Pickleball Shoulder Pain: Is It Your Rotator Cuff and What Should You Do?

Quick Answer: Pickleball shoulder pain often comes from the rotator cuff, the muscles and tendons that stabilize the shoulder, according to the Mayo Clinic. A 2025 study found shoulder injuries in 22.2 percent of 1,758 surveyed players. Watch for overhead pain, arm weakness, and pain that disturbs sleep. Rest, ice, and physical therapy help; see a doctor if pain does not improve.

The rotator cuff connects your upper arm bone to your shoulder blade and controls how your arm lifts and rotates, according to the Mayo Clinic. It is a common source of pickleball shoulder pain, according to the Mayo Clinic, because the sport’s overhead serves, smashes, and reaches load these tendons again and again.

Is your pickleball shoulder pain a rotator cuff problem?

Often, yes, though not always. The rotator cuff is a frequent source of shoulder pain, but the same area can also develop tendinitis, bursitis, impingement, or a tear, according to the Cleveland Clinic. In a 2025 nationwide survey of 1,758 pickleball players published in Sports Medicine Open, 22.2 percent reported a shoulder injury, second only to the knee at 29.1 percent of the same 1,758 players.

Age raises your risk. The Mayo Clinic says rotator cuff tears are most common in people older than 50, and the American Academy of Orthopaedic Surgeons lists age over 40 as the main risk factor through OrthoInfo. That lines up with who gets hurt on a pickleball court: a 2024 study in Arthroscopy, Sports Medicine, and Rehabilitation used national emergency-department data and found that 73 percent of an estimated 13,566 average annual pickleball injuries from 2020 to 2022 occurred in patients age 60 to 79.

Signs that point to a rotator cuff issue, according to the Mayo Clinic and Cleveland Clinic, include:

• Pain with overhead motion, like serving or hitting a smash.
• Weakness lifting or reaching with the arm.
• A dull ache or sharp pain deep in the shoulder.
• Pain that disturbs sleep, especially lying on that side.
• Cracking or popping with movement.

Repeated hard swings and overhead reaches stress the cuff. If the muscles are not strong or warmed up, they can become inflamed or torn. Risk rises with age and with sports that require repetitive overhead motion, such as tennis and baseball, according to OrthoInfo and the Mayo Clinic.

What should you do about it?

Rest early, treat it conservatively, and do not play through it. Playing through shoulder pain tends to make it worse.

Conservative steps, based on Mayo Clinic and Cleveland Clinic guidance:

• Rest the shoulder and pause pickleball at the first sign of trouble.
• Ice the area for 15 to 20 minutes at a time to ease pain and swelling.
• Take an over-the-counter anti-inflammatory, such as ibuprofen, if it is appropriate for you.
• Start physical therapy. It strengthens the rotator cuff and shoulder-blade muscles and corrects movement patterns.
• Ease back gradually, keeping intensity below your pre-injury level and watching how the shoulder responds.

Conservative care works for most partial tears. The American Academy of Orthopaedic Surgeons says nonsurgical treatment relieves pain and improves function in 80 to 85 percent of patients, according to OrthoInfo, and the Cleveland Clinic says about 8 in 10 people with a partial tear get better with nonsurgical treatment. For tears that do not respond, a doctor may discuss a steroid injection or surgery. According to the Mayo Clinic, injection shots often bring temporary relief but can weaken the tendon and reduce the odds that a later surgical repair succeeds. When surgery is needed, the Hospital for Special Surgery reports success rates above 95 percent for small tears and above 70 percent for tears involving two tendons. Catching a tear early keeps the treatment simpler.

When should you see a doctor, and how do you prevent it?

See a professional for warning signs, and strengthen the shoulder to prevent it from happening again. Knowing when to get help, and how to protect the shoulder, keeps a minor issue from becoming a major one.

See a doctor or physical therapist if you have:

• Soreness that lasts more than a couple of hours after playing.
• Pain or weakness that worsens or does not improve with rest.
• Inability to lift the arm, or swelling and bruising after a fall.

One safety note: according to the Mayo Clinic, shoulder pain that comes along with chest discomfort, shortness of breath, cold sweat, or lightheadedness can be a heart attack warning sign. Treat that combination as an emergency and call 911.

To prevent rotator cuff trouble:

• Strengthen the rotator cuff and shoulder-blade muscles off the court. See the off-court workouts guide for exercises to add.
• Warm up the shoulder before play by following the warm-up routine.
• Use your legs and core for power, not just your shoulder, on serves and overhead shots.
• Take rest days and cross-train to avoid overuse. The pickleball injury prevention guide covers a fuller plan.

Prevention matters especially for older players. The 2024 Arthroscopy, Sports Medicine, and Rehabilitation study found pickleball-related hospital admissions rose 257 percent, from 992 in 2020 to 3,541 in 2022, with players 65 and older facing 2.48 times the hospitalization risk of younger adults. Shoulder problems are one entry on a longer list; the most common pickleball injuries guide covers the rest.

Frequently asked questions

Why does your shoulder hurt when you play pickleball?

The rotator cuff is a common cause, irritated by repetitive overhead serves and reaching, according to the Mayo Clinic. Related issues like tendinitis, bursitis, and impingement can also cause shoulder pain, according to the Cleveland Clinic.

How do you know if it is a rotator cuff injury?

Common signs are pain with overhead motion, weakness lifting the arm, a dull ache or sharp pain, pain at night, and popping, according to the Mayo Clinic and OrthoInfo. A doctor can confirm the diagnosis with an exam and sometimes imaging.

Can you keep playing with shoulder pain?

Playing through it usually makes it worse. Rest at the first sign of trouble, treat it conservatively, and return to play gradually once the pain settles.

How do you treat pickleball rotator cuff pain?

Rest, ice, an anti-inflammatory, and physical therapy to strengthen and correct movement typically come first. The American Academy of Orthopaedic Surgeons says this nonsurgical approach relieves pain and restores function in 80 to 85 percent of patients. Tears that do not respond may need an injection or surgery.

When should you see a doctor for shoulder pain?

See a doctor if pain lasts more than a couple of hours after play, worsens or does not improve, or if you cannot lift your arm or notice swelling after a fall. Seek emergency care if shoulder pain comes with chest discomfort, shortness of breath, cold sweat, or lightheadedness, according to the Mayo Clinic.

How common are shoulder injuries in pickleball?

A 2025 study in Sports Medicine Open surveyed 1,758 players and found 22.2 percent reported a shoulder injury, the second most commonly reported injury site behind the knee at 29.1 percent.

Who is most at risk of a rotator cuff tear from pickleball?

Age is the biggest factor. The Mayo Clinic says tears are most common after age 50, and a 2024 study in Arthroscopy, Sports Medicine, and Rehabilitation found 73 percent of an estimated 13,566 average annual pickleball injuries from 2020 to 2022 occurred in players age 60 to 79.

How can you prevent shoulder injuries in pickleball?

Strengthen the rotator cuff and shoulder-blade muscles, warm up the shoulder before play, use your legs and core for power, take rest days, and avoid sudden jumps in how much you play.

Shoulder pain is a cue to slow down, not push through. Build a resilient shoulder with the off-court workouts and warm-up routine above, and find a vetted physical therapist or sports medicine provider through the Pickler Junction directory if pain lingers.

Written by the Pickler Junction Team.