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Pickleball... What's all the Hype About??

Updated: Dec 8, 2023

Is it safe for me to learn? Why is it so popular and why do so many people give others a hard time who love it? I am one of the “over 60” year old’s (and a former tennis player), who has taken a liking to the sport too. Here are a few facts about pickleball and insights of my own, I would like to share.

In 2022 pickleball was the fasted growing sport in America among people over 60. Historically, at an age when most people begin to move less, many are starting to move more by playing pickleball. It is an easy game to pick up and learn and this is one of the reasons so many have taken up the sport. As a physical therapist, I am always looking for new ways and incentives for people to move. Finding a new exercise or sport you love that promotes movement, rather than spending your time channel surfing, is so positive for your overall health and well-being. In addition to the physical benefits, it has so many social benefits as well.

I too have gotten on the Pickleball train and have learned to love the game. It is a game of social and competitive play for all ages. It challenges you to think and react quickly (an important skill we lose as we age) and it encourages side to side and forward and backward movement, which is so important for fall prevention as we age. It is considered a light impact sport and one that will work on your cardiovascular health as well.

So why does pickleball get such a bad rap in the media? Well, there is no doubt that it has gotten the reputation for causing several injuries in the over 65 age group. Some of these injuries are overuse injuries from too much too soon, too often, or acute injuries from a fall. Those that are not physically prepared for the demands of the sport can quickly find themselves in over their head. This age group often does not participate in regular strength and conditioning routines that have prepared their body for quicker movement. The other association of injuries with this age group is they are often part of the “snowbird” group, who do not play the sport as consistently as they should on a regular basis. They tend to enter the game after bouts of sedentary lifestyle between summer and winter.

As I began to play more of this game, I have listened to more and more people talk about these injuries related to pickleball and even some nay-sayers who even say they feel it is too dangerous for them. I do agree, it is important to know your body and its limitations, however a sedentary lifestyle will lead to more serious injuries and the risk of falls than pickleball. Several journal articles have been written lately about the rising number of injuries associated with pickleball and its burden on Medicare and Health care costs for seniors that has not been seen in previous decades. I find this ironic, as it lacked a comparison to the costs on Medicare and healthcare for older adult comorbidities related to poor eating habits and/or lack of exercise.

As a sports medicine physical therapy specialist and pickleball enthusiast, I would like to provide you with some realistic information about the injuries associated with the sport, as well as ways to prevent them. As with any new activity or sport you learn, it is important to know your risks, the demands of the sport and how to prepare your body to play that sport safely to lower your risk of injury.

One of the pickleball injury myths I would like to correct is that pickleball causes more injuries than tennis or other paddle/racquet sports. This is 100% false. Because the court is smaller and the game involves an underarm serve, there tends to be less injuries to the legs and shoulders than other racquet/paddle sports. The fall risk is essentially about the same.

The most common injuries in pickleball are discussed below:

Shoulder Strain:

A common injury from pickleball is a general muscle pull called a shoulder strain. This involves overextending the shoulder from poor movement patterns or too much frequency or intensity of play for your ability. Over time, shoulder injuries can cause pain, inflammation and reduced range of motion of the shoulder.

Prevention: Proper warm up of arm circles and paddle swings that mimic the movements used in play. Strengthening of the rotator cuff and shoulder blade muscles also reduces the stress on the shoulder muscles.

Pickleball elbow:

This common injury to the elbow can be caused by tendonitis or inflammation of the tendons or tissues that connect muscle to the bone around the elbow joint. It can be caused by repetitive motion during pickleball. It can also be caused by gripping the paddle too tight, using too heavy of a paddle, having a weak grip strength or forearm strength and/or improper technique with volleys.

Prevention: High quality and lightweight paddles can help significantly to reduce impact forces and to prevent strain to the tendons and muscles of the forearm, elbow, and shoulder. Stretching and strengthening of the forearm muscles and shoulder muscles to reduce the stress imposed on the forearm with volley play.

Knee or ankle sprains:

It is possible to sprain or damage ligaments in your ankle or knee from lateral or twisting movements on the court.

Prevention: The best prevention is to make sure you have a proper warm up of your legs and ankles by doing some body weight squats, lunges in forward, diagonal, and lateral directions, stretching your quads, hamstrings and calf muscles and even doing some light double leg jumps to warm up your tendons. Proper shoe wear can also help to support the ankle and prevent slippage or too much traction on the surface you are playing on.


Diving for the ball, running backward to return a lob or collision with another player can result in a fall on the court. In addition, if a player plays on a wet or slippery court surface or trips on an obstacle on the court this may also lead to a fall.

Prevention: It is important to have appropriate shoe wear to support side to side motion and have appropriate traction for the type of surface you are playing on. Both outdoor and indoor surfaces can become slippery from sweat, water, and leaves or dust. It is always important to inspect the surface and make smart decisions about playing if the surface is compromised. Communication with your partner before and during play, such calling “mine” for a ball, also helps prevent collision during play.

- If you do fall…. Make sure you do your best to try not to brace your impact, but rather drop and roll with the momentum of the fall. This requires some quick decision making and it may not look very pretty, but it is the best way to prevent a fracture from occurring. The worst thing you can do is fall forward or backwards on an outstretched hand and try to brace or prevent your fall.

Achilles Tendonitis:

Repetitive stress on the tissue that connects the calf muscle to the heel bone is another common injury from the sport. The pain associated with Achilles tendonitis typically begins as a mild ache, but ongoing muscle tension can cause more severe pain and may lead to tendon tears. Some players may even have pain on the bottom of the foot, called plantar fasciitis or back of the heel where the Achilles attaches.

Prevention: These injuries are caused by improper warm up, poor flexibility of the calf muscles and in the case of plantar fasciitis the big toe muscle, weakness of the lower leg muscles and/or improper shoe wear for play.

General injury prevention strategies:


Fueling your body before, during, and after your matches with hydration is important for safety, especially if you will be playing outdoors in the heat. Without proper hydration, your body is not able to regulate heat. I often recommend using an electrolyte powder in your water, such as LMNT or Re-Lyte. Both have balanced minerals without the added sugar or artificial sweeteners that Gatorade has.

Stretch & Strength routine:

The more time you spend on court to learn proper ball placement, the more you can improve your game and have fun with your hitting partners. Pickleball is the sport that keeps on giving, as long as you let it. Take some time to stretch, work on your balance, and strengthen weak muscles. Warm up before your matches and be sure to wear the right gear and pick the right paddle for you. Doing all these things can lead to a lot of fun playing the game of pickle ball and lower your risk for injury.

When to See a Provider:

When you start to have any pain in your back, arm, or knees, take some time off from your sport and try to do some stretching and strengthening to that area of the body. If you return to play and your symptoms return, I recommend you see a sports medicine PT who understands the demands of your sport and can return you to safe play. You do not need a physician referral for this evaluation at Dynamic Performance and Therapy. Your PT will provide you with the proper treatment and exercises to get you back into the game as soon and as safely as possible. In the event you experience a sudden fall, it is important to seek out immediate medical assistance to rule out a fracture.

Pickleball is a fun and fast-growing sport among older and younger adults. It is an easy to learn, social game full of quick movements and quick thinking. If you are a pickle ball novice, my advice to you is to start out by taking an intro class to learn how the game is played. In the La Crosse area you can go to to learn where you can find an instructional class or courts to play on. Be aware of your physical limitations and play within your level of play, choose proper shoe wear and a paddle that’s appropriate for you. I look forward to seeing you on the courts!


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