Pickleball and Top 5 Associated Injuries

Pickleball is one of the fastest-growing sports in Canada — and for good reason. It’s social, fun, and accessible for all ages. But with the boom in popularity comes a rise in common injuries, especially among adults 40+ returning to activity.

As a physiotherapist in Richmond, I treat a lot of pickleball players — from weekend warriors to competitive athletes. Here are the top 5 injuries I see, plus actionable tips to prevent them and stay injury-free.

1. Pickleball Elbow (Lateral Epicondylitis)

What it is:
A form of tennis elbow caused by overuse of the forearm muscles, especially from repetitive backhand shots.

Common symptoms:

• Pain on the outside of the elbow
• Weak grip strength
• Discomfort when lifting or turning the wrist

Prevention tips:

• Refine your backhand technique
• Warm up your forearms before playing
• Strengthen grip and wrist extensors using resistance bands
• Use a paddle with vibration control and proper grip size

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2. Rotator Cuff Strain / Shoulder Tendonitis

What it is:
Overhead shots and serves can irritate the rotator cuff tendons — especially with poor technique or weak shoulder stabilizers.

Common symptoms:

• Pain during or after overhead motions
• Limited shoulder mobility
• Night pain when sleeping on the affected side

Prevention tips:

• Strengthen rotator cuff and scapular muscles
• Work on upper back (thoracic) mobility
• Avoid excessive shoulder “wind-up”
• Stop if you feel shoulder pain — don’t push through it

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3. Achilles Tendonitis

What it is:
Irritation or inflammation of the Achilles tendon due to sudden lunges, quick direction changes, or unsupportive footwear.

Common symptoms:

• Heel or lower calf pain
• Morning stiffness
• Discomfort with jumping or pushing off

Prevention tips:

• Stretch calves and foam roll regularly
• Strengthen with eccentric heel drops
• Wear proper court shoes with heel support
• Warm up gradually, especially before intense games

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4. Knee Pain (Patellar Tendonitis or Meniscus Strain)

What it is:
Hard stops, squats, and twisting can overload the patellar tendon or irritate the meniscus — especially with weak hips or poor movement patterns.

Common symptoms:

• Pain below the kneecap or inside the knee
• Swelling or stiffness after play
• Discomfort with squatting, lunging, or climbing stairs

Prevention tips:

• Strengthen glutes, quads, and hips
• Train single-leg balance and control
• Use supportive footwear and avoid sudden twisting
• Consider bracing or taping if advised by your physio

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5. Lower Back Strain

What it is:
Rotational movements and poor core stability can lead to lower back muscle strain or joint irritation.

Common symptoms:

• Achy or sharp low back pain
• Stiffness after sitting or first thing in the morning
• Pain with bending or twisting

Prevention tips:

• Strengthen core and glutes
• Improve hip and thoracic spine mobility
• Avoid twisting from the waist — pivot with your feet
• Mix in gentle stretches and movement between games

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Final Thoughts from a Physio

Pickleball injuries are often caused by a mix of overuse, poor mechanics, and under-preparation. The best way to stay injury-free is to warm up properly, build strength, and catch issues early.

If you’re starting to feel pain during or after games, don’t wait it out — early physiotherapy treatment can speed up recovery and prevent things from getting worse.

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Book Your Pickleball Physio Check-Up

At Richmond Physiotherapists, we help pickleball players move better, feel stronger, and recover faster with:

• Personalized rehab programs
• Injury prevention screenings
• Return-to-play planning