Health & longevity
Pickleball Injury Prevention
Pickleball's explosive lateral movements, overhead shots, and repetitive forearm use make it one of the more injury-prone racket sports per hour played. The good news: most injuries are preventable with the right warm-up, technique, and load management.
Note: This guide covers prevention and general information. For diagnosis or treatment of existing injuries, consult a licensed physical therapist or sports medicine physician.
Five most common pickleball injuries
Causes, prevention, and warning signs for each.
Pickleball elbow (lateral epicondylitis)
Elbow / forearmCause: Repetitive forearm rotation, tight grip, late contact on forehands
Prevention: Loosen grip to 3-4/10, contact ball in front, strengthen forearm with wrist curls and reverse curls, use a paddle with a softer core
Watch for: Outer elbow tenderness that worsens with gripping, stop playing and rest at first sign
Ankle sprain
Ankle / lower legCause: Rapid lateral cuts, uneven court surfaces, landing awkwardly on volleys
Prevention: Wear proper court shoes with lateral support, do ankle strengthening (single-leg balance, calf raises), warm up with ankle circles
Watch for: Lateral ankle pain or instability, common in the first 6 months of play
Knee pain (patellar tendinitis)
KneeCause: Deep lunges for low balls, repetitive squatting, weak quad and hip muscles
Prevention: Strengthen quads and glutes (squats, step-ups, hip bridges), land softly with bent knees, avoid overextending on low balls
Watch for: Front-of-knee pain that worsens going down stairs, reduce volume and strengthen
Shoulder strain / rotator cuff
ShoulderCause: Overhead smashes, serving mechanics, poor shoulder rotation on drives
Prevention: Warm up shoulders thoroughly, use full body rotation on overheads (not just arm), strengthen rotator cuff with band exercises
Watch for: Pain on reaching overhead or behind your back, don't play through shoulder pain
Achilles tendinitis
Achilles / calfCause: Explosive acceleration, poor calf flexibility, sudden increase in play volume
Prevention: Eccentric calf strengthening (heel drops), dynamic calf warm-up, avoid rapid increases in play frequency
Watch for: Stiffness first thing in the morning, pain 2-4cm above heel, very important to address early
Pre-play warm-up routine
6 moves, takes 8-10 minutes, saves weeks of recovery.
Leg swings (front-back, side-side)
10 each directionHip mobility and hamstring activation
Hip circles
10 each directionHip joint range of motion
Shoulder rolls and arm circles
15 repsShoulder and rotator cuff prep
Lateral shuffles
2 × 20 feetLateral movement pattern activation
Light jog + high knees
60 secondsCore temperature raise
Slow cross-court dinks
3-5 minutesEye-hand coordination and touch calibration before full pace
Load management: the 10% rule
Most overuse injuries (elbow, Achilles, knee) happen when play volume increases too fast. The 10% rule: don't increase your weekly playing time by more than 10-20% week over week. Going from 2 hours/week to 8 hours/week in two weeks is a common injury pathway. Build gradually, take rest days, and listen to early soreness signals before they become injuries.
Frequently asked questions
What are the most common pickleball injuries?
The most common pickleball injuries are: lateral epicondylitis (pickleball elbow) from repetitive forearm use, ankle sprains from quick lateral cuts, knee pain from deep lunges and pivoting, shoulder strain from overhead shots and serves, and Achilles tendon issues from explosive starts and stops. Players over 50 are at higher risk for Achilles injuries; younger players more commonly see ankle and knee issues.
How do you prevent pickleball elbow?
Prevent pickleball elbow by: using proper technique (loose grip, contact in front of body), choosing a lighter paddle with a softer core, doing forearm strengthening exercises (wrist curls, reverse curls) 3x per week, warming up your forearm and elbow before play, and taking rest days when you feel early soreness. Many cases develop from suddenly increasing play frequency, gradual increases of no more than 10-20% per week help prevent overuse injuries.
How should you warm up before pickleball?
Warm up before pickleball with 5-10 minutes of dynamic movement: leg swings, hip circles, shoulder rolls, light jogging, lateral shuffles, and arm circles. Avoid static stretching before play, it reduces muscle power and doesn't prevent injury. Start on court with slow dinking at close range before progressing to full pace. A proper warm-up reduces injury risk and improves early-game performance.
Next steps
Put this into action
Use what you just read to find a game, get on court, and show up prepared.