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Play Smart: Recognizing and Treating Pickleball Injuries

Pickleball has quickly become America’s fastest-growing sport, with players of all ages flocking to courts across the country. As fun as the sport can be, the quick starts and stops, lunges, and arm motions of pickleball can also put players at risk for injury. According to the latest pickleball statistics, analysts estimate that ERs will see as many as 66,750 pickleball injuries this year. Let’s explore some of the most common pickleball injuries, how to recognize symptoms, and when to seek professional treatment.


Common Pickleball Injuries

The most common injuries in pickleball typically involve the ankles, elbows, shoulders, knees, and muscles. Knowing what causes these injuries and how they feel can help you recognize an injury quickly and seek proper treatment when needed to prevent further harm.

Ankle Sprains

Ankle sprains are one of the most frequent injuries caused by constant pivoting and lunging during play. It only takes an awkward landing or quick change of direction to roll an ankle. This can stretch or tear the ligaments.

Pickleball Elbow

Also known as tennis elbow or lateral epicondylitis, this injury develops from repetitive swinging motions and the impact of striking balls. This creates micro tears and inflammation in the tendons that attach forearm muscles to the bony elbow area.  

Rotator Cuff Injuries

Swinging, reaching, and slamming balls can lead to painful rotator cuff injuries in the shoulders over time. Overuse causes rotator cuff tendonitis or tears. 

Knee Injuries

The starting, stopping, pivoting, and lunging of pickleball takes a significant toll on knee joints and ligaments. Meniscus and ACL tears are common knee injuries. Aggravation of underlying arthritis is also common in pickleball.

Strained Muscles

Muscle strains are also prevalent, especially in the hamstrings, calves, quads, and back. Overusing the same muscle groups leads to strains and tears.


Recognizing Injury Symptoms

It’s not always easy to decipher between normal soreness, aches and pains, and an actual injury. Being familiar with how common pickleball injuries feel and manifest can help you tell the difference. For quick reference – sprains affect ligaments and cause immediate swelling/bruising, while strains involve muscles and tendons, and may cause lingering tightness and tenderness in the affected area. If you experience pain during play that lingers afterward, you should have it checked out by a medical professional. 

  • Ankle sprains usually cause immediate pain, swelling, and bruising. You may hear a “pop” at the time of injury, and walking will be difficult due to instability and pain.
  • Pickleball elbow exhibits pain focused on the bony area near your outer elbow. You may feel weakness when gripping items, and pain often worsens with activity.  
  • Rotator cuff issues lead to shoulder stiffness, achiness, and limited mobility, especially when reaching behind. You may also feel weakness in the shoulder and arm as well as pain that worsens overnight. 
  • Knee injuries typically cause pain, swelling, and a sense of instability. You may hear popping or grinding noises within the joint.
  • Strained muscles feel tight and tender when used. You may notice bruising, swelling, and decreased strength until the strain resolves.


How a Physiatrist Can Help with Pickleball Injuries

Should pickleball play result in an injury, many people are quick to visit urgent care or their primary care physician. However, a physiatrist may offer a more comprehensive treatment approach that gets you back on the court and prevents re-injury. 

What is a physiatrist? A physiatrist is a medical doctor who specializes in Physical Medicine and Rehabilitation. They are experts in diagnosing and treating injuries affecting the muscles, nerves, joints, ligaments, and tendons. Rather than focusing solely on the specific area of pain, their training and expertise extend to the entire body. Their goal is to improve pain and, moreover, optimize function. For patients, this means a more extensive selection of treatment options, including physical therapy, medications, joint and tendon injections, and surgery referrals when needed. 

Diagnosing a Pickleball Injury

In most cases, you do not need a referral to see a physiatrist. Diagnosing a pickleball injury will involve a thorough evaluation, including a medical history and physical exam, and ordering appropriate imaging tests like X-rays, MRIs, or Electrodiagnostic Tests to pinpoint the injury. They can then develop a customized treatment plan, which may include:

Treating a Pickleball Injury

  • Physical therapy to strengthen muscles, improve mobility, and retrain proper movement patterns. 
  • Prescribing non-opiate medications like NSAIDs to reduce inflammation and pain.
  • Ultrasound-guided injections for the precise delivery of steroid injections to decrease pain and inflammation.
  • Platelet Rich Plasma Therapy (PRP) to expedite the regeneration and repair of damaged tissue in joint, tendon, and ligament injuries. 
  • Prolotherapy to initiate your body’s natural healing abilities. 
  • Braces or splints to immobilize and protect injured joints.
  • Supervised rehabilitation programs to ensure complete recovery of strength and function before returning to play.
  • Direct surgery referral if conservative treatment options have failed or if the injury is too severe for non-operative management.


Here’s Some Tips on How to Prevent Pickleball Injuriries

With the proper precautions and techniques, pickleball injuries can be prevented. Here are some essential tips to help you stay injury-free.

1. Warm up before playing.

Engaging in a proper warm-up routine is crucial to prepare your muscles and joints for the physical demands of pickleball. Incorporate dynamic stretches and light cardio exercises to increase blood flow and flexibility.

2. Use proper footwear.

Investing in good-quality court shoes with excellent support and traction is essential for preventing slips, falls, and ankle sprains. Ensure that your shoes fit well and provide ample cushioning.

3. Master your technique.

Learning the correct technique is not only important for improving your game but also for preventing injuries. Take lessons from a qualified instructor who can teach you proper grip, footwork, body positioning, and stroke mechanics.

4. Listen to your body.

Pay attention to any discomfort or pain during play. Ignoring these warning signs can lead to more severe injuries. If you experience persistent pain or have concerns about an injury, consult a healthcare professional promptly.

5. Stay hydrated.

Proper hydration is vital for maintaining optimal performance on the court and reducing the risk of muscle cramps or fatigue-related injuries. Drink plenty of water before, during, and after playing pickleball.

6. Take breaks.

Avoid overexertion by taking regular breaks during intense gameplay sessions or tournaments. Rest allows your body time to recover and reduces the likelihood of overuse injuries.

7. Wear protective gear.

Consider wearing protective gear such as knee pads or elbow braces if you have a history of joint issues or want extra support during play.


Prevention is always the best game plan when it comes to sports injuries. However, accidents happen, and if they do, the second-best game plan is to prevent further damage by having your injury evaluated by a physiatrist. 


Is an injury preventing you from getting back on the court?

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