Common Pickleball Injuries and How to Prevent Them

Headshot of OSMS Orthopedic Surgeon, Dr. Michael Parman, MD

By Dr. Michael Parman, Sports Medicine Fellowship Trained Orthopedic Surgeon

Dr. Michael Parman received his medical degree from the Medical College of Wisconsin where he then completed his residency at the University of Cincinnati. During his time at the New England Baptist Hospital, where he completed his fellowship in Sports Medicine, Dr. Parman was able to provide medical care for the Boston Celtics and Harvard University Athletes. 

In his free time, Dr. Parman likes to stay active, relishing in friendly competition through a game of golf or pickleball. 


According to the Sports & Fitness Industry Association (SFIA), pickleball is the fastest growing sport in America and participation had virtually doubled in 2022 (USA Pickleball, 2023). In the U.S. alone, there are more than 8.9 million people playing pickleball (USA Pickleball, 2023) with an estimate of over 19,000 pickleball related injuries occurring each year (Forbes Magazine, 2023).

On average, the yearly health costs for pickleball injuries is between $250 and $500 million dollars (Forbes Magazine, 2023). UBS predicts that 366,000 outpatient visits, 8,000 outpatient surgeries, 67,000 emergency room visits, and 4,700 hospitalizations will result from pickleball injuries (Forbes Magazine, 2023), which means the number of pickleball related injuries are only increasing.

Dr. Ziegler and Dr. Parman playing pickleball at an indoor pickleball court.

While pickleball seems like a fairly low impact, easy, and fun sport to pick up and play with friends, the sudden change of direction and frequent low bending required throughout a match, puts players at high risk of injury especially to the low back and legs.

Frequent and sudden changes in direction can lead to injuries like ankle sprains, Achilles and calf injuries, meniscus tears, and knee sprains.

Sudden bending over at the waist to reach for low bouncing balls without proper form can lead to herniated or slipped discs and low back strains. Additionally, improper coordination can lead to increased amounts of falls which can then lead to bony injuries like wrist fractures.

Common Pickleball Injuries:

Dr. Michael Parman examining a patient's knee.

Sprains and Tears – Occur when a ligament or tendon tears, stretches, or pulls due to twisting, over-rotation, or rolling of the extremity.

Achilles/Calf Injury – Occurs when the Achilles tendon, which connects the calf muscles to the heel bone, partially or completely tears or ruptures.

Herniated or Slipped Disc – Occurs when the center of a spinal disc, otherwise known as the nucleus, slips through a tear or rupture in the exterior surrounding it, called the annulus.

Overuse Injuries – Occur over a long period of time when the muscles breakdown from repetitive use. Examples of overuse injuries include tennis elbow, thrower’s shoulder (shoulder impingement), rotator cuff tendonitis and Achilles tendinopathy.

Prevention:

Warm-up – Start with dynamic exercises for 10 minutes (jogging, jumping jacks, etc.) prior to strenuous play. Other exercises to include within your warm-up are simple arm circles and leg swings. These exercises/movements will loosen up your joints and get blood flowing into your muscles prior to a pickleball match. It is also important to stretch out your leg muscles, especially the Achilles tendon, as frequent sudden changes in direction can cause injury to these tendons if not properly stretched.

Exercise Regularly – It is always a good idea to stay physically fit, eat a healthy diet, and stay hydrated. This will reduce the risk of injury as well as make you a better overall player. This is crucial to preventing overuse injuries.

Proper Footwear – Supportive shoes with good grip for both indoor and outdoor surfaces can prevent injuries such as ankle sprains. If you play frequently, it may be worthwhile to invest in shoes specifically designed for pickleball.

Proper Raquet– A high quality lightweight racquet can help reduce forearm injuries like tennis elbow (lateral epicondylitis), and shoulder injuries like rotator cuff tendonitis.

Taking Lessons: If you’re brand new to the sport it may be worthwhile taking a few lessons in order to understand the proper form. This will teach proper swing technique and more importantly footwork and coordination which can prevent injuries associated with falls.

There are many ways to prevent injuries while playing pickleball, but most importantly, know your limitations. If playing pickleball is the first athletic activity you have done in a while, be aware of your physical limitations and any pre-existing injuries.

If you have pre-existing injuries, braces such as for the ankle or wrist may be helpful. In addition, any pre-existing aches and pains may lead to overcompensation which can ultimately lead to aches and pains in other joints and body parts.

Dr. Ziegler and Dr. Parman together posing for a picture at an OSMS Sponsored Veterans Day Pickleball Tournament

If you or someone you know suffers an injury from pickleball, or another sport, Schedule an Appointment with Dr. Parman or one of our other orthopedic and sports medicine physicians.


Sources:

“Achilles Tendon Injuries.” Johns Hopkins Medicine, 8 Aug. 2021, www.hopkinsmedicine.org/health/conditions-and-diseases/achilles-tendon-injuries.

“Achilles Tendon Rupture.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 25 Aug. 2022, www.mayoclinic.org/diseases-conditions/achilles-tendon-rupture/symptoms-causes/syc-20353234.

Bohannon, Molly. “Pickleball Injuries Cost Americans Nearly $400 Million This Year-and Seniors Are Hit the Hardest.” Forbes, Forbes Magazine, 28 June 2023, www.forbes.com/sites/mollybohannon/2023/06/26/pickleball-injuries-cost-americans-nearly-400-million-this-year—and-seniors-are-hit-hardest/?sh=5870494cc266.

“Herniated Disk.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 24 Oct. 2023, www.mayoclinic.org/diseases-conditions/herniated-disk/symptoms-causes/syc-20354095.

“Sprained Ankle.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 11 Aug. 2022, www.mayoclinic.org/diseases-conditions/sprained-ankle/symptoms-causes/syc-20353225.

“Torn Meniscus.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 6 Jan. 2022, www.mayoclinic.org/diseases-conditions/torn-meniscus/symptoms-causes/syc-20354818.

Wang, David A. “What Is an Overuse Injury?” Hospital for Special Surgery, 4 Apr. 2023, www.hss.edu/article_overuse-injury.asp.

Zhang, Melissa. “SFIA Topline Report Tabs Pickleball as America’s Fastest-Growing Sport for Third Consecutive Year.” USA Pickleball, 22 Feb. 2023, usapickleball.org/news/sfia-topline-report-tabs-pickleball-as-americas-fastest-growing-sport/.

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