How to Not Get Hurt Playing Pickleball

Pickleball is the fastest growing sport in the world for the 50-80-year-old group and is growing fast in younger populations as well. Unfortunately, it has replaced CrossFit as the number one referral source to my orthopaedic surgery practice. Why the popularity, and how to stop the carnage?

How to Avoid Pickleball Injuries

Pictured center in blue: former Stone Clinic nurse and regular national Pickleball champion Bee Kilgore celebrating a mixed doubles Gold Medal at the USA Pickleball National Championships

Pickleball is fast, fun, loud, and accessible to people of all ages. It is much easier than tennis, more fun than badminton, and more competitive than almost any other small-group sport. It is particularly exciting for the 50-80-year-old crowd for a number of reasons: It helps promote good balance, provides a good cardio workout, and improves eye/hand coordination. 

But injuries are common; in 2021, 86% of emergency room visits caused by pickleball injuries occurred in people over 60 years old. Why?

The usual answers are poor preparation, poor stretching, more ego than skill, lack of warmup, hard court surfaces, and the high competitiveness of the games. There’s no question that warming up before any sport, slowly stretching the tissues that are about to get ballistically stretched, curbing one’s ego, and setting realistic goals are all helpful.

However, the number one reason I see pickleball injuries (and from most sports) is mental errors. These errors start before the games. The distractions of work, relationships, and the politics of teammates all clutter the mind of the soon-to-be injured athlete. 

Next is the impatience to get the game going. Like the golfer who rushes from work to the tee, skipping the practice range, the first swings are erratic. Without being in the groove, the miscoordination of the body’s musculature causes the back to over-rotate, the shoulder to awkwardly thrust forward, and the calf, quad, and hamstring muscles to fire out of sync. 

The errors pile up. Failing to take into account how much your ankles bend, how well your knees flex (and how far they flex), how tight your hips are, and how stiff your back and shoulders are, you wind up and swing for the overhead, only to hear the fateful ‘pop’ of something that has just torn.

The distractions occur not just at the beginning of the game. As the points add up the heart rate climbs and fatigue sets in. But victory seems so close! The game is just too much fun and too exciting for everyone to just take a minute, take inventory of their bodies, and adjust their pace. Hormonal rushes of adrenaline, testosterone, pheromones, and endorphins obscure any hope of rational caution and metered play. Treating the injury, I invariably hear, “I knew I shouldn’t have…”

Our minds know our bodies. The number one way to prevent a pickleball injury is to think—to be smart, be aware, and be present in your body. And to move in the ways you can, rather than in the fantasies you have.

Medically authored by
Kevin R. Stone, MD
Orthopaedic surgeon, clinician, scientist, inventor, and founder of multiple companies. Dr. Stone was trained at Harvard University in internal medicine and orthopaedic surgery and at Stanford University in general surgery.