The 5 Most Common Pickleball Injuries and How to Prevent Them

Summer means more people are headed outdoors to play pickleball. It also means more players are getting sidelined by injuries.

"Given that pickleball requires a lot of quick stopping and going and changing directions in a population that has a higher number of older participants, there are are many opportunities for an athlete to get hurt," says Rob Andrews, PT, DPT, a physical therapist with the Hospital for Special Surgery in New York City.

Pickleball injuries have been on the rise for some time, especially among the sport's mostly older fanbase. Older adults account for a whopping 85 percent of reported pickleball injuries, according to a May 2021 study in ‌Injury Epidemiology‌.

"It's important that athletes take care of their bodies to prepare for the demands of the sport," Andrews tells LIVESTRONG.com.

Below, we'll take a look at five of the most common pickleball injuries, along with exercises and stretches you can do to prevent them.

Court sports like pickleball call for quick direction changes from side to side. As such, it's common for athletes to roll an ankle or experience a lateral ankle sprain, Andrews says.

According to the American Academy of Orthopedic Surgeons (AAOS), an ankle sprain occurs when the ligaments (tough tissue that connects two bones) in the ankle stretch too far and tear. Tears can be tiny or major, but they're typically accompanied by swelling and pain during movement and at rest.

Anyone can sprain an ankle, but you're more likely to do it if your ankle is weak and unstable. Do the following two moves to help strengthen your ankles.

‌Lateral Banded Walk‌

Strengthening the muscles on the side of your leg and hip — particularly the gluteus medius (the muscle on the side of your butt) and peroneals (muscles in your lower legs) — can help your ankle stabilize during quick direction changes. The lateral banded walk targets these muscles, helping reduce your odds of rolling an ankle, Andrews says. He suggests adding the lateral banded walk to your pickleball warmup routine.

‌Single-Leg Romanian Deadlift‌

Building balance and proprioception (your awareness of where your body is in relation to your environment) is also key for preventing ankle sprains, Andrews says. This single-leg exercise challenges your balance and strengthens the intrinsic foot muscles that contribute to proprioception. The single-leg Romanian deadlift (RDL) also has the added bonus of strengthening your glutes. Incorporate the single-leg RDL into your pickleball warmup routine.

"Plantar fasciitis is an overuse injury that results in pain on the bottom of the foot or heel," Andrews says. It occurs when the plantar fascia (a thick band of connective tissue that supports your foot arch) becomes irritated and inflamed, per the Cleveland Clinic. The sensation can range from a dull, constant ache to a sharp, stabbing pain in your heel or along the bottom of your foot.

The plantar fascia is designed to absorb the forces we place on our feet when walking or navigating the pickleball court. However, when there's too much pressure, the tissue becomes damaged, leading to inflammation and pain, according to the AAOS. Repetitive foot movements, unsupportive shoes and tight calf muscles can all strain the plantar fascia and increase your risk of pain, Andrews says.

Do the following move to help stretch your calves and plantar fascia.

‌Runner's Stretch‌

Aside from wearing supportive shoes and varying your foot movements, stretching your calves and plantar fascia with the runner's stretch can ease tension along the bottom of your feet. This may relieve pressure on your feet, helping prevent plantar fasciitis.

Andrews recommends doing this stretch before and after your pickleball session.

Acute (short-term) and chronic back injuries are fairly common in pickleball. "Because the sport involves staying in a somewhat flexed-spine position for most of the play, in addition to the rotation involved to hit the ball, the spine can be an easy target for an injury," Andrews says.

Spending so much time with your spine flexed (bent) can lead to chronic pain, particularly in the lumbar (lower) spine. In addition, the sudden twisting required to return a serve puts the muscles and tendons in your spine at risk of an acute injury like a pull or strain. The tell-tale signs of a strain include pain that gets worse when you move, muscle cramping or spasms and decreased range of motion (difficulty walking, bending forward or sideways, or standing straight).

Do the following moves to help improve your spinal mobility.

‌Cat-Cow Pose‌

Improving spinal mobility is an easy way to decrease your likelihood of back pain, Andrews says. The better your spine can move through its full range of motion, the lower your chances of pulling or straining a muscle or tendon. Cat-cow pose is a great mobility exercise for moving the spine in two basic positions: extension (lengthening) and flexion (bending).

Do cat-cow pose during your warmup to help loosen your spine before playing pickleball, Andrews suggests. You can also perform the move afterward to ease any tightness from playing with your spine in a mostly flexed position.

‌Open-Book Exercise‌

Your spine must also be able to twist from side to side. If it can't, you're more likely to strain it during sudden movements. The open-book exercise teaches your spine to twist, helping you avoid pain and injury. It's another great movement to include in your pickleball warmup, Andrews says.

Lateral epicondylitis, or "tennis elbow," is an overuse injury of the extensor tendon in your forearm that bends your wrist backward away from your palm. "[The tendon] is especially used during the backhand shot," Andrews says.

Repetitive movements, such as the backhand shot, can aggravate the tendon, causing pain and tenderness outside your elbow. The pain often begins as mild and gradually worsens over time, becoming most noticeable when you grip your racket, per the AAOS.

Do the following move to help strengthen and lengthen your wrist extensors.

‌Eccentric Wrist Extension‌

This move strengthens your wrist extensors while lengthening them. This helps prepare the tendons for the repetitive movements of a pickleball game, so they're less likely to become damaged and inflamed. Andrews suggests performing this exercise three to five times per week.

This is another overuse injury involving tendons — this time, in the Achilles tendon that connects your calf muscles to your heel bone, Andrews says. This tendon is recruited whenever you walk, run, jump or push up on your toes.

Pickleball involves many of these movements, making the Achilles tendon susceptible to injury when these movements become intense or repetitive. The pain typically begins as a mild ache in the back of your leg or above your heel and may become more severe after prolonged periods of play.

Do the following move to help stretch and strengthen your Achilles tendon and the muscles around it.

‌Eccentric Heel Raise‌

Andrews recommends the eccentric heel raise to lower your risk of Achilles tendinopathy. Eccentric heel raises keep tension on the Achilles tendon and calf muscles while they lengthen into a stretched position, he notes. This strengthens the tendon and surrounding muscles through their full range of motion, so they're less likely to become strained when running, jumping and pushing up on your toes.

Incorporate the eccentric heel raise into your pickleball warmup, Andrews suggests.