Pickleball is booming — and we’re seeing it in our clinic. Whether you’re a first-timer or a regular on the court, the sport is fantastic for fitness, coordination, and getting outdoors. But with more players comes more injuries, and understanding what to look out for can be the difference between a week off and a month off.
Here’s what we see, what to do, and when to come and see us.
Pickleball has its own injury profile — and it’s not just tennis
Because pickleball borrows heavily from tennis in terms of arm mechanics, upper limb injuries are similar across both sports. But from the waist down, it’s a different story. Pickleball is almost exclusively played on hard synthetic courts, which generate higher ground-reaction forces through your feet, ankles, knees, and hips compared to the softer surfaces (grass, clay) common in tennis.
That means lower limb and lumbar spine injuries in pickleball players often look different — and need to be treated differently.
Common injuries we see include:
Upper limb: Tennis elbow, golfer’s elbow, wrist ligament sprains, minor finger dislocations, forearm and shoulder muscle strains, and rotator cuff-related pain.
Lower limb: Ankle sprains, calf and Achilles strains, knee pain (particularly around the patella), and hip flexor tightness or strain — especially in players who are new to the sport or ramping up their frequency quickly.
Spine: Lumbar muscle strains and facet joint irritation are common, particularly in players with a history of back pain or those who haven’t played a racket sport before.
More serious injuries — including rotator cuff tears, shoulder dislocations, elbow ligament damage, stress fractures, and biceps tendon ruptures — do occur, and these need proper imaging, assessment, and a structured rehab plan to heal well.
Soft tissue injuries: the first 48 hours matter
For muscle and ligament injuries — rolled ankles, sore elbows, strained shoulders — what you do in the first 48 hours significantly affects how well and how fast you heal.
Do: Apply ice and compression, elevate the area where possible, and rest from aggravating activity. Use a walking aid like crutches if weight-bearing is painful.
Avoid: Heat on the injured area, alcohol, and aggressive massage directly over the injury site. Anti-inflammatory medications like ibuprofen are worth discussing with a health professional before reaching for them — the evidence around their use in the early stages of soft tissue injury has evolved, and they’re not always the right call.
The biggest mistake we see: waiting too long
Most patients who come to us with a significant injury say the same thing — “I thought it would just get better on its own.” Sometimes it does. Often it doesn’t, and by the time they book in, what could have been a straightforward two-week recovery has become a two-month one.
Early physio assessment gives you clarity. You’ll know exactly what you’re dealing with, what to do and what to avoid, and have a realistic timeframe for getting back on the court. For many injuries, a single session is enough to set you on the right path.
Don’t overlook overuse — it sneaks up on you
Acute injuries get the attention, but overuse injuries are arguably more common in recreational pickleball players — particularly those who’ve ramped up quickly or returned to sport after time off. Persistent elbow soreness, a shoulder that aches after play, a knee that’s stiff the morning after a game — these are your body’s early warning signals. Left untreated, they tend to escalate.
If something has been niggling for more than a week or two, it’s worth getting it looked at. Overuse injuries respond well to early intervention and poorly to being ignored.
Prevention: the conversation we don’t have enough
One thing that often surprises patients is how much of this is preventable. A few things that genuinely make a difference:
- Warm up properly. Five to ten minutes of dynamic movement before play — leg swings, shoulder circles, light lateral steps — meaningfully reduces your injury risk.
- Wear the right shoes. Court shoes with lateral support are important on synthetic surfaces. Running shoes aren’t designed for the sideways movement patterns in pickleball and can increase ankle and knee stress.
- Build up gradually. Pickleball is deceptively demanding. If you’re new or returning after a break, give your tendons and joints time to adapt before ramping up frequency or intensity.
- Strength and conditioning matters. Hip, glute, and shoulder strength in particular can offload stress from the joints most at risk in this sport. A physio can help you identify your weak links.
What does a physio appointment actually involve?
We hear this question more than you’d think — and it’s a fair one. If you’ve never seen a physio for a sports injury, it can feel uncertain.
At your first appointment, we’ll take a thorough history of what happened, assess the injured area (and often surrounding areas that may be contributing), and give you a clear diagnosis or working hypothesis. From there, we’ll put together a plan — which might include hands-on treatment, a home exercise program, load management advice, and a timeline for return to sport. No guesswork, no “just rest and see.”
When to book in
You don’t need to be in serious pain to come and see us. Book an appointment if:
- You’ve had an acute injury that isn’t clearly improving after a few days
- You have a niggling pain that keeps coming back during or after play
- You want to know whether you’re safe to keep playing
- You’d like a movement screen or injury-prevention plan before your season ramps up
We’re experienced in racket sports injuries and see pickleball players regularly. Getting on top of something early almost always leads to a faster recovery — and means more time on the court doing what you enjoy.
Book an appointment we’d love to help.