The 5 Most Common Pickleball Injuries (and How to Avoid Them)

• Most pickleball injuries in adult players are degenerative issues meeting sudden new demands, not freak accidents.
• According to Dr. Kendall Perrine, ND (Purist Natural Medicine, Arroyo Grande), the most preventable mistake is playing through nagging pain or masking it with anti-inflammatories instead of getting it checked early.
• Core and glute strength and mobility work are protective of the joints, helping keep them stable and well hydrated.
• Soreness typically resolves in 3 to 5 days, though timelines differ from person to person; pain that is sharp, worsening, or lasts beyond two weeks warrants evaluation.
• Proper mechanics from day one, the kind taught in beginner sessions, may help you avoid the technique-driven injuries altogether.

Because the sport's demands and the typical player's preparation do not match. Pickleball asks for repeated quick lateral movements, sudden stops, and overhead reaches, often from players who have not trained laterally in years.

Most players who take up pickleball later in life already have some wear and tear. Add cross-training gaps, weak core and glute strength, and an inflammatory diet or nutrient deficiencies, and that combination is what tips someone into pain.

Dr. Kendall Perrine, ND, Purist Natural Medicine (Arroyo Grande, CA)

She describes what she sees clinically as mostly degenerative issues: osteoarthritis layered on top of muscle weakness and ligament laxity in the knees, shoulders and hips. It is rarely one cause. That is good news in disguise, because multi-cause problems have multiple prevention levers.

Repetitive strain on the tendons outside the elbow, the same mechanism as tennis elbow, driven by paddle impact and technique that does not absorb force well. What may help: technique instruction early, appropriate paddle weight and grip size, and forearm strengthening. Full breakdown: Read more

Lateral movement and sudden stops load the knees more than straight-line sports do, and knees are where pre-existing arthritis most often lives. Lowering that risk centres on the muscles above and around the knee, which is Dr. Perrine's most-repeated point.

Core and glute strength is usually neglected, and most people underestimate how much those two areas protect the knees, hips and lower back during quick lateral movements.

Dr. Kendall Perrine, ND, Purist Natural Medicine (Arroyo Grande, CA)

If knee pain has already arrived: Read more

Overheads and serves ask aging rotator cuffs for range they have not used lately. What may help: warm up the shoulder before the first overhead, not during it, and build pulling strength such as rows to balance all the reaching.

Lateral push-offs on hard surfaces, often late in a session when stabilising muscles fatigue. What may help: court shoes rather than running shoes, which are built for forward motion rather than sideways, and the same glute stability work that supports the knees.

Backpedalling for lobs is the classic mechanism, and wrists and hips take the landing. The safer habit is tactical rather than physical: turn and run rather than backpedal, and let some lobs go. No point is worth a fractured wrist.

The most preventable mistake is ignoring nagging pain and playing through it, or leaning on NSAIDs to mask it, instead of getting it looked at early.

Dr. Kendall Perrine, ND, Purist Natural Medicine (Arroyo Grande, CA)

Her threshold: normal soreness typically fades in three to five days, though everyone heals on their own timeline. Get pain checked when it lasts more than a couple of weeks, when it is progressively getting worse, when it is sharp or has a popping quality, or when it makes you limp or stops you mid-play.

Three habits address most of the risk: a real warm-up before every session (Read more), two short strength sessions a week focused on core and glutes, and proper mechanics from your first week of play, which is exactly what our free beginner intro sessions teach: Free intro sessions

• Elbow pain that keeps coming back: Read more
• Knees, and what sits between physiotherapy and surgery: Read more
• The five-minute warm-up: Read more
• Recovering between sessions: Read more
• Playing on after 50: Read more
• Local treatment options in SLO County: Read more
• What coastal conditions do to your joints: Read more
• Indoor courts, and when a softer surface helps: Read more