Common Pickleball Injuries & How to Prevent Them

By Josh · Last reviewed October 2, 2026

Medical disclaimer. Please read. This guide is general information for recreational players, not medical advice. It cannot diagnose your pain or replace a clinician. If something hurts persistently, see a doctor or physical therapist. For every exercise below: start easy, stop if it causes pain, and progress slowly.

TL;DR

Pickleball is low-impact but high-repetition: most injuries are overuse (tendons, elbows, heels) or quick-cut mishaps (ankles, knees).
The big three fixes: warm up for 5 minutes, wear court shoes with lateral support, and ramp up playing time gradually instead of doubling it overnight.
Strengthen the weak links: calves, quads, glutes, rotator cuff, and forearm extensors absorb the forces your joints otherwise take.
Pain is information. Soreness that fades is normal; sharp, swelling, or lingering pain is a stop sign.

1. Tennis elbow (lateral epicondylitis)

What it is: irritation of the forearm tendons where they attach at the outer elbow. The classic "it hurts to shake hands or lift a coffee mug" overuse injury.

Why pickleball causes it: thousands of short, sharp impacts per session, especially with a too-small grip (forces over-squeezing), a flicky wrist, or arm-only swings that never engage the shoulder and body.

Prevention: size your grip so you can hold the paddle without squeezing; keep the wrist neutral; let your body rotation power groundstrokes. We cover the gear side. Grip size, weight, cushioning — in depth in our tennis elbow guide.

Exercises

Eccentric wrist extensions: rest your forearm on a table, palm down, holding a light weight or can. Lift the wrist up slowly (2 seconds), then lower it even more slowly (4 seconds). 2 sets of 10–15. Stop if it hurts.
Forearm stretch: extend your arm, palm down, and gently press the back of your hand downward with the other hand until you feel a mild stretch along the top of the forearm. Hold 20–30 seconds, repeat 3 times per arm.
Grip-and-release: squeeze a soft ball or rolled towel for 5 seconds, then fully open and spread your fingers. 10 reps. Builds endurance without overloading the tendon.

2. Achilles tendinopathy & calf strain

What it is: Achilles tendinopathy is a gradual, achy-stiff irritation of the tendon above the heel. Often worst in the morning or when starting play. A calf strain is a sharper, more sudden pull in the muscle belly itself.

Why pickleball causes it: the sport is constant push-off: lunging for dinks, exploding out of the ready position, backpedaling. Sudden jumps in court time are the classic trigger.

Prevention: ramp up playing volume gradually (no doubling your sessions in a week); warm up calves before play; wear supportive shoes with a real heel counter; stretch calves after playing, not just before.

Exercises

Slow heel drops: stand on a step with heels hanging off, rise up on both feet, then lower the heels slowly below step level over 4–5 seconds. Start with both legs, progress to single-leg as it gets easy. 3 sets of 12. Mild discomfort is okay; sharp pain is not.
Wall calf stretch (knee straight): hands on a wall, one leg back with heel pressed down, knee straight. Hold 30 seconds per leg, 3 rounds. Targets the gastrocnemius.
Wall calf stretch (knee bent): same position but bend the back knee slightly. This shifts the stretch deeper to the soleus. Hold 30 seconds per leg, 3 rounds.

3. Rotator cuff irritation & shoulder impingement

What it is: a dull ache or "pinch" at the front or side of the shoulder, often worse with overheads or reaching. Commonly associated with irritation of the rotator cuff tendons under the shoulder's bony arch.

Why pickleball causes it: overhead smashes and high volleys load the shoulder in its most vulnerable position, especially when players muscle the ball with the arm instead of rotating the body — or when they play through fatigue and form breaks down.

Prevention: warm up shoulders before play; don't smash every overhead at 100% — placement beats power; strengthen the external rotators; rest the shoulder if it starts aching mid-session rather than "loosening it up" with more smashes.

Exercises

Band external rotations: hold a light resistance band with elbows tucked at your sides, bent 90°. Rotate forearms outward slowly, keeping elbows pinned to your ribs. 2 sets of 12–15 per side.
Scapular wall slides: back against a wall, arms in a "goalpost" position. Slide arms upward while keeping elbows, wrists, and back of hands in contact with the wall. 2 sets of 10. Teaches the shoulder blade to move correctly overhead.
Doorway chest stretch: forearms on a doorframe, step through gently until you feel a stretch across the chest and front of the shoulder. Hold 30 seconds, 3 rounds. Tight pecs contribute to impingement mechanics.

4. Knee pain (patellar tendinopathy, meniscus irritation)

What it is: patellar tendinopathy is an achy pain just below the kneecap, worse with lunging and stairs. Meniscus irritation tends to feel like catching, clicking, or soreness along the joint line after pivoting.

Why pickleball causes it: the kitchen line is a lunge factory. Deep knee bends to reach low dinks, plus hard pivots on a planted foot when changing direction. Weak quads and glutes let the knee cave inward, multiplying the stress.

Prevention: strengthen quads and glutes (they're your knee's shock absorbers); keep knees tracking over toes on lunges; wear shoes with good traction so you don't stick-and-twist; avoid playing every day on hard outdoor courts without rest days.

Exercises

Wall sits: back against a wall, slide down until knees are near 90°, hold 20–45 seconds. 3 rounds. Builds quad endurance for long kitchen exchanges.
Step-downs: stand on a low step, slowly lower the opposite heel toward the floor, keeping the standing knee tracking over your toes (not caving inward). 2 sets of 10 per leg.
Glute bridges: lie on your back, knees bent, lift hips until your body forms a straight line from shoulders to knees. Squeeze glutes at the top for 2 seconds. 3 sets of 12.

5. Ankle sprains

What it is: the classic "rolled ankle" — usually the foot turning inward, stretching or tearing the ligaments on the outside of the ankle. Ranges from mild (walk it off) to severe (can't bear weight).

Why pickleball causes it: hard lateral cuts, sudden stops, and stepping on stray balls. Running shoes. Built for forward motion, not side-to-side. Are a major contributor.

Prevention: wear court shoes with lateral support; clear stray balls before rallies; strengthen ankles with balance work; tape or brace a previously sprained ankle. Re-sprains are common without support.

Exercises

Single-leg balance: stand on one foot for 30 seconds, progress to eyes closed or on a cushion. 3 rounds per leg. The single best ankle-sprain prevention exercise there is.
Alphabet ankles: seated, lift one foot and "write" the alphabet in the air with your big toe. Full range of motion in every direction. Once through per foot.
Calf raises with control: rise up slowly, pause 2 seconds at the top, lower slowly. 3 sets of 15. Strong calves stabilize the ankle on landing.

6. Plantar fasciitis

What it is: sharp heel or arch pain, classically worst with the first steps in the morning or when standing up after sitting — irritation of the thick band of tissue under the foot.

Why pickleball causes it: hours of impact on hard courts, especially in flat or worn-out shoes, with tight calves pulling extra tension through the foot.

Prevention: supportive shoes with arch support (replace when tread dies); keep calves flexible; avoid going from zero to daily play; consider aftermarket insoles if your shoes lack support.

Exercises

Frozen bottle roll: roll the arch of your foot over a frozen water bottle for 5–10 minutes. Cold plus massage. Do it after playing.
Towel scrunches: barefoot, scrunch a towel toward you using only your toes. 2 minutes per foot. Wakes up the small foot muscles that support the arch.
Calf stretch (wall): tight calves are plantar fasciitis's best friend. See the Achilles section above. The same wall stretches apply here.

7. Wrist strain

What it is: achy soreness on the top or underside of the wrist, usually from overuse rather than a single incident. Distinct from a sprain, which follows a fall or twist.

Why pickleball causes it: flicky "wristy" shots — snapping the wrist on dinks, speed-ups, and rolls. Plus death-gripping the paddle, which keeps forearm and wrist muscles tense all session.

Prevention: keep the wrist neutral and let the arm and shoulder generate pace; relax your grip between shots; strengthen the wrist gradually rather than jumping into heavy topspin play.

Exercises

Light wrist curls: forearm on a table, palm up, light weight in hand. Curl the wrist up slowly, lower slowly. Flip to palm-down for extensions. 2 sets of 12 each direction.
Prayer stretch: palms together in front of your chest, slowly lower your hands while keeping palms pressed until you feel a stretch in the wrists. Hold 20 seconds, 3 rounds.
Wrist circles: gentle full circles in both directions, 10 each way, as a warm-up before play.

Your 5-minute pre-game warm-up

Most pickleball injuries happen in the first 15 minutes, to cold tissue. Run through this before your first game. Five minutes, no equipment:

March or jog in place (1 min): get blood moving. Swing your arms.
Leg swings (30 sec per leg): hold a fence, swing each leg forward-back, then side-to-side. Loosens hips.
Arm circles (30 sec): small to large, forward then backward. Wakes up shoulders.
Lateral shuffles (1 min): short side-to-side shuffles across the court. This is your sport's movement. Rehearse it cold.
Torso twists (30 sec): feet planted, rotate the trunk side to side. Your groundstrokes will thank you.
Easy dinks (1 min): start rallies at half pace. Let the first few balls be ugly. That's the point.

Footwear & court surfaces

Two equipment notes that prevent more injuries than any paddle ever will:

Shoes: wear court shoes, not running shoes. Court shoes are built for lateral cuts with a stable heel and reinforced sides; running shoes are built to go straight and can let an ankle roll. Replace them when the tread wears smooth — dead tread on a dusty outdoor court is a slip waiting to happen. No brand endorsement here: fit and lateral stability matter more than the logo.
Surfaces: outdoor hard courts are the harshest on joints; indoor wood or cushioned surfaces are kinder. If your knees or heels complain, notice where you play — alternating surfaces across the week is a legitimate load-management strategy.

When to see a doctor

Self-care covers mild, improving irritation. Get evaluated promptly if you notice any of these red flags:

You heard or felt a pop, followed by swelling or inability to bear weight or push off.
Visible deformity, or a joint that looks "wrong."
Numbness, tingling, or weakness in a limb.
Pain that is severe at rest or at night, or swelling that doesn't start improving within a few days.
An injury that isn't clearly improving after 1–2 weeks of rest and relative rest.
Chest pain, dizziness, or fainting during exertion. Stop playing and seek care immediately.

When in doubt, get checked. A physical therapist can usually tell you in one visit whether you're dealing with a load-management problem or something that needs imaging.

Frequently asked questions

Is pickleball bad for your knees?

Not inherently. But the stop-start lunging and pivoting can aggravate knees that are already vulnerable, especially with weak quads or worn-out shoes. Most knee complaints in pickleball are overuse-type irritation rather than structural damage. Strengthening the quads and glutes, warming up, and wearing proper court shoes go a long way. Persistent or sharp knee pain deserves a clinician, not a gear swap.

How do I avoid tennis elbow in pickleball?

The biggest lever is grip: a grip that is too small forces over-squeezing, which loads the forearm tendons where tennis elbow lives. Relax your hold, keep your wrist neutral rather than flicky, and avoid arm-only swings — let your shoulder and body rotation do the work. Our dedicated tennis elbow guide covers the gear side (grip size, weight, cushioning) in depth.

Why does my Achilles hurt after pickleball?

Aching or stiffness in the Achilles after play is commonly associated with sudden spikes in court time. More games, longer sessions, or harder surfaces than your calves are used to. Gradual ramp-up, calf strengthening (like slow heel drops), and supportive footwear are the standard prevention trio. Sharp pain, a pop, or inability to push off could indicate something more serious — see a clinician promptly.

What shoes should I wear for pickleball?

Court shoes with lateral support. Running shoes are built for forward motion and can let your ankle roll on hard lateral cuts. Look for a stable heel, good traction for your surface (outdoor vs indoor), and replace them when the tread wears smooth. No specific brand is required; fit and lateral stability matter more than the logo.

Should I play through pain in pickleball?

Mild muscle soreness that fades with warm-up is one thing; sharp pain, swelling, pain that changes how you move, or pain that lingers for days is another. Playing through the second kind tends to turn small problems into long ones. Rest, ice, and relative rest are reasonable first steps for minor irritation — but anything that does not improve within a week or two, or any red-flag symptom, should be evaluated by a doctor or physical therapist.

Reminder: this guide is general information, not medical advice. Bodies differ, and internet articles can't examine you. If pain persists, see a doctor or physical therapist. Early evaluation beats months of guessing.