Orthopedic Guidance

Injuries & Conditions

Pickleball injuries in the mature athlete run the gamut from ankle sprains to ACL tears, low back sprains to rotator cuff injuries. Dr. Engasser explains what you need to know.

Understanding Pickleball Injuries

Many pickleball injuries are nagging issues that do not prevent you from playing, but need a little help. Others are more serious and require prompt medical attention. Knowing the difference is key.

This section covers the most common injuries and conditions seen in pickleball players, with practical guidance on self-care, when to seek professional help, and what treatment options are available.

Shoulder

Rotator Cuff Injuries

Overview

The rotator cuff is a group of four muscles and tendons that stabilize the shoulder joint. Overhead shots and repetitive arm movements in pickleball can cause rotator cuff tendinitis, partial tears, or full tears.

Symptoms

Pain with overhead activity, weakness when lifting the arm, pain at night when lying on the affected shoulder.

Treatment

Most rotator cuff problems respond to rest, ice, anti-inflammatory medication, and physical therapy. Surgery is reserved for full tears that do not respond to conservative treatment.

Elbow

Tennis Elbow (Lateral Epicondylitis)

Overview

Despite the name, tennis elbow is extremely common in pickleball players. It is caused by overuse of the forearm muscles that attach to the outside of the elbow, often from repetitive backhand strokes.

Symptoms

Pain and tenderness on the outside of the elbow, weakness in the wrist and hand, pain when gripping or lifting.

Treatment

Rest, ice, a counterforce brace, and stretching exercises are the mainstays of treatment. Corticosteroid injections may help in persistent cases. Surgery is rarely needed.

Ankle

Ankle Sprains

Overview

Ankle sprains are one of the most common acute injuries in pickleball, typically occurring when a player rolls the ankle during a quick lateral movement or misstep.

Symptoms

Pain, swelling, and bruising around the ankle. Difficulty bearing weight in more severe sprains.

Treatment

RICE (Rest, Ice, Compression, Elevation) for the first 48–72 hours. Most sprains heal with conservative care. Severe sprains or suspected fractures require x-ray evaluation.

Back

Low Back Pain

Overview

The twisting, bending, and quick directional changes of pickleball can strain the muscles and ligaments of the low back. Disc problems are also common in the mature athlete.

Symptoms

Aching or sharp pain in the lower back, stiffness, pain that radiates into the buttock or leg (sciatica).

Treatment

Rest, ice or heat, gentle stretching, and over-the-counter anti-inflammatories. Persistent or radiating pain warrants evaluation by a spine specialist.

Knee

Knee Pain & Meniscus Injuries

Overview

The knee is one of the most commonly injured joints in pickleball. Meniscus tears, patellar tendinitis (jumper's knee), and osteoarthritis flare-ups are all frequently seen.

Symptoms

Pain, swelling, stiffness, clicking or locking of the knee, difficulty fully straightening or bending the knee.

Treatment

Depends on the specific diagnosis. Many knee conditions respond to conservative care. Meniscus tears and significant cartilage damage may require arthroscopic surgery.

Knee

ACL Tears

Overview

ACL (anterior cruciate ligament) tears can occur from sudden pivoting, cutting, or landing awkwardly. While less common than other injuries, they are among the most serious.

Symptoms

A 'pop' at the time of injury, immediate swelling, instability or giving way of the knee.

Treatment

Depends on the patient's age, activity level, and degree of instability. Many mature athletes do well with physical therapy and activity modification. Surgical reconstruction is an option for those who want to return to high-demand activities.

Questions to Ask If You Need Surgery

If surgery is recommended, Dr. Engasser advises patients to ask their orthopedist the following questions:

  • Why is this procedure being recommended? Are there alternatives?
  • What are the benefits in terms of pain relief and functioning?
  • What are the risks involved, and what is the success rate?
  • How many of these procedures are performed annually at this hospital?
  • What will happen if I don't have the surgery now?
  • Will I need physical therapy, and when can I return to pickleball?