Pickleball Injury Prevention

Welcome to another edition of the Doctor’s Note where we talk about what’s on our minds when it comes to your health.

This week I had the pleasure of bringing my long-time friend and fellow physician, Dr. Pat Riggins, onto the pickleball courts to talk about the growing popularity of the sport—and, more importantly, how to stay healthy and injury-free while playing it. Pickleball has quickly become one of the fastest-growing sports in the country, especially among adults in their 40s through 70s. It’s competitive, social, and simply a lot of fun, giving many people a reason to get active again. But with more people getting on the court—often after years without this kind of quick, intense movement—we’re also seeing more injuries, from muscle strains to ligament tears, simply because the body may not be prepared for all the sudden stops, starts, pivots, and repetitive play that pickleball requires.

Dr. Riggins and I talked through some of the injuries he’s seeing—knee and Achilles injuries, rotator cuff tears, and even wrist and hip fractures—but just as importantly, why they’re happening. A lot of it comes down to getting on the court without enough conditioning or warm-up, along with that competitive tendency we all have to push a little harder than we probably should. The good news is that some simple, consistent stretching and strength work for both the lower and upper body can make a real difference in helping prevent injury. Even for those who have had joint replacements, pickleball can still be a great way to stay active and enjoy some healthy competition—you just have to be willing to do a little extra preparation.

PODCAST NOTES 

• Pickleball is uniquely accessible to people of all ages, but its exploding popularity among older adults in their 40s through 70s is largely due to its ability to reignite a sense of competitiveness and fun, while offering ways to stay physically active and socially connected. On smaller courts, players can quickly pick up the skills needed to participate, and the joy of cross-generational gameplay is clearly fueling the sport's growth.

• Engaging in sports like pickleball doesn’t just keep you moving—it can have a real impact on your lifespan. Research shows that those who play social, mentally engaging sports like pickleball and tennis may extend their lives by nearly a decade compared to those who are sedentary. The fun, camaraderie, and the mental stimulation of keeping score and strategizing all contribute to long-term health and vitality.

• A significant rise in pickleball injuries is tied directly to people jumping into the sport with little—or no—recent background in physical activity. Many come to the courts deconditioned, lacking flexibility and strength, and often neglect the need for a focused warm-up, which sets them up for muscle pulls and joint injuries early in play or when their stamina wanes.

• The lower body is especially vulnerable in pickleball, with Dr. Riggins seeing everything from simple strains (Achilles, calf, and hamstring) to more serious injuries like Achilles tendon ruptures and meniscus or ligament tears in the knees. These can sometimes require surgery and extensive rehab, emphasizing again that prevention is crucial for those who want to stay on the court.

• Upper extremity injuries, while somewhat less common, are still a concern, especially among those who play frequently or with high intensity. Issues include rotator cuff strains and tears, tennis and golfer’s elbow, and even labral or biceps injuries from repetitive motions. Even though pickleball isn’t as overhead-heavy as tennis, the fast, reaction-based movements and repetitive nature of play can still lead to damage.

• Falls are another real risk, especially when players push beyond their limits, try risky moves, or simply misjudge a shot. Dr. Riggins detailed treating wrist fractures (sometimes requiring plates and screws) and even hip fractures in players as young as their 50s, all from falls on the court due to an aggressive move or simply fatigue.

• Analysis of injury timing reveals a clear trend: most injuries occur within the first 5–10 minutes of play (when muscles are cold and unprepared) or at the very end of a session when exhaustion has set in. This underscores the need not only for proper warm-up and conditioning, but also for listening to your body and taking breaks before fatigue leads to poor decisions or slower reactions.

• Proper prevention comes down to consistent physical conditioning—focusing on leg, hip, and shoulder strength, as well as flexibility. Both Dr. Riggins and I emphasized the importance of warming up before play, performing dynamic stretches, and building up muscle through functional exercises. Even those with joint replacements can enjoy the game safely with proper preparation and a commitment to knowing their limits and not pushing beyond what their bodies can handle.

I want to encourage everyone—especially those getting back into a sport or trying pickleball for the first time—not to overlook the basics. Take a few minutes before you play to loosen up, keep up with some simple strength and flexibility work, and most importantly, listen to your body. A little preparation can go a long way toward keeping you on the court and enjoying the game for years to come. Pickleball is a great way to stay active, be around people, and have some fun, so do what you can to take care of your body along the way. Get out there, play smart, and enjoy the game.

Stay educated. Stay healthy.

Till next week.