Dr. Steven G. Ward, DO · Tucson & Oro Valley
Pickleball injuries: prevention & rehab
Pickleball is great exercise, and it’s the fastest-growing sport in the country. It also sends many players to the doctor. Here are the most common injuries, how to avoid them, and simple exercises to help you recover.
Top tips for every player
- Warm up 5–10 minutes — brisk walk, side shuffles, arm circles, then gentle stretches.
- Wear court shoes made for side-to-side movement. Not running shoes, not sandals.
- Never backpedal. Turn and shuffle back for lobs, or let the ball go.
- Build up slowly. Add playing time gradually and take rest days.
- Stay hydrated — Tucson heat adds up fast. Play early or late in summer.
- Strength and balance work 2–3 days a week helps protect every joint.
Common injuries, prevention & rehab
Achilles tendon rupture & calf strain
A sudden push-off or lunge can tear the calf muscle or the Achilles tendon. A rupture often feels like being kicked in the back of the heel. If you suspect a rupture, stop playing and call us the same day.
How to avoid it
- Warm up 5–10 minutes and stretch the calf before play
- Build up playing time gradually, especially after time off
- Wear court shoes with good heel support
- Avoid sudden lunges from a flat-footed stance; stay on the balls of your feet
Home rehab exercises
- Wall calf stretch (knee straight, then bent) 3 × 30 sec each
- Seated towel stretch 3 × 30 sec
- Double-leg heel raises, progress to single-leg 3 × 15
- Slow lowering off a step (eccentric heel drop) 3 × 10
Handouts: Foot & ankle conditioning program (AAOS, from our Exercises page)
Ankle sprain
Quick side-to-side moves and stepping on a ball or a partner’s foot can roll the ankle.
How to avoid it
- Wear court shoes made for side-to-side movement, not running shoes
- Clear stray balls off the court
- Do balance training if you have sprained before; consider a brace
- Shuffle sideways rather than crossing your feet
Home rehab exercises
- Ankle alphabet (trace letters with your toes) 2 rounds
- Band ankle moves in 4 directions 3 × 15 each
- Single-leg balance, progress to eyes closed 3 × 30 sec
- Heel raises 3 × 15
Handouts: Foot & ankle conditioning program (AAOS, from our Exercises page)
Meniscus tear & knee strain
Pivoting and twisting on a planted foot can tear the meniscus, the cartilage cushion between the femur and tibia. Many players also have knee arthritis that flares with play.
How to avoid it
- Strengthen the quadriceps and hips
- Move your feet to the ball instead of twisting on a planted foot
- Bend the knees and hips to reach low balls; avoid deep twisting squats
- Choose a court surface and shoes with good grip but not too much
Home rehab exercises
- Quad sets (tighten the thigh muscle, knee straight) 3 × 10, hold 5 sec
- Straight leg raises 3 × 10
- Mini squats to a chair (0–45°) 3 × 10
- Side-lying leg raises for the hip 3 × 12
Handouts: Meniscus repair · Partial meniscectomy · Knee conditioning program (AAOS, from our Exercises page)
Wrist fracture from falls
Falling backward or sideways onto an outstretched hand is the most common cause of serious pickleball fractures, especially in players over 50 and players with osteoporosis.
How to avoid it
- Never backpedal for a lob; turn and shuffle back, or let it go
- Wear shoes with good grip and keep the court clear and dry
- Ask your doctor about a bone density check if you are over 65 (women) or have had a fracture
- Work on balance and leg strength off the court
Home rehab exercises
- Only after your fracture is cleared to move:
- Wrist bend up/down and side to side (gentle range of motion) 3 × 10
- Palm up/palm down turns 3 × 10
- Ball or putty squeeze 3 × 10, hold 5 sec
- Light wrist curls with a 1–2 lb weight 3 × 10
Handouts: Distal radius (wrist) fracture care · Wrist fracture instructions (PDF)
Lateral epicondylitis (“pickleball elbow”)
Overuse of the forearm muscles strains the tendon on the outside of the elbow, causing pain with gripping and backhands.
How to avoid it
- Use a lighter paddle with the right grip size
- Don’t squeeze the grip too tightly
- Use your shoulder and body on backhands, not just the wrist
- Take rest days; consider a forearm strap
Home rehab exercises
- Wrist extensor stretch (arm straight, gently bend wrist down) 3 × 30 sec
- Slow wrist extension lowering with 1–2 lb weight 3 × 15
- Ball or putty squeeze 3 × 10
- Palm up/palm down turns with a hammer or light paddle 3 × 10
Handouts: Epicondylitis exercise program (AAOS, from our Exercises page)
Rotator cuff strain & tendinitis
Repeated overhead shots and serves can irritate or tear the rotator cuff, particularly in players over 50.
How to avoid it
- Warm up the shoulder with arm circles and light swings
- Limit overhead smashes when the shoulder is sore
- Keep rotator cuff and shoulder blade muscles strong
- Build up playing time gradually
Home rehab exercises
- Pendulum swings 2 × 30 sec
- Band external rotation, elbow at side 3 × 15
- Band internal rotation, elbow at side 3 × 15
- Shoulder blade squeezes 3 × 10, hold 5 sec
Handouts: Shoulder exercises · Rotator cuff & shoulder conditioning (AAOS) · Rotator cuff repair
Low back strain
Bending to reach low balls and twisting through shots can strain the low back muscles.
How to avoid it
- Bend at the hips and knees, not the waist
- Strengthen your core and hips
- Warm up with gentle trunk rotations
- Use a ball retriever instead of bending over repeatedly
Home rehab exercises
- Pelvic tilts 2 × 10
- Knee-to-chest stretch 3 × 30 sec each
- Bridges 3 × 10
- Bird dog 2 × 10 each side
Handouts: Low back pain exercises (PDF) · Spine conditioning program (AAOS)
Plantar fasciitis
Heel pain that is worst with the first steps in the morning, from repeated stress on the tissue under the foot.
How to avoid it
- Wear supportive court shoes and replace them when worn
- Stretch the calf and foot before and after play
- Avoid playing barefoot or in sandals
- Increase playing time slowly
Home rehab exercises
- Plantar fascia stretch (pull toes back while seated) 3 × 30 sec
- Roll the arch over a frozen water bottle 2–3 min
- Towel scrunches with the toes 3 × 15
- Wall calf stretch 3 × 30 sec
Handouts: Foot & ankle conditioning program (AAOS, from our Exercises page)
Injured on the court?
Dr. Ward treats sports injuries for players of all ages in Tucson and Oro Valley.
Call 520-881-1394 More home exercisesSources
- American Academy of Orthopaedic Surgeons (AAOS), OrthoInfo: 5 Pickleball Injury Prevention Tips, Achilles Tendon Rupture (Tear), Sprained Ankle, Tennis Elbow (Lateral Epicondylitis), Plantar Fasciitis and Bone Spurs, Distal Radius Fractures (Broken Wrist).
- Forrester MB. Pickleball-related injuries treated in emergency departments. J Emerg Med. 2020;58(2):275–279.
- Weiss H, Dougherty J, DiMaggio C. Non-fatal senior pickleball and tennis-related injuries treated in United States emergency departments, 2010–2019. Inj Epidemiol. 2021;8:34.
- Ghattas YS, Zeblisky P, Cassinat J, et al. Pickleball-related fractures in the United States from 2002 to 2022: an analysis using the NEISS database. Orthop J Sports Med. 2024;12(6):23259671241255674.
- Lee PM, Nishi R, Obana KK, et al. Pickleball-related geriatric fractures and pediatric equipment-related injuries are increasing in emergency departments across the United States. Arthrosc Sports Med Rehabil. 2025;101228.
- Vitale K, Liu S. Pickleball: review and clinical recommendations for this fast-growing sport. Curr Sports Med Rep. 2020;19(10):406–413.
- Photo: “Pickleball Players” by TheVillagesFL, Wikimedia Commons, CC BY-SA 4.0.
This page is general education, not medical advice for your specific condition.