Key takeaways
- Normal post-play soreness typically resolves in 3 to 5 days, though everyone heals on their own timeline. Pain that is sharp, worsening, lasts beyond two weeks, or changes how you move is worth getting evaluated.
- According to Dr. Kendall Perrine, ND, of Purist Natural Medicine in Arroyo Grande, the most common issues in players over 50 are degenerative, osteoarthritis layered on top of muscle weakness, and rarely have a single cause.
- Core and glute strength and mobility work are protective of the knees, hips and lower back, helping keep those joints stable and well hydrated.
- Between physical therapy and surgery there is a middle category of non-surgical treatment options many players do not know exists.
- The most preventable mistake is playing through nagging pain or masking it instead of getting it checked early.
Why do joints hurt more when you start pickleball after 50?
Because most players bring existing wear and tear to the court, and pickleball's quick lateral movements find it. It is usually a combination of factors rather than a single injury.
I'm seeing mostly degenerative issues, osteoarthritis layered on top of muscle weakness and ligament laxity in the knees, shoulders and hips. It's rarely one cause. 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)
The good news inside that answer: almost every factor she lists is changeable. Strength can be built, nutrition can be improved, and recovery habits can be learned at any age.
How do you tell normal soreness from a real problem after 50?
Normal soreness typically fades within 3 to 5 days and does not change how you move. A real problem announces itself differently.
Get pain checked when it lasts more than a couple of weeks, when it's progressively getting worse, when it's sharp or has a popping quality, or when it makes you limp or stops you mid-play. Those are signals it's not just soreness anymore.
Dr. Kendall Perrine, ND, Purist Natural Medicine (Arroyo Grande, CA)
Her line for players who love to tough it out: normal soreness is fine to play through, but sharp, stabbing or limiting pain is not. That is the line that turns a minor issue into a real injury.
What is the most preventable mistake older players make?
Ignoring nagging pain, or masking it.
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)
The second most preventable mistake is treating pickleball as your only training. Dr. Perrine says core and glute strength, especially the medial glutes, are the most neglected areas in the players she sees, and most people underestimate how much those muscles protect the knees, hips and lower back during quick lateral movement. In her words, core and glute strength matter more than the shoe on your foot. Two short strength sessions a week is a realistic starting dose, paired with the five-minute pre-play routine in our warm-up guide: Read more
What are your options if a joint problem develops, besides surgery?
More than most players are told. The conventional path presents two choices, physical therapy or surgery, but there is a middle category.
Physical therapy builds the muscles around a joint to stabilise it, which is valuable, but it can't repair the ligament or tendon attachments themselves, and it can't regenerate cartilage. That's the gap regenerative injection therapies fill, before you'd ever consider joint replacement.
Dr. Kendall Perrine, ND, Purist Natural Medicine (Arroyo Grande, CA)
These non-surgical options exist right here in SLO County. Dr. Perrine offers regenerative injection therapy in Arroyo Grande. We cover the options in detail, including who is a candidate and realistic recovery timelines, in our local guide: Read more
Do players over 50 really have to give up pickleball when joints act up?
Usually not, and the framing matters as much as the treatment.
There's so much doom and gloom in conventional medicine. A lot of doctors tell people they have to give something up. I'm not that kind of doctor. My job is to use every tool available to keep someone on the court, not take them off it.
Dr. Kendall Perrine, ND, Purist Natural Medicine (Arroyo Grande, CA)
She sets realistic expectations, since no treatment including surgery comes with guarantees, but says pain frequently improves by a meaningful percentage, letting players delay surgery or avoid it altogether while staying active.
How do you actually start, or restart, at 50+ on the Central Coast?
If you are new or coming back, do not start with competitive open play on cold muscles. Start where the learning curve is gentle: our free beginner intro sessions teach proper mechanics from day one, which is exactly the technique gap Dr. Perrine describes, and we will match you with players at your level so you are not chasing 30-year-olds in week one. Free intro sessions · Central Coast court guide
Common questions
Is pickleball safe for people with arthritis?
Generally yes, with modifications. It is low-impact relative to most racquet sports, and movement is generally considered part of managing osteoarthritis. Dr. Perrine notes that players with existing knee or hip arthritis may benefit from easing in on softer or indoor surfaces to reduce impact loading. Check with your own provider about your specific joints.
How long should soreness last after playing pickleball?
Three to five days is typical, per Dr. Perrine, and healing timelines differ from person to person. Soreness lasting beyond two weeks, worsening, or accompanied by sharp pain, popping or limping warrants an evaluation.
What exercises protect your knees for pickleball?
Core and glute work, especially the medial glutes, which stabilise the hip and knee during lateral movement. Dr. Perrine recommends five minutes of dynamic activation before play rather than static stretching alone.
Where can I get joint pain evaluated in SLO County without going straight to a surgeon?
Options include physical therapy, chiropractic care and regenerative medicine. Dr. Kendall Perrine at Purist Natural Medicine in Arroyo Grande offers a discovery call to discuss whether her non-surgical approach fits your situation.
Play more, hurt less. Find courts and games near you: Central Coast court guide · New to the game? Join a Free intro sessions
About the contributing expert. Dr. Kendall Perrine, ND, is a naturopathic doctor at Purist Natural Medicine, splitting her time between Arroyo Grande, CA and Dana Point, CA, with a focus on regenerative, non-surgical approaches to joint and soft-tissue pain.
Published by Pickleball Agent, the pickleball hub of the Central Coast. This article is educational and reflects the contributing expert's professional perspective. It is not medical advice, no outcome is implied or guaranteed, and healing timelines differ from person to person; consult your own healthcare provider about your specific situation.
