Pickleball Injury Prevention: What the Data Says Actually Works

Most pickleball injury advice starts and ends with stretching. The data points somewhere else.

What injuries actually happen?

A study by Forrester published in the Journal of Emergency Medicine analyzed pickleball injuries treated in United States emergency departments from 2001 to 2017, using the National Electronic Injury Surveillance System. The study estimated about 19,012 pickleball-related injuries nationally over that period, with the number rising each year from 2013 to 2017 as the sport grew.

The injury breakdown from that study:

• Sprains and strains: 28.7 percent, the single most common diagnosis.
• Fractures: 27.7 percent, close behind.
• Lower extremity injuries: 32.0 percent of all cases, more than any other body region.
• Upper extremity injuries: 25.4 percent, the second largest group.

Most injuries were not severe in the moment. In 88.0 percent of cases, the patient was treated and released from the emergency department the same visit. Most injuries also happened at a sports or recreational facility rather than at home, in 74.3 percent of cases, which points to the court itself, not general daily life, as where the risk sits.

Who gets hurt?

Age concentrates the risk. In the same study, patients 50 and older made up 90.9 percent of the emergency department visits, and the sexes were close to evenly split at 50.4 percent male.

That age group is also where pickleball’s growth is concentrated. US participation reached 24.3 million players in 2025, up from 4.2 million in 2020, according to the Sports & Fitness Industry Association, and older adults make up a large share of that increase. The Forrester study did not break out what share of injuries came specifically from falling versus other mechanisms, so that link cannot be stated as a measured number here. What the data does establish is which group shows up in the emergency department most: adults 50 and older, playing a sport with fast lateral movement and a hard playing surface. The guide on whether pickleball is safe for seniors covers what that means for older players in more detail.

What actually reduces the risk?

Lower extremity injuries made up close to a third of the emergency department cases in the Forrester study, which puts footwear and footwork near the top of any prevention list.

Court shoes are the first piece. Running shoes are built for forward motion, and the side-to-side movement pickleball demands can roll them at the ankle. The comparison of pickleball shoes and tennis shoes covers what a court-specific outsole does differently.

A real warm-up is the second piece. Cold muscles and tendons are more prone to the strains and sprains that made up 28.7 percent of the injuries in the Forrester data. The pickleball warm-up routine guide walks through a sequence built for that, and the guide to post-play stretches covers the recovery side once play is done.

Training load is the third piece. Going from twice a week to daily play, or from casual rallies straight into tournament-length sessions, asks joints and tendons to adapt faster than they are built to. Increasing volume gradually gives connective tissue time to catch up.

Balance and movement quality round it out. Pickleball asks players to change direction quickly, recover from a split step, and react to a ball at the net, all skills that depend on balance as much as strength. The guide on pickleball and fall prevention covers exercises built around exactly that kind of movement.

Which injuries need a doctor?

Some injuries need more than rest and time. As a general rule, get evaluated for a pop or snap felt at the moment of injury, swelling that comes on quickly, an inability to put weight on the joint, numbness or tingling, or pain that is not improving after a week or two. The guide on when to see a doctor for a pickleball injury walks through these signs in more detail.

Wrist and forearm pain after a fall deserves particular attention in players 50 and older, since upper extremity injuries made up 25.4 percent of the cases in the Forrester study and this age group accounts for the large majority of emergency department visits. Anyone with osteoporosis, a balance disorder, a prior fracture, or a diagnosed joint condition should talk to a doctor before increasing how much they play, not after something goes wrong.

Frequently asked questions

What is the most common pickleball injury? In a 2020 study in the Journal of Emergency Medicine, sprains and strains accounted for 28.7 percent of emergency department visits for pickleball, and fractures accounted for 27.7 percent, making these the two leading diagnoses.

How many pickleball injuries end up in the emergency room? The Journal of Emergency Medicine study estimated about 19,012 pickleball-related injuries were treated in US emergency departments between 2001 and 2017, with the count rising each year from 2013 to 2017.

Are older players at higher risk? Yes. Patients 50 and older made up 90.9 percent of the pickleball injuries in the Journal of Emergency Medicine study. That age group also represents a large share of the sport’s 24.3 million US players in 2025, according to the Sports & Fitness Industry Association. The 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 court-specific shoes instead of running shoes, since running shoes are built for forward motion and can roll during pickleball’s side-to-side movement. Pair that with a gradual increase in how often you play rather than a sudden jump in volume.

Does stretching prevent pickleball injuries? Warming up and stretching support the muscles and tendons behind the sprains and strains that made up 28.7 percent of injuries in the Journal of Emergency Medicine study, but they do not address every injury type recorded in that data, including fractures.

When should I see a doctor? Get evaluated for a pop or snap at the moment of injury, fast swelling, an inability to bear weight, numbness or tingling, or pain that has not improved after a week or two of rest.

Is the pickleball injury rate rising? Yes. The Journal of Emergency Medicine study found the number of emergency department visits for pickleball injuries increasing every year from 2013 to 2017, the period when the sport’s participation numbers also began climbing.

Do most pickleball injuries need surgery? No. In the Journal of Emergency Medicine study, 88.0 percent of patients were treated and released from the emergency department the same visit, without hospital admission.

Most pickleball injuries in the data are sprains, strains, and fractures that respond to the basics: proper shoes, a real warm-up, gradual training loads, and balance work, not stretching by itself. If a fall or a hard landing leaves you with more than routine soreness, Pickler Junction’s directory of pickleball physicians and therapists can help you find someone nearby. This article is general information, not medical advice.

Written by the Pickler Junction Team.