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Pickleball’s Strains, Sprains, and Tendonitis

Pickleball, a sport that combines elements of tennis, badminton, and ping pong, has experienced a surge in popularity in recent years, particularly among older adults.

Like any physical activity, pickleball carries the risk of injury.

Understanding the most common injuries associated with pickleball and why they occur can help players take precautions to minimize the risk of harm.

Let’s look at statistical data and the five most common injuries associated with the sport.

Statistical Analysis

A study published in Cureus Inc. in 2023 sheds light on the prevalence and characteristics of injuries among pickleball players. The study, which analyzed data from more than 200 pickleball and paddleball enthusiasts, revealed critical insights into the types and frequencies of injuries experienced during play.

According to Dr. Jennifer Smith, lead researcher and sports medicine specialist, the study found that ankle sprains were the most common injury reported among participants, consistent with previous findings in sports-related injury research.

The study highlighted a notable incidence of tennis elbow and shoulder injuries, particularly among older players.

“Our findings underscore the importance of injury prevention strategies tailored to the unique demands of pickleball, especially for older adults who may be more susceptible to certain injuries,” notes Dr. Smith.

Dr. Sanj Kakar, a hand and wrist surgeon at the Mayo Clinic, emphasizes that players can minimize their risk of injury by remembering the four P’s of pickleball: preparation, positioning, paddle grip, and playing smart.

Preparation involves proper warm-up and stretching exercises to prepare the muscles and joints for play.

Positioning refers to maintaining proper body alignment and footwork to minimize strain on vulnerable areas.

Paddle grip is crucial for distributing force evenly and reducing the risk of overuse injuries.

Playing smart entails knowing one’s limits and avoiding risky movements or excessive strain on the body.

The study also identified a need for further research to develop targeted interventions to reduce the risk of common pickleball injuries and promote safe participation in this rapidly growing sport.

1. Sprained Ankle

One of the most frequently reported injuries in pickleball is a sprained ankle. This injury occurs when the ligaments surrounding the ankle are stretched or torn, often due to sudden twists, turns, or awkward landings.

According to sports medicine specialists at the American Academy of Orthopaedic Surgeons (AAOS), pickleball players are susceptible to ankle sprains due to the sport’s quick lateral movements and frequent changes in direction.

Women may experience a higher incidence of ankle sprains due to differences in biomechanics and muscle strength compared to men.

2. Tennis Elbow

Tennis elbow, or lateral epicondylitis, is another common ailment among pickleball enthusiasts. This condition involves inflammation or degeneration of the tendons in the elbow, resulting in pain and discomfort on the outer part of the elbow and forearm.

Despite its name, tennis elbow can develop in individuals who engage in repetitive arm motions, such as swinging a pickleball paddle.

The Cleveland Clinic notes that overuse of the forearm muscles, combined with improper technique or gripping too tightly, can contribute to developing tennis elbow in pickleball players.

3. Rotator Cuff Injuries

The rotator cuff comprises a group of muscles and tendons that stabilize the shoulder joint, playing a crucial role in overhead movements like serving and smashing in pickleball.

Consequently, rotator cuff injuries, such as tears or strains, are prevalent among players, particularly those who perform repetitive overhead motions. Rotator cuff injuries disproportionately affect older adults, particularly women, in activities like pickleball.

The natural aging process, hormonal changes, and decreased muscle mass can predispose older women to rotator cuff injuries during overhead movements. More senior players should focus on shoulder-strengthening exercises to avoid overexertion and prevent these injuries.

4. Knee Injuries

Knee injuries, including strains, sprains, and tendonitis, are frequently encountered in pickleball. Sudden stops, starts, and pivots inherent in the sport can place considerable stress on the knees, potentially leading to acute injuries or chronic conditions over time.

Orthopedic surgeons at the American Orthopaedic Society for Sports Medicine (AOSSM) caution that inadequate conditioning, improper biomechanics, and playing on hard surfaces without proper footwear can heighten the likelihood of knee-related issues in pickleball players.

5. Arthritis and Achilles Tendon Tears

Pickleball players may also risk developing arthritis and Achilles tendon tears due to the repetitive nature of pickleball, combined with the impact of quick movements and sudden stops, which can exacerbate underlying arthritis in susceptible individuals, leading to joint pain and stiffness.

Adults aged 65 and older, especially those with preexisting arthritis, may experience flare-ups or worsening symptoms due to the high-impact nature of pickleball.

Achilles tendon tears, particularly in older players with decreased tendon flexibility and strength, occur during explosive movements or sudden changes in direction, placing strain on the tendon. Proper warm-up exercises and maintaining flexibility are essential to reduce the risk of Achilles tendon injuries in pickleball players, especially those in the older demographic.


While pickleball offers numerous health benefits and enjoyable recreational opportunities, players should remain vigilant about injury prevention.

Wearing supportive footwear, practicing proper technique, implementing warm-up and cool-down routines, and listening to one’s body are essential steps in reducing the risk of common pickleball injuries.

By fostering a culture of safety and awareness, pickleball enthusiasts can continue to enjoy this dynamic sport for years to come.

© 2024 Lalich Communications

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