December 1, 2023
The most common pickleball injuries arise out of repetitive use
By: Kenton H. Fibel, M.D.
Pickleball is a popular recreational “racket sport” that combines elements of tennis, ping pong, and badminton into one game that many people of varying ages and stages of athletic ability enjoy. In fact, it appears first on many lists for the title of “fastest growing sport in America,” with a 171 percent increase in participation between 2018-2022, especially in middle-aged adults. As with any sport, however, even recreational, a risk of injury always exists. In sports medicine practices across the United States, including ours, an increasing number of patients present with injuries related to playing pickleball. From the novel participant to the experienced, knowing about the common injuries these players sustain, what causes them, and most importantly, how to prevent them is essential.
The most common pickleball injuries arise out of repetitive use and so aren’t necessarily “acute” in nature – they happen over time. Repetitive use injuries in players affect the wrist and elbow and lower extremity injuries – including acute flares of underlying hip and knee osteoarthritis as well as calf and hamstring strain injuries.
In the wrist, injury can occur because of the repeated torque and twisting motion required to paddle the ball. In the elbow, a phenomenon called “tennis elbow,” medically referred to as lateral epicondylitis, involves tendinitis and pain on the outside of the elbow resulting from repetitive use.
A calf strain can occur when explosively lunging forward for a low shot and can bring about pain that feels like a kick in the calf. Calf injuries should be monitored and evaluated to ensure they aren’t more serious injuries such as an Achilles tendon rupture. Additionally, hamstring strains can also occur with explosive court movements in pickleball, and depending on the degree of the strain, it may take longer to heal. For this reason, it is also vital to have the injury evaluated by a sports medicine physician.
Of course, other types of bodily injury can arise from pickleball play, including shoulder strains, rotator cuff injuries, bursitis, and impingement. In addition, knee injuries, such as meniscus and ACL tears, and ankle injuries, such as sprains, are also risks.
A combination of the following factors causes most pickleball injuries:
- Improper Warm-up and Cool-down: Not warming up properly before playing and not cooling down afterward can increase the risk of injury.
- Lack of Flexibility: Pickleball requires flexibility in the hips, knees, shoulders, and elbows. A lack of flexibility can make pickleball players more prone to injury.
- Improper Technique: Using improper pickleball playing techniques can stress the joints and muscles unnecessarily.
- Overuse: Playing pickleball too often without giving the body’s muscles, ligaments, and joints enough time to rest can lead to overuse injuries.
- Inadequate Equipment: Wearing improper shoes or using a pickleball paddle that is too heavy, or light can also increase the risk of injury.
Awareness of the factors that can increase a person’s risk of injury while playing pickleball is crucial to knowing how to prevent those injuries. Some helpful steps every pickleball player can take include:
- Commit to always stretching while warming up before playing pickleball and stretching while cooling down afterward. Regular stretching can help improve flexibility and reduce the risk of injury.
- Be diligent about the use of proper pickleball playing techniques. When available, take lessons from a qualified instructor to learn appropriate pickleball techniques.
- Avoid overuse injuries. Don’t play pickleball too often without giving your body enough time to rest.
- Use the right equipment. Wear proper shoes and use a paddle that is the right size and weight for you.
The sport of pickleball is an incredibly fun physical activity that people of all ages can enjoy. And while injuries can occur, knowing what they are and what causes them can go a long way towards preventing them from happening to you. If you have sustained an injury playing pickleball that hasn’t seemed to heal with conservative treatments such as rest and over-the-counter medication, be sure to see a sports medicine specialist to get to the bottom of it.