Back on the Court: The Pickleball Court

By Achieve Physical Therapy April 2026

The courts are calling! We want to make sure you answer that call with confidence. Spring has arrived in Barrington, and that means one thing for a growing number of people in our community: it's pickleball season. The outdoor courts are filling back up, and the excitement of getting back to the game, for those that do not play indoor, is real.

But after months of winter slowdown, jumping back into outdoor play can put stress on a body that hasn't moved in quite the same way for a while. At Achieve Physical Therapy, we believe being active is one of the best things you can do for your health — and the research backs that up. The goal isn't to scare you off the court. It's to help you play more, not less, by staying smart from the start.

Here's what we would like you to know about the most common pickleball injuries, what the evidence says about preventing them, and how to get back to the game feeling strong.

🏓Why Pickleball Injuries Are on the Rise

Pickleball is now the fastest-growing sport in the United States — and with that growth comes a rise in related injuries. But here's the important context: most pickleball injuries are preventable. They tend to happen when players return to play too quickly, skip a warm-up, or don't give their bodies time to adapt after a break. That's great news — because it means a few simple habits can make a significant difference.

The Top Pickleball Injuries (And What's Really Going On)

1. Ankle Sprains

Rapid lateral movements, pivoting, and lunging for shots make the ankle one of the most commonly injured areas in pickleball. Ankle sprains occur when the ligaments supporting the joint are overstretched or torn — most often from rolling the ankle inward.

2. Knee Pain & Meniscus Irritation

The quick stopping, starting, and rotational demands of pickleball place significant load on the knee. Many players experience pain at the front of the knee (patellar tendinopathy) or inside the joint from meniscus stress — especially when returning to play after time off.

3. Pickleball Elbow (Lateral Epicondylitis)

Often called "tennis elbow," this condition involves irritation of the tendons on the outside of the elbow. It's triggered by repetitive gripping, swinging, and impact — and is one of the most reported upper extremity injuries in racquet sports.

4. Shoulder Strains & Rotator Cuff Issues

Stiff shots, serves, and rapid arm movements can strain the rotator cuff muscles and surrounding structures, particularly in players who aren't conditioned for sustained overhead activity.

5. Achilles Tendinopathy

The Achilles tendon, which connects the calf muscles to the heel, takes on enormous load during explosive movements like sprinting and jumping.

6. Lower Back Strain

Repetitive twisting, bending, and reaching put the lumbar spine under stress — especially if core strength and hip mobility have decreased during the off-season.

Evidence-Based Prevention Strategies: Play More by Preparing Well

Research consistently shows that load management, progressive training, and neuromuscular preparation are the most effective ways to prevent sport-related injuries. Here's how that translates to pickleball:

1. Warm Up With Purpose (5–10 Minutes)

A proper dynamic warm-up increases blood flow, improves joint mobility, and warms up the muscles you'll rely on during play. Static stretching before activity is not recommended — save that for after your game.

Try this pre-game routine:

• Leg swings (forward/back and side to side) — 10 reps each leg

• Hip circles — 10 circles clockwise and counter clockwise

• Lateral shuffles — 2 x 10 yards

• Mini squats — 2  x 10 yards

• Arm circles and cross-body shoulder stretches 30-60 seconds of each

• Light jogging or skipping — 3 minutes

2. Ease Back In Gradually

If you've been less active over winter, resist the urge to play at full intensity right away. Research on tendon and tissue adaptation shows that your body needs 4-6 weeks to recondition after a period of reduced loading.

• What this looks like in practice:

• Week 1-2 Shorter sessions 30-45 min), moderate pace, focus on technique

• Week 3-4 Gradually increase duration of play and intensity

• Week 5 Return to full competitive play

3. Strengthen the Muscles That Protect Your Joints

Strength training is one of the most well-supported injury prevention strategies in the literature. You don't need a gym — just consistency!

Key exercises for pickleball players:

• Calf raises (standing double leg and single leg) — to protect the Achilles and ankle

• Single-leg balance/hop — improves ankle stability, loading, and proprioception

• Glute bridges — support the knee and lower back

• Wrist flexion and extension forearm strengthening — reduce elbow injury risk

• Rotator cuff exercises (band external rotation) — protect the shoulder

Aim for 2-3 sessions per week during the early weeks of the season.

4. Wear the Right Footwear

This one is often overlooked. Court shoes with lateral support are significantly better for pickleball than running shoes, which are designed for straight-ahead movement. A well-fitted court shoe reduces ankle sprain risk and improves your stability during lateral cuts. Reach out to your local indoor pickleball facility or store!

5. Rest Is Part of the Plan

Evidence from sports medicine research shows that adequate recovery between sessions is essential for tissue repair and injury prevention. For most recreational players returning to the court this spring, 1-2 rest days between sessions is appropriate early in the season. Listening to your body is not weakness — it's smart training.

6. Address Soreness Early

Muscle soreness in the first 24-48 hours after play is normal and expected. But sharp, localized, or persistent pain is a signal worth paying attention to. Catching a minor issue early — before it becomes a significant injury — is always the better path.

🟢 The Bottom Line: Movement Is Medicine

The research is clear: physical activity is one of the most powerful tools we have for long-term health. Pickleball, in particular, offers cardiovascular benefits, improved balance and coordination, social connection, and mental well-being — all in one sport.

At Achieve Physical Therapy our approach is never to tell you to stop moving. It's to help you move better, longer, and with more confidence. Fear of injury should never keep you on the sidelines — preparation should get you on the court.

If you're returning to pickleball this spring and want a movement screen, personalized prevention plan, or help addressing any nagging pain before it becomes a problem, we'd love to help.

📞 Questions about Getting Back on the Court?

Achieve Physical Therapy: 756 W Northwest Highway, Suite B, Barrington

📱 Call us: 847 387 3610

✉ Email us: Julie@AchievePTWellness.com

🌐 Learn more: www.achieveptwellness.com

Let's get you back to doing what you love — stronger than ever. 🏓

#AchieveYourBest!