According to the Association of Pickleball Professionals (APP), an estimated 48.3 million adults dinked, hit, and volleyed a small, holey plastic ball over a 34-inch net in 2023, making it one of the fastest-growing sports in the U.S. Its remarkable year-over-year growth is estimated at 111%. The simplicity with which anyone can play at a reasonable level is one of its biggest selling points.

So, why has it become so popular? The answers vary, but The New York Times suggests that pickleball appeals to a wide range of ages and experience, and it provided a welcome new pastime and exercise during the pandemic. And clearly the interest stuck.

And it’s not just for old folks. Research shows that the highest number of players fall within the 25-34 age range, which helps dispel the myth that pickleball is only for more senior generations. But players young to old can sustain an injury on the court.

“I see patients of all ages and, as with any sport, pickleball does carry its risk of injury,” explains Dr. Caitlin Nicholson, a sports medicine physician at Midwest Orthopaedics at Rush. “I see patients in my clinic with both upper and lower body injuries.”.”

A 2023 study of over 200 picklers  showed that 41.2% of reported injuries were caused by falling or diving for a shot, 30% from active game injuries, and 5.4% from overuse.

Most common pickleball injuries

Achilles tendinitis or tear. This is the tendon that runs behind the heel and can become strained from both overuse and traumatic ‘snap’ from a sudden movement. In some cases, surgery is required to fully repair the tendon.

Knee injuries. This includes sprains, muscle strains – including quadriceps and hamstrings – and meniscal or ACL injuries.

Elbow tendinitis. Also called “tennis elbow,” this is typically an overuse injury that can cause pain in the forearm. Surgery is unlikely, but tennis elbow can persist for a long time.

Shoulder injuries. These can range from overuse injuries such as rotator cuff tears or labral tears, to a fracture if a player falls directly onto the shoulder.

Wrist injuries. Wrist sprains or fractures commonly occur from tripping and falling on an outstretched hand.

Ankle sprain. This is one of the most common pickleball injuries and usually happens when a player makes a sudden lateral movement on the court. Usually, this injury is treated with I.C.E. (ice, compression, elevation), rest, and physical therapy.

Back strains. This injury, unless a player has a pre-existing back condition, is typically from overuse. Relief can be provided with an over-the-counter pain reliever, rest, and sometimes bracing.

Dr. Jourdan Cancienne, a sports medicine surgeon at Midwest Orthopaedics at Rush, who also sees many pickleball players in his practice, encourages players at all levels to invest in prevention before stepping onto the court. If an injured player is lucky, they may be back playing in several weeks. However, some injuries, like an Achilles tear or wrist fracture, can take a player out of the game for months.

Tips to prevent pickleball injuries

Warm up. Allow 5-10 minutes of warm-up before starting play, including calves, quads, hamstrings, inner thighs, back, shoulders, elbows, and wrists. Light jogging or marching helps prepare your body for play. Also, warm up with some light hitting before jumping into play.

Crosstrain. That means doing other exercises to strengthen muscles, performing balance-enhancing exercises, and increasing stamina.

Maintain a healthy weight. In addition to being more agile on the court, this can also help prevent other weight-related issues like diabetes and heart conditions. Eating a healthy diet can also provide more stamina.

Avoid taking more than two steps to the side, and NEVER run backwards for a ball. This is how most falls occur on the court.

Stretch. This is perhaps the most important tip. Before stepping onto the court, spend at least 10-15 minutes on dynamic stretches. Holding stretches for a few seconds can loosen up the muscles and tendons, but holding stretches for too long can increase your risk for injury.