How to Prevent Pickleball Injuries

If you’ve read about a big increase in pickleball injuries and it’s stopping you from exploring the sport, shoulder surgeon Ilya Voloshin, MD, has some reassuring perspective on pickleball’s injury profile, along with some advice about the sport: get out there and try it!

Voloshin is Chief of the Shoulder and Elbow Division at UR Medicine Department of Orthopaedics and Physical Performance. He is also a longtime, avid tennis and squash player who has become a big fan of pickleball. He offers some perspective on some risks – and the major rewards – of this sport.

Is there a rise in pickleball injuries?

Yes, injuries have increased, but it is in proportion to the millions of adults who are taking up the sport. Pickleball is the fastest growing sport in the U.S., with the number of players rising from 4.8 million in 2021 to 8.9 million in 2023, according to USA Pickleball. The more people play any sport, the more injuries will occur.

Pickleball attracts people across all age groups, including a significant proportion of people in their 50s, 60s and 70s, and that demographic is more prone to orthopaedic injuries. But that shouldn’t discourage them from playing; in fact, pickleball is an excellent option for older adults who can no longer play more demanding sports.

As a shoulder surgeon, and a pickleball player, I know that the stress on joints from pickleball are far less than many other sports. I tell my patients who have had shoulder surgery and can no longer play vigorous racquet sports that they can participate in pickleball without unduly risking the repair I made to their shoulder.

What kinds of injuries do doctors see in pickleball?

Most of the injuries involve strains to joints, muscles, and tendons, and there are fractures related to falls. But here’s what I want people to remember: You can fall walking into the grocery store, too, and there is a very real risk to not being active in your older years. You can sit on the couch and not get a physical injury, but that increases your risk of cardiovascular disease, stroke and all the other problems related to inactivity.

It’s better to participate in physical activity and enjoy the many benefits while you take simple steps to minimize your risk of injury.

Before we get to injury prevention, what are the benefits of pickleball?

Pickleball is truly amazing; it has become extremely popular because even people who were not physically active have taken it up and find they can participate and have fun. I have never seen a sport where even people with debilitating injuries can still be competitive.

I’m an experienced racquet athlete, but when I was learning pickleball, there were people in their 70s who could beat me. I have patients who have had strokes, have a dropped foot, all kinds of shoulder and elbow injuries, but they are playing pickleball competitively and are excited to be out there. That tells me this sport is a game-changer and it is going to keep growing.

Playing a sport is great for older adults’ physical conditioning, their mental state, and their socialization. As far as I’m concerned, everyone should be playing pickleball because it’s a lot easier on your body than any other racquet sport.

The court size is smaller, so there is less running; the racquet is shorter and lighter and the ball is lighter, so there’s less strain on the shoulder and elbow. In my opinion, it is actually safer for people to play pickleball compared to tennis, squash, paddle, and racquetball for those reasons. And because it’s a competitive game, it’s fun; it’s not a chore like riding a stationary bike in your basement alone, so people are more apt to stick with it.

How can people help prevent pickleball injuries?

• Get game-ready with proper conditioning: If you have not been physically active, talk to your doctor or physical therapist before jumping into this or any sport. Get some cardiovascular conditioning: walking and bicycling are low-impact ways to build your endurance.
• Take a lesson: If you have played a racquet sport before, that’s great, but you don’t need prior racquet experience to play pickleball. You do need to know the basics of the game and proper form.
• Warm up: Do some light, active stretching before you play to warm up your muscles and joints to reduce risk of strain.
• Play at your level: Play with people who have the same skill set as you do. As you learn the game and improve your strategy you will not need to lunge as much for balls you can’t reach; that is how falls, muscle pulls, and joint strains can happen. Don’t play beyond your physical abilities – find a competitive group of players at your level and gradually improve; play for fun and exercise and recognize that your skills will grow the more you play.
• Stay hydrated: Be sure you are drinking plenty of water before and during play. Dehydration can make you dizzy, which can lead to a fall on the court.
• Rest: Recognize when you are putting too much demand on your body and take a break from play. A good stretching routine as well as muscle recovery modalities will minimize injury risk. Pickleball players may want to play every day because it’s so much fun, but they need to listen to their bodies and recover when they need it. Tired muscles and overworked joints are more prone to injury.
• Get treatment when necessary: If rest isn’t helping and you are still feeling pain and loss of mobility, see your physician. You may need medical treatment and rehabilitation to recover properly.