twice a week, targets the four most common pickleball injuries at once. Calf raises, slow and single-leg (3×12 per side) — Achilles and calf armor. Single-leg balance, eyes forward, 30 seconds per side, progressing to standing on a pillow — ankle sprain prevention that actually works. Lateral band walks (2×10 steps each way) — knee and hip control for the shuffle-heavy pickleball movement diet. Wrist curls and reverse curls with a light dumbbell (2×15) — the elbow’s bodyguard. None of it requires a gym; all of it is the difference between playing four days a week at 65 and watching from the bench.

Frequently asked questions

What are the most common pickleball injuries?

The most common are pickleball (tennis) elbow, ankle sprains, calf and Achilles strains, rotator-cuff/shoulder irritation, knee pain, and falls that can cause wrist fractures. Most come from quick lateral movement and sudden stops.

How do you prevent pickleball injuries?

Warm up before playing, wear proper court shoes, never backpedal for lobs (turn and run instead), build basic leg/core/shoulder strength, avoid overplaying, use controlled technique, and stop if you feel sharp or lingering pain.

Why does my calf hurt after pickleball?

Calf pain often comes from the explosive push-off the sport demands, which can strain the calf muscle or Achilles. A sudden sharp pain or “pop” in the calf or heel should be checked by a doctor, as it can indicate a tear.

Is pickleball hard on your knees?

It can be — the twisting, low squatting for dinks, and quick direction changes stress the knees. Good shoes, a warm-up, leg strength, and controlled movement reduce the load. Persistent knee pain should be evaluated by a professional.

Play smarter, not just harder

Good technique is the best injury insurance — clean footwork and a controlled swing put far less strain on your joints. I coach both in Central Mass. Your first session is half off.

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