Pickleball Injury Prevention: What the Data Says Actually Works

Quick Answer: Slips, trips, and falls cause about 63 percent of pickleball injuries, and ankle sprains are the most common single injury at roughly 31 percent. Players over 50 account for the large majority of emergency department visits. Court shoes, movement habits, and backing off the backpedal matter most.

Most pickleball injury advice starts and ends with stretching. The data points somewhere else. Here is what actually sends players to the emergency room, and what reduces the odds.

What injuries actually happen?

Falls, overwhelmingly. When researchers looked at emergency department data, slip, trip, fall, and dive mechanisms accounted for about 63 percent of all pickleball injuries. This is not a sport where most people get hurt by overuse. They get hurt by hitting the ground.

The injury breakdown:

• Ankle sprains: roughly 31 percent of injuries, the single largest category.
• Knee injuries, including meniscus tears and ligament sprains: about 19 percent.
• Shoulder injuries such as rotator cuff tears: reported by about 15 percent of surveyed players over 50.
• Strains and sprains overall: around 29 percent of emergency department cases.

Age concentrates the risk sharply. Patients 50 and older make up about 91 percent of emergency department visits for pickleball. Emergency visits rose 232 percent between 2018 and 2022, reaching over 36,000 a year, though that partly reflects how fast participation grew.

There is also a difference in injury type by sex among seniors. Men were substantially more likely to suffer strains and sprains, while women were more likely to suffer fractures, and considerably more likely to fracture a wrist.

What actually reduces the risk?

Address the mechanism. If two out of three injuries come from falling, then the interventions that matter are the ones that keep you upright.

Court shoes, not running shoes. This is the highest-leverage change most players can make in a single afternoon. Running shoes have soft, tall midsoles and directional tread that go unstable the moment you move sideways. Our comparison of pickleball and tennis shoes covers what to look for.

Stop backpedaling for lobs. Retreating backward with your weight behind you is how a large share of wrist and hip fractures happen. Turn and shuffle sideways instead. This one habit is worth more than any amount of stretching.

Warm up before you play. Do it properly rather than as a formality. Our warm-up routine has the full sequence, and it is the piece this article deliberately does not duplicate.

Build up gradually. Sudden jumps in volume drive overuse problems, particularly shoulder and elbow. If you went from twice a week to daily, that is a risk change.

Look at the court surface. Standing water, loose balls, and cracks are trip hazards. Clearing a stray ball takes three seconds.

What I tell players who are honest about their limits is that the ego shots cause the injuries. Nobody tears something reaching for a ball they were positioned for.

Which injuries need a doctor?

More of them than players like to admit. This article is general information, not medical advice.

Get evaluated for any injury involving a pop or snap at the moment of injury, immediate swelling, an inability to bear weight, joint instability, numbness or tingling, or pain that is not improving after a week or two of rest. Anyone over 50 who falls onto an outstretched hand should take wrist pain seriously given the fracture pattern in the data.

Overuse problems have their own guides. See pickleball elbow for lateral elbow pain and our guide on playing with bad knees if knee pain is your limiter. Anyone with osteoporosis, a balance disorder, a prior fracture, or a diagnosed joint condition should talk to a doctor before increasing play, not after something goes wrong.

Recovery is not just rest. For shoulder injuries specifically, physical therapy focused on rotator cuff strengthening has been reported to shorten recovery time meaningfully compared with rest alone.

Frequently asked questions

What is the most common pickleball injury? Ankle sprains, at roughly 31 percent of injuries. Knee injuries follow at about 19 percent.

How do most pickleball injuries happen? Slips, trips, falls, and dives account for about 63 percent of injuries. Most people are hurt by contact with the ground rather than by overuse.

Are older players at higher risk? Patients 50 and older account for about 91 percent of emergency department visits for pickleball injuries. Our guide on whether pickleball is safe for seniors covers this in detail.

What is the single best thing I can do to avoid injury? Wear proper court shoes and stop backpedaling for lobs. Those two changes address the mechanism behind the majority of serious injuries.

Does stretching prevent pickleball injuries? Warming up and post-play stretching help, but they do not address falls, which cause most injuries. Treat footwear and movement habits as the priority and see our post-play stretches as a complement.

When should I see a doctor? Any pop or snap at the moment of injury, immediate swelling, inability to bear weight, joint instability, numbness, or pain not improving after a week or two.

Is the injury rate actually rising? Emergency visits rose 232 percent from 2018 to 2022, though participation grew enormously in the same period, so the raw increase overstates the per-player risk change.

Most pickleball injuries are falls, and falls respond to footwear and footwork rather than to stretching alone. To find a physician or physical therapist who works with players, browse our physicians and therapists directory.

Written by the Pickler Junction Team.