Common Pickleball Injuries and How to Prevent Them
By Nova Physical Therapy, an outpatient physical therapy clinic in North Hollywood, CA | Published October 2026
Pickleball is easy to learn, social, and fun, which is why so many people are picking up a paddle for the first time. But a sport that's easy to start can also be easy to overdo. Quick stops, lunges, backpedaling for a lob, and hours of play on hard courts all add up.
Pickleball injuries are rising along with the sport's popularity. This article covers the most common injuries, why they happen, simple ways to prevent them, what to do if you get hurt, and how to return to the court safely.
The short answer
The most common pickleball injuries are sprains and strains, fractures from falls, and bruises. A national study of emergency visits by players 60 and older found that strains and sprains made up about 33% of injuries, fractures about 28%, and that slips, trips, falls, and dives caused about 63% of injuries. The wrist was the most commonly injured and most commonly fractured body part (Weiss et al., Injury Epidemiology 2021). Warming up, wearing court shoes, avoiding backpedaling, building up playing time gradually, and working on strength and balance can help lower your risk.
What are the most common pickleball injuries?
Sudden injuries often happen during quick movements or falls:
• Ankle sprains from quick side-to-side movements or stepping wrong
• Calf and hamstring strains from sudden sprints or lunges
• Wrist fractures from falling onto an outstretched hand
• Knee injuries from pivoting or twisting
• Achilles tendon injuries, including ruptures, from explosive push-offs
• Bruises and head injuries from falls
Overuse injuries tend to build up over weeks of play:
• Elbow pain, often on the outside of the elbow (tennis elbow), from repeated gripping and swinging
• Shoulder pain from overhead shots and serves
• Knee and heel pain from repeated stops, starts, and hard courts
• Lower back pain from bending low for dinks and twisting
In the study of older players, men were more likely to have strains and sprains, while women were more likely to have fractures, especially wrist fractures (Weiss et al., 2021).
Why are pickleball injuries increasing?
The biggest reason is simple: many more people are playing. Researchers have tracked a steady rise in pickleball injuries treated in emergency departments, with injuries among players 60 and older reaching the same level as senior tennis injuries by 2018 (Weiss et al., 2021). Studies of more recent years have reported further increases in injuries and hospitalizations (Arthroscopy, Sports Medicine, and Rehabilitation, 2024).
Other factors that may add to the risk:
• Many players are older adults, who may have lower bone density, slower reaction time, or balance changes
• New players jump in quickly, sometimes playing several hours a day soon after starting
• Running shoes aren't built for quick side-to-side movement
• Backpedaling for lobs is a common cause of falls
• Skipping a warm-up before fast, explosive movements
How can I prevent pickleball injuries?
• Warm up for 5 to 10 minutes. Light jogging or brisk walking, leg swings, arm circles, and a few easy rallies before playing hard.
• Wear court shoes. Tennis or pickleball shoes give better side-to-side support than running shoes.
• Don't backpedal. For lobs, turn sideways and shuffle or let your partner take it. Falling backward is a common way to injure a wrist, hip, or head.
• Build up gradually. Add playing time a little at a time, especially when you're new or returning after a break.
• Train strength and balance. Leg, hip, and core strength plus balance exercises support quick movements and may help prevent falls.
• Check your paddle and grip. A grip that's too small or too large can strain the forearm and elbow.
• Stay hydrated and take breaks, especially on hot Southern California days.
• Know your limits. If you have osteoporosis, balance problems, or a heart condition, talk with your physician about safe play.
What should I do if I get hurt?
Stop playing. Playing through pain often makes injuries worse.
Get medical care right away if you have:
• A hit to the head, especially with headache, confusion, dizziness, or vomiting
• A wrist, arm, or leg that looks deformed or that you can't use
• Trouble putting weight on your leg
• A sudden pop or kick-like feeling in the back of your ankle, and trouble pushing off or rising onto your toes, which can signal an Achilles rupture
• Severe swelling or bruising soon after an injury
• A fall, especially if you're older or have osteoporosis, with pain in the wrist, hip, or back
• Chest pain, shortness of breath, or fainting during play
For minor sprains and strains, protect the area for the first day or two, keep it moving gently within comfort, and gradually return to activity as pain allows. If pain or swelling isn't improving after a few days, or you're not sure how serious it is, get it checked.
Questions about pain medication or imaging are best directed to your physician.
How can physical therapy help me get back to playing?
A physical therapist can help you recover from a pickleball injury and lower the chance of the next one. An evaluation may include:
• How the injury happened and how often you play
• Strength, motion, and balance testing
• How you move on the court, including lunging, shuffling, and stopping
• Screening for signs that need a physician's evaluation
A typical plan may include:
• Exercises to restore motion and strength in the injured area
• Balance and agility training for quick movements
• Gradual practice with pickleball-specific movements
• Guidance on warm-ups, shoes, grip, and playing schedule
• A step-by-step plan for returning to drills, then games, then tournaments
Physical therapy doesn't guarantee a specific result or timeline. If you've had surgery or a fracture, your physician's guidance comes first.
At Nova Physical Therapy in North Hollywood, sports injury rehab is one of our core services, and every plan starts with an evaluation so treatment fits what we find.
Do I need a referral for physical therapy in California?
Not to get started. California allows direct access to physical therapy. A physical therapist can evaluate and treat you without a referral for up to 45 calendar days or 12 visits, whichever comes first. After that, a physician or podiatrist needs to sign the plan of care for treatment to continue. Your insurance plan may have its own referral rules, so check your coverage.
Frequently asked questions
Is pickleball safe for older adults?
For many people, yes, and staying active has real health benefits. Falls are the biggest risk, so warming up, wearing court shoes, not backpedaling, and working on balance and strength help. If you have osteoporosis or a heart condition, talk with your physician first.
What is "pickleball elbow"?
It's a common name for pain on the outside of the elbow from repeated gripping and swinging, similar to tennis elbow. Grip size, technique, and gradual strengthening can help.
What shoes should I wear for pickleball?
Court shoes made for tennis or pickleball. They support side-to-side movement better than running shoes.
How can I avoid falling in pickleball?
Avoid backpedaling for lobs, stay balanced on your feet, wear court shoes, and work on leg strength and balance. Falling backward is a common cause of wrist and head injuries.
When can I play again after a sprained ankle?
It depends on the sprain. Most people need to walk, jog, and move side to side without pain before returning. A physical therapist can guide a gradual return.
Should I play through pain?
No. Pain that changes how you move is a sign to stop and rest. Ongoing pain should be checked.
Do I need a referral to see a physical therapist?
No, not to start. California allows direct access within the limits described above.
About Nova Physical Therapy
Nova Physical Therapy is an outpatient physical therapy clinic in North Hollywood, California, led by a Doctor of Physical Therapy. We help people recover from sports injuries, back and neck pain, work injuries, auto accident injuries, knee pain, and shoulder problems, and we also work with balance problems and rehab after surgery. Patients come to us from North Hollywood, Burbank, Studio City, Toluca Lake, Valley Village, and across the San Fernando Valley. Learn more about Nova or see our services.
Schedule an evaluation
If a pickleball injury is keeping you off the court, or you want to play more without getting hurt, an evaluation can help you build a plan.
Nova Physical Therapy
4795 Vineland Ave #E, North Hollywood, CA 91602
Call (818) 639-3402 | Book an appointment online
Disclaimer
This article is for general education only. It is not medical advice, a diagnosis, or a treatment recommendation for any individual. Injuries vary, and only an in-person evaluation can determine what is right for you. Get medical care first for serious injuries, falls, or head injuries. No treatment guarantees symptom resolution, and results vary. Physical therapists evaluate movement and function within their scope of practice and refer to physicians when findings warrant. Physical therapy in California is regulated by the Physical Therapy Board of California.
References
1. Weiss H, Dougherty J, DiMaggio C. Non-fatal senior pickleball and tennis-related injuries treated in United States emergency departments, 2010–2019. Inj Epidemiol. 2021;8:34. Link
2. A Substantial Increase in Injuries and Hospitalizations Associated With Playing Pickleball From 2020 to 2022. Arthrosc Sports Med Rehabil. 2024. Link