Pickleball is the fastest growing sport for adults in America with a growth in popularity of over 50% in 2023! It’s an exhilarating sport enjoyed by many for its fast pace and strategic play while still being approachable and fun for adults over 40. However, like any physical activity, it comes with the risk of injury. Understanding the most common injuries and how to prevent them can help you stay on the court and play safely.

1. Tennis Elbow or Pickleball Elbow (Lateral Epicondylitis)
What Is Tennis Elbow?
Tennis elbow is a condition characterized by pain and inflammation on the outer part of the elbow, caused by repetitive strain and overuse of the forearm muscles.
How to prevent Tennis Elbow
- Proper Technique: To avoid tennis elbow, focus on maintaining relaxed grip pressure, as squeezing the handle too tightly can transfer unnecessary stress to your forearm tendons. Use your core and shoulder rotation to generate power instead of relying solely on your wrist or forearm, and avoid “arming” the ball with excessive wrist motion—opt for a fluid, full-body motion instead. For one-handed backhands, lead with your shoulder and keep your wrist stable, while two-handed backhands help distribute force evenly and reduce stress on the dominant arm. Always complete your stroke with a full follow-through to avoid abrupt, jerky motions that strain the elbow. When serving, engage your entire body—especially your legs, hips, and shoulders—to generate force, ensuring a fluid, smooth motion from toss to follow-through to prevent overstraining your arm.
- Strengthening Exercises: Focus on strengthening your forearm muscles with the following exercises:
- Wrist curls and reverse wrist curls
- Forearm supination and pronation
- Grip strengthening with a squeeze ball
- Wrist Extensions with Resistance Bands
- Stretching: Incorporate regular stretching of the forearm muscles before and after play.
- Wrist Extensor Stretch: Extend your arm with your palm facing down and gently pull your fingers back to stretch the top of your forearm.
- Wrist Flexor Stretch: Extend your arm with your palm facing up and pull your fingers back to stretch the underside of your forearm.
- Forearm Stretch Against a Wall: Press your palm flat against a wall with fingers pointing downward to stretch both wrist flexors and extensors.
- Reverse Prayer Stretch: Place the backs of your hands together and push upward to stretch the tops of your forearms.
- Finger Extensions with a Rubber Band: Open your fingers against a rubber band to stretch and strengthen small forearm muscles.
- Shoulder and Upper Arm Stretch: Cross one arm across your chest and pull it closer to stretch your shoulder and upper arm.

2. Rotator Cuff Injuries
What Is a Rotator Cuff Injury?
The rotator cuff is a group of muscles and tendons that stabilize the shoulder. Injuries here often result from repetitive overhead movements.
How to Prevent Rotator Cuff Injuries
- Strength Training: Strengthen the shoulder muscles with exercises like shoulder presses and rows.
- Proper Warm-Up: Always warm up your shoulders with dynamic stretches and light exercises before playing.
- Rest: Avoid overplaying and give your shoulders adequate rest between sessions.

3. Achilles Tendonitis
What Is Achilles Tendonitis?
This condition involves pain and inflammation of the Achilles tendon, which connects the calf muscles to the heel bone. It’s often caused by sudden increases in physical activity.
How to Prevent Achilles Tendonitis
- Gradual Increase in Activity: Gradually increase the intensity and duration of your play to avoid overloading the tendon.
- Stretching and Strengthening: Regularly stretch and strengthen your calf muscles.
- Proper Footwear: Wear supportive shoes that provide adequate cushioning.
4. Ankle Sprains
What Is an Ankle Sprain?
An ankle sprain occurs when the ligaments that support the ankle are stretched or torn, typically due to sudden twists or turns.
How to Prevent Ankle Sprains
- Ankle Strengthening: Strengthen the muscles around your ankle with exercises like calf raises and ankle circles.
- Balance Training: Improve your balance with exercises such as standing on one leg or using a balance board.
- Supportive Footwear: Wear shoes that provide good ankle support and stability.

4. Knee Injuries
What Is a Knee Sprain?
Knee injuries can range from strains and sprains to more severe issues like meniscus tears or ligament injuries, often caused by quick lateral movements and pivots.
How to Prevent Knee Injuries
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- Strengthening Exercises: Strengthen the muscles around your knees with exercises like squats and lunges.
- Proper Technique: Focus on using proper footwork and technique to reduce stress on the knees.
- Knee Braces: Consider wearing knee braces for additional support if you have a history of knee problems.
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6. Lower Back Pain
What Causes Lower Back Pain?
Lower back pain can result from poor posture, overuse, or improper technique during play.
How to Prevent Knee Injuries
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- Core Strengthening: Strengthen your core muscles with exercises like planks and leg raises.
- Proper Technique: Maintain good posture and use proper technique to avoid unnecessary strain on your back.
- Stretching: Incorporate regular stretching of the lower back and hamstrings.
Tips for Overall Injury Prevention
- Warm-Up and Cool Down: Always warm up before playing and cool down afterward to prepare your muscles and reduce the risk of injury.
- Stay Hydrated: Proper hydration is essential for muscle function and recovery.
- Listen to Your Body: Pay attention to any signs of pain or discomfort and rest as needed to prevent overuse injuries.
- Use Proper Equipment: Ensure your paddle, shoes, and other gear are appropriate and in good condition.
- Cross-Train: Incorporate other forms of exercise, such as swimming or cycling, to improve overall fitness and reduce repetitive strain on specific muscles.
By understanding these common pickleball injuries and taking proactive steps to prevent them, you can enjoy the game safely and stay on the court longer. Remember, a little preparation and care can go a long way in keeping you healthy and playing your best. Happy pickleballing!