Pickleball
Pickleball has taken over courts across the country, its growing popularity has led to an increase in orthopedic injuries. It is fun, social, and easy to learn, but the quick stops, starts, pivots, and reaches can place significant demands on the body. As participation continues to rise, so does the risk of injuries affecting muscles, tendons, ligaments, and joints.
With fairly easy rules to grasp, pickleball grew from 4.8 million people participating in 2021 to a booming 25 million as of 2025. This surge has been able to draw players of varying age ranges from Gen Z to baby boomers and now there are indoor/outdoor facilities dedicated to the sport. The community around the sport is exciting to see, but an ankle injury during a weekend match can quickly turn that fun into time away from work, exercise, and the activities you enjoy.
Injury patterns tend to vary by sex and age. Older adults, particularly those 65 and above, may face greater consequences following a fall with increased concerns of fracture risk. And females may have increased risk of inversion ankle sprains and fractures. The most common injuries have been fractures primarily at wrist or lumbar vertebrae from falls, and strains/sprains/ligamentous compromise typically at the lower leg/ankle.
While pickleball has been regarded as a sport popular among older adults because of its psychosocial and physical benefits, it is important to recognize how age-related changes in strength, reaction time, balance, and coordination can affect injury risk. Quick changes of direction, unexpected reaches, and falls can place higher demands on the body, which is why preparation and prevention matter.
Hence, for pickleball and other court sports, balance and coordination training can help improve neuromuscular control through the trunk, arms, and legs to improve range of motion and function. Fortify these dynamic movements with strengthening exercises that include lateral movement, trunk rotation, controlled deceleration, and quick reaction drills can help your body better tolerate the demands of the game.
Many of our daily activities and exercise routines are dominated by forward and backward movement. We sit at desks, walk, run, and perform exercises such as leg press, curls, and chest press. Pickleball however requires much more than that. Players have to shuffle laterally, rotate through their trunk, decelerate, reach outside their base of support, and make quick directional changes. If you want your body to tolerate pickleball, you should train some of the movements pickleball actually requires such as lateral, rotational, and quick reactive movements.
I’m part of the pickleball surge myself. I have been playing for nearly 2 years and try to get on the court about once per week in the warmer months. Just like my patients, I want to keep playing the sports I enjoy without being sidelined by an avoidable injury. If pain is keeping you off the court, or if you want guidance on how to prepare your body for the demands of pickleball, come see us at Spine & Sports Physical Therapy. We can help you move well, build confidence, and get back to enjoying your time on the court.
Written by: Dr. Brian Ranger PT, DPT