Essential Tips to Prevent Pickleball Injuries: A Physical Therapist’s Perspective

By Professional Physical Therapy

Pickleball, America’s fastest growing sport, is taking a toll on players’ wrists, legs, and shoulders. Its rise in popularity has resulted in an increase in injuries seen by physical therapists, especially among injury-prone seniors.

Pickleball participation has exploded since the pandemic began and is leading to more injuries. Fortunately, it is possible to improve your body’s ability to react and tolerate the demands of Pickleball. We will identify the common injuries and Professional’s Director of Athletic Training will share the best exercise recommendations to help prevent injuries. Physical therapy can also be a game changer for players by providing personalized treatment plans, pain relief techniques, and injury prevention strategies.

Professional’s Kristin Westover, PT, MPT, CIMT confirms, “We are seeing more patients coming in for conditions like tennis elbow and rotator cuff tendonitis, related to Pickleball. Some of our patients have pre-existing conditions that are likely exacerbated by the sport. It’s hard to get them in when some are playing hours per day.”

Common Pickleball Injuries

The most common injuries reported among Pickleball players are:

1. Tennis/Pickleball Elbow – Backhand shots can cause pain and tenderness outside your elbow, on your paddle arm.
2. Ankle Sprains – Quick lateral movements and pivoting required during the game can put stress on the ankle ligaments.
3. Achilles Tendon Injuries – Pain that begins as a mild ache in the back of the leg or above the heel and may become more severe after prolonged periods of play.
4. Rotator Cuff Tendonitis – Aggressive overhead shots can cause strain on the rotator cuff muscles, leading to discomfort and limited shoulder mobility.
5. Knee Injuries – Overuse, abrupt movements, and the constant stop-and-start nature of the game can cause knee pain.

Our Best Warmup Exercise Recommendations to Prevent Pickleball Injuries

Since Pickleball is generally considered a low-impact sport, many people do not take the precautions and engage in proper training before they hit the court. If you are looking to start playing the game or stay in the game, warmup exercises can make a big difference.

Professional’s Director of Athletic Services, Angelo Marsella, MA, ATC, USAW recommends and demonstrates exercises and stretches to prevent pickleball injures. Below we list the most common injuries associated with pickleball and offer valuable tips to prevent them.

Tennis Elbow: To help prevent tennis elbow try these prevention exercises.

       

1. Wrist Prayer Stretch: Put your palms together in front of you in a prayer position. Gently press your palms together as you lower your hands until you feel a stretch in your wrists. Keep your palms together and hold for 30 seconds, 3 times.
2. Reverse Prayer Stretch: Place the back of your hands together in front of you, fingers pointing toward the floor. Lower your elbows relative to your hands until you feel a stretch across the back of your wrists. Keep your hand together and hold for 30 seconds, 3 times.
3. Fist Opener: Make a fist, extend your arm, and hold it in front of you and then gently squeeze your fist for 30 seconds. Then open the fist and stretch your fingers until your hand is flat. Open and then relax and close the hand. Repeat the movement 8-10 times.

Ankle Sprains & Achilles Tendon Injuries: For strong ankles and good balance try these prevention exercises.

           

1. Star Balance Drill, 4 Way Cone Touches
   • Place 4 cones around your body as shown in the images above. If you don’t have cones, any objects you have around the house will work.
   • Balance on left leg, knee slightly bent with hands on your hips. Use opposite leg to reach for each cone and tap with foot. Go clockwise and tap each cone: front, right, back, left.
   • Switch legs and repeat. Try this 3 times on each leg.
2. Eccentric Heel Raises: Stand on a step with the balls of your feet on the edge. Your heels should be hanging over the edge of the step. Hold onto something stable for balance. Keep both knees straight. Using both feet, lift your heels and rise up onto the balls of your feet. Slowly lower yourself down. Try 3 sets, 12 times on each leg.

Rotator Cuff Tendonitis/Shoulder Injures: To strengthen your shoulders and avoid tendonitis try these prevention exercises:

           

1. Arm Circles: Raise and extend your arms to your sides without bending your elbows. Slowly rotate your arms forward, making small circles. Complete a set in one direction and then switch, rotating backward. Then repeat, and make larger circles, both forward and backward. Try both small and large circles 10 times each.
2. Posterior Capsule Stretch: Bring arm across in front of body and hold elbow with the other arm. Gently flex the bent elbow to further pull the arm across chest until stretch is felt in the back of the shoulder. Hold for 30 seconds, repeat 3 times each arm.
3. Band Shoulder Stretches
   • Put resistant bands around your wrists with both hands in front of you, palms facing each other. Make sure there is constant tension on the band. Pull band out and then release, doing 5 quick motions.
   • Repeat motion with palms up, 5 times.
   • Extend arms overhead and make circles, clockwise and counterclockwise. Make sure there is tension on the band, 5 times.

Knee Injuries: Strengthening muscles around your knee to give it more stability try these prevention exercises.

           

1. Multi-directional Lunges, 3 rounds on each leg.
   • Forward Lunge: Step forward with your right leg, placing your heel on the ground first, then sink your hips until both knees bend at 90 degrees (knee should not touch the floor). Resume to original stance.
   • Angle at 45 Degrees Lunge: Step out to the side at a 45-degree angle with your right leg, knee should not touch the floor. Resume the original stance.
   • Side Lunge: Step your right leg outwards at a 180-degree angle. You are not bending the left knee this time, just the right knee. Resume to original stance.
   • Backward Lunge: Step straight backwards with your right leg and touch the floor with your toes first. Lower your right knee towards the floor but do not touch it. Bend both knees at 90 degrees. This position is almost a direct reverse of the forward lunge.

More Safety Tips to Prevent Pickleball Injuries

In addition to warming up properly, we suggest the following guidelines to enjoy the game safely.

• Chose proper footwear: Invest in court-specific shoes that offer excellent support and traction, reducing the risk of ankle sprains and other foot-related injuries.
• Use the right paddle grip: Employing the correct grip technique can alleviate stress on the wrist and elbow, minimizing the risk of developing tennis elbow.
• Focus on technique: Seek guidance from experienced players to learn proper techniques for strokes and footwork. Correct form can reduce the risk of injuries and improve overall performance.
• Strengthen muscles: Incorporating strength training exercises focusing on the core, legs, and upper body to build overall body strength and support joints during the game.
• Don’t forget to cool down: After playing, cool down with light walking and stretching to gradually reduce heart rate and prevent muscle stiffness.
• Stay hydrated: Drink plenty of water before, during and after playing to reduce muscle fatigue.
• Listen to your body: Pay attention to signs of pain, discomfort, or fatigue. Rest and give yourself time to recover if you feel overworked.

It’s important to note that the prevalence of injuries can be reduced significantly through proper warm-up routines, using the right equipment, implementing good technique, and being mindful of one’s limitations. If you’re experiencing persistent pain or discomfort from pickleball or any sport, it’s advisable to consult with a healthcare professional or physical therapist for personalized advice and treatment.

How Physical Therapy can Help You Recover from Pickleball Injuries

PT can help players prepare their bodies for the physical demands of the sport. It can also use techniques that can alleviate pain and rehabilitate common pickleball injuries.

• Manual Therapy – specialized hands-on techniques to help improve joint and soft tissue restrictions.
• Electrical Stimulation – small electrical pulses to the injured area, helps temporarily reduce pain.
• Therapeutic Exercises – targeted exercises to strengthen weakened muscles, improve stability, and restore normal movement patterns.
• Dry Needling – technique that involves inserting thin needles into trigger points in your muscles to help alleviate pain.
• Kinesio Taping – can provide support and stability without restricting range of motion.

In addition to these pain relief techniques, Professional Physical Therapy can be offer:

• Injury Assessment and Diagnosis
• Individualized Treatment Plans
• Education and Injury Prevention Strategies
• Gradual Return to Play

At Professional, our therapists are movement experts. We are skilled at assessing your physical abilities, providing guidance on injury prevention, and preparing your body to tolerate an active lifestyle.

If you are experiencing pain during Pickleball or any sport, it is often an indicator that your body is telling you something is wrong. Symptoms can progressively get worse and lead to other problems if not successfully diagnosed and treated. Visit one of our Professional Physical Therapy clinics near you to get started. Request an appointment for a consultation so you can feel better and get back to doing the things you love.

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