Pickleball and Injury Prevention: A Physical Therapist’s Perspective

Pickleball has rapidly become one of the fastest-growing recreational sports in the country. Combining elements of tennis and ping pong, this paddle sport appeals to players of all ages and skill levels. Since 2021, its popularity has skyrocketed, with participation numbers soaring to over 19 million players.1 Several factors contribute to its widespread appeal: the rules are simple and accessible for beginners, and the game provides a relatively low-impact alternative to more physically demanding sports.

However, with this surge in popularity has come a notable rise in injuries. Despite its reputation as a low-impact activity, pickleball was responsible for an estimated $350 million in medical costs related to game-related injuries in 2023 alone.2 This article will delve into the common causes of pickleball injuries, practical strategies for prevention, and the crucial role physical therapy can play in both injury prevention and rehabilitation.

Common Injuries in Pickleball

Though considered low-impact, pickleball requires frequent changes in direction, quick bursts of speed, and repeated motions—all of which place strain on various parts of the body. As a result, players are susceptible to a wide range of injuries, including: ankle sprains, calf strains, Achilles tendon issues, lower back pain, knee injuries, and shoulder injuries.

These injuries typically result from the nature of the sport itself. For example, sudden lateral movements or rapid lunges can lead to ankle sprains or calf strains. Knee injuries often occur when a player pivots abruptly or lands awkwardly. Meanwhile, repetitive reaching and swinging motions, particularly with poor form, can cause overuse injuries in the lower back and shoulders.

Although these risks exist, many of them can be significantly reduced with proper preparation—including appropriate footwear, a structured warm-up routine, and addressing pre-existing imbalances or weaknesses through physical therapy.

The Importance of Warming Up

A well-executed warm-up is essential before any physical activity, especially one that involves quick directional changes and bursts of movement. As a physical therapist, I frequently see injuries that could have been prevented with just a few minutes of dynamic warm-up. These exercises help increase blood flow, activate key muscle groups, and enhance coordination.

For the upper body, consider: shoulder rolls, gentle arm circles, lateral side bends. These movements prepare the arms, shoulders, and upper back for reaching and swinging.

For the lower body, try: air squats, lunges, heel raises, light jogging or skipping in place. These exercises help warm up the hips, knees, and ankles—areas especially prone to injury in pickleball. If you’re unsure where to begin, consulting a physical therapist, trainer, or coach can help tailor a warm-up routine to your specific needs.

Physical Therapy: Not Just for Recovery

While many associate physical therapy with post-injury rehabilitation, it is equally valuable as a preventative tool. Minor, everyday aches and pains often signal deeper issues such as muscle imbalances, joint stiffness, reduced flexibility, or instability in key joints. Though these issues may seem insignificant, they can become problematic when the body is stressed—especially during athletic activity.

If you experience lingering discomfort after playing pickleball, it may be worth consulting with a physical therapist. A comprehensive evaluation can identify movement inefficiencies, strength deficits, or biomechanical issues that may predispose you to injury. Addressing these concerns proactively can help you continue playing the sport you love, safely and for years to come.

Pickleball is an incredibly enjoyable and inclusive sport, but like any physical activity, it carries inherent risks. My goal as a physical therapist is to help individuals stay active, healthy, and injury-free—no matter their sport of choice. By incorporating proper warm-ups, being attentive to your body’s signals, and utilizing physical therapy for both prevention and rehabilitation, you can continue to enjoy the game while minimizing your risk of injury. Stay active, stay safe, and keep playing!

Dr Elizabeth Bynum, PT, DPT is a Physical Therapist at ProClinix Sports Physical Therapy & Chiropractic in Tarrytown. For any questions regarding her article or to learn more about ProClinix, feel free to reach out to her at 914-207-7337 or via email at ebynum@proclinix.com In addition to their Tarrytown location, ProClinix has other convenient locations in Ardsley, Armonk, Larchmont, Pleasantville, West Harrison and Yorktown.