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MEDICAL EDUCATION SERVICE

Play Smart. Move Ready. Keep Playing.

Pickleball is a fun, social way to stay active as you age—but the quick stops, starts, lunges, reaches, and directional changes place genuine physical demands on your body.

A few simple habits, from warming up and building strength and balance to choosing appropriate footwear and managing your playing load, can help you reduce preventable risks and stay ready for the game you enjoy.

Dr. Amanda Foster
Dr. Amanda Foster
Physical Therapy & Sports Rehabilitation Consultant • 8 min read
Pickleball Injury Prevention
5–10 MINUTES

Dynamic Warm-Up

A short, progressive warm-up can help you transition from rest into the multidirectional movements used during pickleball.

2 DAYS

Strength Training

Adults 65+ are advised to include muscle-strengthening activities on at least 2 days each week as part of their overall physical activity routine.

BALANCE

Practice Regularly

For adults 65+, the CDC recommends including balance activities as part of weekly physical activity. Balance, strength, and aerobic activity form an important combination for maintaining physical function.

Why Pickleball Injuries Happen—and What You Can Control

1. Rapid Direction Changes

Pickleball frequently requires you to move sideways, forward, backward, and diagonally. A sudden change of direction can challenge your feet, ankles, knees, hips, balance, and ability to control your body.

What You Can Do

Practice controlled lateral movement, weight shifting, step-and-hold exercises, and lower-body strengthening away from the court. Start with movements you can control rather than trying to immediately match the speed of experienced players.

2. Falls and Loss of Balance

Falls are the leading injury mechanism identified in the latest pickleball-specific systematic review. A player may lose balance while lunging, reaching, changing direction, stepping backward, or trying to recover quickly.

What You Can Do

Integrate balance work into your regular training routine:

  • Supported single-leg standing
  • Controlled weight shifts
  • Step-and-hold exercises
  • Heel-to-toe walking

💡 Keep a sturdy support nearby when practicing challenging balance exercises.

3. Doing Too Much Too Soon

Pickleball is enjoyable, which can make it easy to increase your playing time quickly. But your enthusiasm can increase faster than your body's ability to adapt. Going from occasional play to multiple long sessions in a short period can place a very different demand on your muscles, tendons, joints, and overall recovery capacity.

What You Can Do

Gradually increase your playing frequency, duration, and intensity—especially after a long break. If you change one part of your routine, consider keeping the other variables relatively stable while your body adapts.

4. Starting Cold

Going directly from sitting in a car or at home to rapid court movement gives your body little time to transition into activity.

What You Can Do

Give yourself approximately 5–10 minutes to gradually increase your movement before your first game. Start easy and progressively introduce the movements you'll use on the court.

5. Insufficient Strength and Conditioning

Pickleball involves repeated pushing, stopping, bending, stepping, reaching, and recovering. Your body doesn't need to be exceptionally strong—but it benefits from having an adequate physical foundation for those demands.

What You Can Do

Complement pickleball with regular strength training. Useful movements include:

  • Sit-to-stands
  • Step-ups
  • Calf raises
  • Supported hip hinges
  • Resistance-band rows
  • Controlled lateral steps

For adults 65+, the CDC recommends muscle-strengthening activity on at least 2 days each week as part of a broader physical activity routine.

6. Limited Balance and Body Control

Balance is more than standing on one foot. During pickleball, you need to control your body while your weight shifts, your feet reposition, and your upper body reaches toward the ball.

What You Can Do

Practice balance when you're not playing. Start with simple supported exercises and gradually make them more challenging as your control improves.

7. Inappropriate Footwear

Pickleball includes substantial side-to-side movement. Footwear designed primarily for straight-line running may not provide the same type of support or stability you want for court movement. USA Pickleball recommends comfortable court shoes and specifically notes the importance of footwear suited to pickleball's lateral movement.

What You Can Do

Choose court shoes that fit comfortably, provide appropriate traction, match your indoor/outdoor playing surface, are in good condition, and allow your toes room without foot sliding.

8. Court Hazards and Poor Court Awareness

Good physical preparation cannot compensate for a wet surface, debris, equipment left near the court, or an unexpected collision.

What You Can Do

Before playing: check the court surface for moisture/debris, keep loose equipment out of the playing area, know where partner and opponents are, be aware of neighboring courts, and avoid moving backward without knowing what's behind you.

9. Playing Through Fatigue

Your movement can change when you're tired. Steps may become less precise. Reaction time may feel slower. You may reach farther instead of repositioning your feet. That's when a movement that normally feels easy can become harder to control.

What You Can Do

Pay attention to how you're moving, not just how much longer you can keep playing. Taking a break is part of smart training—not a sign that you're giving up.

10. Ignoring a New or Worsening Problem

There is a difference between normal effort and a symptom that is getting worse. Trying to play through significant pain, swelling, instability, dizziness, or another concerning symptom isn't a good strategy.

What You Can Do

Stop and assess what's happening. If symptoms persist, worsen, or interfere with normal activities, seek appropriate professional guidance before returning to play.

Video Demonstration: Pickleball Injury Prevention

Watch our complete video guide for visual movement demonstrations and court safety tips.

1. Warm Up for the Movements You're About to Make

A good pickleball warm-up doesn't need to be complicated. Start with easy movement and gradually progress toward the movements you'll use on the court.

A simple 5–10 minute progression:

  • 1–2 minutes: Easy walking or marching
  • 1–2 minutes: Shoulder circles, arm swings, and gentle trunk movements
  • 1–2 minutes: Hip circles, leg swings, and mini squats
  • 1–2 minutes: Controlled side steps and weight shifts
  • 1–2 minutes: Gradually faster pickleball-specific movements

The goal is to ramp up—not wear yourself out.

For the complete routine, see our Pickleball Warm-Up Exercises guide.

2. Build the Physical Qualities Pickleball Demands

Playing pickleball is valuable, but you don't have to expect the sport itself to train every physical quality. Think about what the game asks you to do:

  • Strength: Push, stop, bend, and recover.
  • Balance: Control your body while your weight shifts.
  • Mobility: Reach comfortable positions.
  • Coordination: Combine those movements smoothly.
  • Endurance: Continue moving as the game progresses.

Training these qualities outside the court can complement your time playing.

3. Injury Prevention Isn't About Avoiding Movement

It can be tempting to think that staying safe means avoiding bending, lunging, rotation, or fast movement. That's not the goal.

Your body benefits from being exposed to movement and physical challenge in an appropriate, progressive way. Instead of avoiding every challenging movement, work toward being able to perform the movements you need comfortably, progressively, and with control.

4. Don't Confuse Flexibility With Readiness

Being flexible doesn't automatically mean you're ready to play. Before pickleball, your body needs to transition from rest into movement. That's why dynamic movement is generally a better fit at the beginning of a session than spending a long time holding static stretches.

Save longer, comfortable flexibility work for after play or a separate mobility session.

For more information, see our Pickleball Stretches guide.

5. Increase Your Playing Load Gradually

One of the easiest ways to overdo pickleball is to increase several variables at the same time. For example: you normally play once a week, then you suddenly play four days in one week with several games each day. Your motivation may be ready; your body may not be.

Instead, when possible, change one variable at a time (frequency, duration, intensity) and give your body time to adapt.

A Simple Pickleball Safety Checklist

Before you step onto the court, ask yourself:

  • BODY: Am I reasonably recovered and ready to play?
  • WARM-UP: Have I gradually warmed up?
  • SHOES: Am I wearing appropriate court footwear?
  • COURT: Is the playing surface clear and suitable?
  • AWARENESS: Do I know where my partner, opponents, and nearby players are?
  • PACE: Am I playing at an intensity appropriate for my current fitness?
  • RECOVERY: Have I given myself enough recovery between sessions?

Dainely: Support for Active Movement

Dainely Belt — Support for Active Movement: Designed for active adults who want comfortable support while moving through everyday activities, recreation, pickleball, golf, walking, travel, and more. Explore Dainely Belt →

Daily Support & Recovery System: Combines the Dainely Belt and Extender with practical movement preparation and recovery routines designed around active adults. Explore Support & Recovery System →

Ergo Cushion: Comfort between games, during travel, or relaxing after a day on the court. Explore Ergo Cushion →

Medical Disclaimer

This article is provided for general educational and wellness purposes only. It is not intended to diagnose, treat, cure, or prevent any disease, medical condition, or injury.

No exercise, warm-up, product, footwear choice, or safety strategy can guarantee that an injury will not occur. Exercise selection, playing frequency, and intensity should be appropriate for your individual fitness level and abilities.

Stop playing or exercising if you experience sharp or worsening pain, significant swelling, instability, dizziness, or other concerning symptoms. Consult a physician or physical therapist for tailored medical advice.

Evidence-Based Strategies & Practical Action Points

A 2026 systematic review of 15 studies examining lower-extremity injuries in adult pickleball players found that sprains, strains, and fractures were among the most commonly reported injuries. Here are the core actions to protect your body:

  • 1. Dedicated Warm-Up: Spend 5–10 minutes ramping up with dynamic walking, arm circles, hip rotations, and mini squats before starting your first game.
  • 2. Build Foundation Strength: Regular bodyweight and resistance exercises on at least 2 days per week protect tendons, ligaments, and knee joints.
  • 3. Progressive Loading: Avoid sudden spikes in playtime. Increase frequency or intensity gradually over several weeks.
  • 4. Lateral Court Footwear: Wear dedicated court shoes with side-to-side support rather than straight-line running shoes.
  • 5. Respect Fatigue & Rest: Take breaks between games and schedule rest days to allow muscle and joint tissue to recover fully.