The Risky Business of Pickleball Versus Your Body

In a recent article on finance.yahoo.com, Dr. Joshua Dines of HSS stated, “Pickleball was almost too easy to play.”

While this quote is meant to be provocative, it is important to understand what Dr. Dines means. While all physical activities require a base level of physical ability, some activities require more than others to even try the sport.

For many individuals, it is easy to start playing Pickleball! But it can have ill effects on the body. Many people who are new to the sport find themselves injured.

To get started, all you need is a paddle and a local court. Over the past few years, both of these requirements have become quite accessible. The skill required to play the game is minimal and the nature of the court size and type of ball make it attainable for a wide variety of ages and skill levels. There is a minimal amount of running and because of this, the impact may be less on the body as compared to tennis where the running and change of direction speeds are higher. You can also compare pickleball to a sport like soccer where just to play in a game, you need to be able to run, change direction, and kick all at the same time! That’s why pickleball has become such a fast-growing sport for adults.

Due to the sport’s excitement and so many people trying it out for the first time, we find individuals who have not been physically active or have not participated in a sport in years end up in a physical therapy clinic or at their local orthopedist after being injured. So for a sport that is supposed to be so easy, why are the injuries piling up so high?

1. Pickleball is a multi-directional sport

We spend the majority of our lives moving forward and backward. Most gym exercises are even in the forward and backward direction (think squats, most lunges, bench press, rows). Pickleball requires you to move side to side as well as twist—and that’s where most injuries occur.

Since many of our day-to-day activities are forward and backward motions, this causes a problem when we engage in repetitive activities that involve side-to-side movements as well as rotational movements like pickleball. Not only is this a movement that is not part of most individual's day to day, but it is repeated hundreds of times during a game, and frequently at a higher intensity. Overuse in these directions frequently leads to:

  • Knee pain

  • Low back pain

  • Tendon injuries in the shoulder and elbow

2. Low impact does not mean low speed

Most people refer to activities where their feet hit the ground hard as “high impact.” Some sports that often get this label are running, basketball, and tennis. The size of a pickleball court limits the speed that you can reach, decreasing the ground impact through your body.

While reduced court size has some benefit, there is still speed involved in the game. Faster movements require increased strength to both start and stop. Many pickleball injuries we see in the clinic are due to a lack of strength needed to handle the speed of a game. Even individuals who spend time working out in the gym frequently perform slow and well-controlled movements. This is good when handling weights, but the carryover needed for quick movements may not be there.

Speed causes injuries such as:

  • Patellar tendon pain

  • Achilles tendon pain

  • Knee pain

  • Back pain

3. Injuries mainly happen with stopping and a change of direction

Quickly reducing speed is the hardest part of any court sport. You need to have strong enough legs to stop yourself and change direction, and you also need to have enough shoulder and wrist strength to stop your paddle after hitting the ball.

Tennis elbow and rotator cuff pain is common with all racquet/paddle sports due to overuse of these muscle groups when slowing the racket down after hitting the ball.

In the lower extremity, we commonly see plantar fasciitis and knee pain due to weakness of the muscles that have to slow your body down when changing direction.

All of these factors listed above are “hidden” challenges of pickleball that may make it more likely for injury than you might think. The goal of this article is not to keep you off the court, but to provide insight into all the things you may want to work on to improve your game and prevent injury.

If you have been injured playing pickleball, have any questions about an injury you are dealing with, or are looking to prevent injury and improve your pickleball game, give our office a call for more information or simply request an appointment.


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