Pickleball and Physiotherapy

Pickleball is the fastest growing sport. There's no question why injuries from this sport is also growing and the players' need to take care of their bodies should be a priority.

Stay on the Court, Not on the Sidelines

Pickleball has become one of the fastest-growing sports in North America, attracting players of all ages and skill levels. What starts as a fun, social activity often turns into a competitive and physically demanding sport. As more people play more frequently, physiotherapists are seeing a growing number of pickleball-related injuries.

Whether you're a beginner learning the basics or a seasoned player competing in tournaments, understanding the physical demands of pickleball—and how physiotherapy can help—can keep you playing pain-free for years to come.

Why Does Pickleball Have a High Injury Rate?

One of the biggest misconceptions about pickleball is that it's a "low-impact" sport. While the court is smaller than a tennis court, the game involves frequent:

• Quick lateral movements

• Explosive starts and stops

• Lunging for low balls

• Repeated squatting and bending

• Rapid changes in direction

• Overhead serves and smashes

• Prolonged rallies requiring fast reaction times

Many players also participate several times a week without incorporating strength training, mobility work, or adequate recovery. This combination can increase the risk of both overuse injuries and sudden strains.

Additionally, pickleball has become especially popular among adults over 40, many of whom are returning to sport after years away from regular athletic activity. Changes in flexibility, strength, balance, and recovery can make injuries more likely if the body isn't properly prepared.

Common Pickleball Injuries Physiotherapy Commonly Treat

Shoulder Pain

Repeated overhead shots, serves, and smashes place significant stress on the shoulder muscles and rotator cuff. Poor mechanics or muscle weakness can lead to tendon irritation, impingement, or rotator cuff injuries.

Tennis Elbow (Lateral Epicondylalgia)

Despite the name, tennis elbow is extremely common in pickleball. Repetitive gripping and backhand strokes can overload the tendons on the outside of the elbow, causing pain during play and even everyday activities.

Knee Pain

Quick pivots, lunges, and sudden stops place high loads on the knees. Players may develop patellofemoral pain, ligament sprains, or aggravate underlying arthritis.

Achilles Tendon and Calf Injuries

Explosive movements and pushing off during play can strain the calf muscles or Achilles tendon, especially if flexibility and strength are lacking.

Ankle Sprains

Rapid direction changes and reaching for wide shots can lead to rolled ankles, particularly on outdoor courts or uneven surfaces.

Low Back Pain

The repetitive twisting, bending, and rotational movements involved in pickleball can contribute to lower back stiffness or pain, particularly in players with limited hip mobility or poor core stability.

Wrist and Hand Injuries

Falls while trying to reach difficult shots often result in wrist sprains or fractures. Proper balance and reaction training can help reduce this risk.

How Physiotherapy Can Help

Physiotherapy isn't just for recovering from injuries—it also plays a key role in preventing them.

A physiotherapist can assess:

• Joint mobility

• Muscle strength

• Balance

• Flexibility

• Movement mechanics

• Agility and coordination

By identifying weaknesses or movement limitations before they become painful, a personalized treatment plan can reduce injury risk and improve performance.

Treatment may include:

• Manual therapy

• Targeted strengthening exercises

• Mobility training

• Balance and proprioception exercises

• Sport-specific movement training

• Education on warm-ups and recovery

• Return-to-play planning after injury

Injury Prevention Tips for Pickleball Players

Here are a few simple habits that can make a big difference:

Warm Up Before Every Match

Spend 5–10 minutes preparing your body with dynamic movements such as:

• Leg swings

• Walking lunges

• Arm circles

• Light jogging

• Side shuffles

Avoid starting with static stretching alone.

Build Strength Off the Court

Strong muscles absorb force more efficiently and protect your joints. Focus on:

• Glute strength

• Core stability

• Rotator cuff strengthening

• Leg strength

• Grip and forearm endurance

Strength training two to three times per week can significantly reduce injury risk.

Improve Balance

Better balance reduces your risk of ankle sprains and falls. Single-leg exercises and dynamic balance drills are especially helpful for pickleball players.

Wear Proper Court Shoes

Running shoes are designed for forward movement and don't provide the lateral support needed for pickleball. Court shoes offer better stability during side-to-side movements and can help reduce the risk of ankle injuries.

Listen to Your Body

Persistent soreness, stiffness, or pain during play is not something to ignore. Early treatment often prevents a small issue from becoming a long-term injury.

Don't Wait Until You're Injured

Many players wait until the pain becomes severe before seeking treatment. Unfortunately, this often means a longer recovery and more time away from the court.

Seeing a physiotherapist early can help identify the source of discomfort, address contributing factors, and develop a personalized plan to keep you active. Whether you're dealing with shoulder pain after serving, knee discomfort during lunges, or elbow pain from repetitive shots, early intervention can make recovery faster and reduce the likelihood of recurring problems.

Stay Healthy, Play Longer

Pickleball is an incredible sport that promotes fitness, social connection, and lifelong activity. Like any sport, however, it places unique demands on the body. With proper preparation, good technique, and the right rehabilitation when needed, most injuries can be prevented—or effectively managed.

At Betterform Physiotherapy, we help pickleball players of all levels recover from injuries, improve performance, and stay on the court doing what they love. Whether you're playing recreationally or preparing for your next tournament, we're here to help you move confidently and play pain-free.

Ready to get back in the game? Book an assessment with our physiotherapy team and let us help you stay strong, mobile, and injury-free—both on and off the pickleball court.