The Most Common Pickleball Injuries — and How to Prevent Them
Dr. Tonia Thornton, DPT
Board-Certified Physical Therapist
Pickleball is the fastest-growing sport in America — and the injuries are growing right alongside it. The quick lateral movements, overhead shots, and repetitive arm motions put significant demands on your body, especially if you're playing multiple times a week.
Here are the injuries we see most often at Peak Swing PT, and what you can do about them.
Shoulder Impingement and Rotator Cuff Strains
Overhead shots and serves put repetitive stress on the shoulder. When the rotator cuff muscles are weak or imbalanced, the shoulder joint doesn't track properly — leading to impingement, inflammation, and eventually tears. If reaching overhead or serving causes a sharp or aching pain, don't push through it.
Tennis Elbow (Lateral Epicondylitis)
Despite the name, tennis elbow is one of the most common pickleball injuries. The repetitive grip and wrist extension during dinks and volleys overloads the forearm tendons. You'll feel it as pain on the outside of your elbow, especially when gripping or lifting.
Knee Pain and Meniscus Issues
The quick starts, stops, and pivots of pickleball are tough on the knees. Players often develop patellar tendinitis or aggravate existing meniscus issues. Weak quadriceps, tight hip flexors, and poor landing mechanics all increase the risk.
Achilles Tendinitis and Ankle Sprains
Explosive movements to the ball and sudden direction changes put heavy loads on the Achilles tendon and ankle ligaments. Calf tightness and poor ankle mobility are the biggest risk factors.
Low Back Pain
The rotational nature of pickleball strokes — combined with the bent-over "ready position" — stresses the lumbar spine. Players with weak core muscles or tight hip flexors are especially vulnerable.
Prevention Strategies That Actually Work
- Warm up properly — 5-10 minutes of dynamic movement before you play, not just hitting the ball around
- Strengthen your rotator cuff and core — these are the engine of every shot
- Work on lateral agility — controlled side-to-side drills build the stability your knees and ankles need
- Don't ignore early warning signs — mild soreness that shows up after every session is your body asking for help
- Get a movement evaluation — a physical therapist can identify your specific weak links before they become injuries
Already Injured?
If you're dealing with pain that's limiting your play, a 60-minute evaluation at Peak Swing PT will identify the root cause and build a plan to get you back on the court — stronger and more resilient than before.