A woman came in last month, barely putting weight on her right leg. She’s 61, just discovered pickleball, playing four times a week and loving every minute of it. Then her knee started talking to her. First after games, then during them, then walking down her own stairs.
She was frustrated, and a little scared. She had finally found something that made her feel strong and social and alive, and now her body seemed to be telling her she could not have it.
I hear a version of this almost every week now.
Pickleball has come a long way from a backyard game. It is one of the most popular sports in the country, and people of every age are playing it. It is social, it is easier to learn than tennis, and you get a real workout without covering a full court. All of that is good.
But easy to learn is not the same as easy on the body. As more people play, I am seeing more pickleball injuries walk through my door.
Who is actually getting hurt?
For a long time, pickleball had a reputation as a sport for older adults. That’s not necessarily true anymore. I see teenagers, people in their thirties, and people well into their seventies all playing hard.
That range matters when we talk about injuries, because the same game asks very different things of different bodies.
Someone brand new to the sport is often asking their body to do things it hasn’t done in years. Quick side-to-side steps. Lunging for a ball. Stopping short and changing direction. An experienced player is doing those same movements several times a week, over and over, long after the body has started asking for a break.
Either way, the body has to keep up. When it can’t, something gives.
The most common pickleball injuries
Some of these happen all at once, from a fall or a bad step. Others build slowly from the same motion repeated a few thousand times.
The ones I see most often are:
- Ankle sprains
- Knee pain
- Achilles tendon injuries
- Calf and hamstring strains
- Shoulder pain
- Wrist injuries and fractures
- Tennis elbow and other elbow pain
- Low back pain
Falls are a common cause, especially for older players moving faster than their balance is ready for. Younger players tend to show up with strains and sprains from sudden lunging and cutting.
But here is the part I want you to sit with. The injury is rarely just about pickleball.
Why the same sport hurts different bodies differently
In nearly 40 years of practice, one thing has become clear to me. The body is a connected system. It doesn’t work in separate parts, and it doesn’t break down in separate parts either.
An ankle that has lost some of its motion will quietly send that extra load up to the knee. A stiff mid-back changes how your shoulder has to reach for an overhead shot. Hips that don’t rotate well will hand that job to your lower back, and your lower back will do it until it won’t.
So when your knee hurts on the court, the knee is often just the place where the problem finally showed up. It’s not always where the problem started.
Early in my career, I looked at people as a shoulder, or a knee, or a low back. I don’t do that anymore. Now I look at the whole person and how everything is moving together, because that is where the real answer usually lives.
Pain is information, not a verdict
The biggest mistake I see is treating pain as something you simply push through.
If your knee hurts every time you change direction, or your shoulder aches for a day after you play, or your Achilles complains after a few games, that’s not a character flaw, and it’s not a reason to quit. It is information. Your body is telling you something about how it is moving and what it is compensating for.
The location of the pain gives us a clue, but it doesn’t tell us the whole story. That is what a physical therapy evaluation is for. We look at your strength, your mobility, your balance, your coordination, and the specific movements that are giving you trouble on the court. Then we work out why it is happening, and what needs to change so you can keep playing the game you love.
And if you are new to pickleball, you don’t have to wait until you are hurt to pay attention. A little preparation, and a little honesty about what your body is ready for, goes a long way.
Keep playing the game you love
That woman with the knee is back on the court. Not because we chased the knee, but because we found the stiff ankle underneath it and gave her body a better way to move. That is almost always how this goes.
Pickleball is one of the best things for older adults to do to stay active and connected. If it has become part of your routine, that is something to protect. Pain doesn’t have to be part of the routine, too. When your body starts sending signals, listen early, and let us help you understand what it is asking for.
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