Pickleball is Booming… and so are the Injuries

Pickleball is exploding in popularity — and so are the injuries. It’s déjà vu from the CrossFit boom a decade ago. When people rush headfirst into a new sport without the right foundation, injury rates skyrocket.

It’s Not the Sport… It’s the Surge

Is pickleball more dangerous than other racket sports?  Not exactly. The injury rate appears to be higher because the ratio of participation is significantly higher, mainly due to the rapid rise in popularity. I mean, ask yourself, “How many people today do you know that play tennis regularly?” Now ask yourself, “How many people do you know that play pickleball on a regular basis?” You see my point.

However, I would agree that the injury risk is higher for new athletes who are just starting to play the sport.

The Injury List: Pickleball Injuries You Need to Know

Pickleball is fun. But it’s also a stop-and-go, multi-directional sport. That means the biggest risks, like many sports that involve rapid acceleration and deceleration in multi-directional vectors, are the following:

• high risk of ankle and high ankle sprains
• high risk of acute plantar fasciitis or aggravation of chronic plantar heel pain.
• high risk of knee sprains, meniscal tears, and ACL tears (due to valgus torque forces)
• high risk of low back strains and even aggravation of lumbar discogenic pain (pain due to a lumbar herniated or degenerative disk)
• high risk of aggravation of hip pain due to hip impingement (femoralacetabular impingement), degenerative arthritis of the hip, and or labral tear of the hip
• high risk of tennis elbow
• high risk of rotator cuff tendonitis and shoulder impingement

How to Play Pickleball Without Breaking Down

While the sport of pickleball does increase the risk of these syndromes and injuries, the risk can be significantly mitigated by proper training and preparation. Athletes new to the sport are encouraged to start slowly, playing at half speed and only once a week, while allowing their body to acclimate to the demands of the sport, specifically the lateral and front-to-back explosive acceleration and deceleration forces.

However, remember that this is just a guideline. You need to know your body to play smart. Seek professional advice. It would be best to have a movement screen performed by a certified strength and conditioning coach, movement coach, sports chiropractor, or physical therapist.

Don’t Just Play. Train.

If you want to thrive in pickleball — or life — train like an athlete. Focus on:

• Strength
• Power
• Speed & agility
• Endurance

And RECOVERY

Why is endurance necessary for a quick sport like pickleball? Having a good engine helps prevent fatigue later in the round, which can result in a reduced risk of injury. Most people don’t train like athletes… but expect to play like one.  In my opinion, we should all train to be athletes. Athletes train for strength, power, speed, agility, and endurance. Sports-specific training, such as VO2 max training, sprinting, and skills acquisition, all depend on the demands of the sport.

The well-rounded human athlete will in train most of these disciplines in order to be able to lift heavy things off the ground, complete a 4-mile ruck wearing a 25-60 pound pack, sprint, generate power, go for a long bike ride or a hike, be mobile, and yes, dominate pickleball.

Written By Dr. Matt Fontaine

Dr. Matt Fontaine is a lifelong athlete with over 24 years of experience as a sports chiropractor. His private practice in integrative physical medicine focuses on an accurate diagnosis, rapid recovery, and peak performance. He has served as a sports chiropractor in Major League Baseball and with the ART Ironman Triathlon Medical team. He completed his residency at the Texas Back Institute and has spent the last decade-plus serving a patient community that includes the U.S. armed forces, veterans, and other governmental agencies. His new book is Only One Body (Adjusted Inkworks, August 19, 2025). Learn more at Dr. Matt Fontaine.