The most effective way to prevent pickleball injuries is to address the sport’s biggest risks before you step on the court: falls and sudden lateral movements that your body isn’t conditioned for. Fractures account for nearly 33% of all pickleball injuries treated in U.S. emergency departments, followed closely by strains and sprains at about 31%. The wrist is the single most injured body part, followed by the lower back, lower leg, and head. Most of these injuries are preventable with the right preparation, equipment, and technique.
Why Pickleball Injuries Are Different
Pickleball looks gentle compared to tennis, but the court demands constant lateral shuffling, quick direction changes, and long stretches at the net in a low, bent position. That combination catches people off guard. The sport attracts a wide age range, and many players jump in without building the strength or movement habits the game requires. Achilles tendon injuries are a particular concern for older players. Research published in 2024 found that pickleball-related Achilles injuries occur at an average age of 64.5, compared to 48.6 for Achilles injuries in other sports, and they’re more likely to require surgery.
Warm Up Before Every Game
Cold muscles and tendons are far more vulnerable to strains and tears. A good warm-up doesn’t need to be long, but it does need to raise your heart rate and move your joints through their full range. Start with a slow jog in place for two to three minutes to increase blood flow to your legs. Then work through dynamic stretches: leg swings (forward and side to side), walking lunges, arm circles, and gentle trunk rotations. Hold static stretches like a hamstring or calf stretch for about 30 seconds per side after you’ve warmed up a bit, not while your muscles are still cold.
This matters more than most players realize. The transition from standing still to explosive lateral movement is exactly when Achilles tendons and calf muscles give out.
Build Lower-Body Strength Off the Court
Strengthening exercises are even more protective than stretching. Stanford Medicine sports medicine specialists recommend calf raises on a step as one of the simplest and most effective exercises for pickleball players. Do three variations: straight-leg calf raises, bent-knee calf raises, and eccentric calf raises (where you slowly lower your heel below the step over three to four seconds). These load the Achilles tendon and calf muscles in the same way pickleball does, building the tissue’s ability to handle sudden force.
Beyond calf work, squats and lateral lunges prepare your legs for the constant bending and side-to-side movement the game demands. Strong quadriceps and glutes also take pressure off your knees and lower back. Even two or three short sessions per week makes a meaningful difference, especially for players over 50.
Fix Your Dinking Posture
Lower back pain is one of the most common complaints among regular pickleball players, and dinking at the kitchen line is usually the culprit. The problem is bending at the waist to reach low balls instead of using your legs. When you hunch over repeatedly for an extended rally, your lower back absorbs all the strain.
The fix involves a few adjustments. Widen your stance so your base is broader, which automatically lowers your center of gravity. Bend your knees like a shallow squat rather than folding at the waist. Keep your chest up and your back relatively straight, hinging from the hips only when you need to reach for a ball. Think “use your legs to dink.” Your arm guides the paddle, but the power and positioning should come from your lower body. This is easier said than done in fast exchanges, but even a conscious effort to stay more upright will reduce the load on your spine over a long session.
Wear Court Shoes, Not Running Shoes
This is one of the simplest changes you can make, and one of the most impactful. Running shoes are designed for forward motion. They have soft, elevated soles that feel great on a jog but become a liability on a pickleball court. Without reinforced sidewalls, your foot is more likely to roll during quick lateral movements, and the higher sole height makes you less stable overall.
Court shoes, whether designed specifically for pickleball or for tennis, are built for lateral support. Look for reinforced sidewalls, a structured midsole, and a lower profile that keeps you closer to the ground. Good ankle support is especially important if you play on hard outdoor courts where the surface offers less give. If you play indoors, choose shoes with non-marking soles that grip the gym floor without sticking.
Choose the Right Paddle
Elbow and wrist pain, often called “pickleball elbow” (the same condition as tennis elbow), develops when the tendons on the outside of your forearm get overloaded from repeated impact. Your paddle plays a direct role in how much stress reaches those tendons.
Heavy paddles require more effort to swing, which means more strain on your arm with every shot. Look for paddles in the 7.5 to 8.5 ounce range if you’re prone to elbow or wrist issues. Grip size matters too: a grip that’s too small forces you to squeeze harder than necessary, while one that’s too large can cause your hand to slip and lose control. Most paddle manufacturers list grip circumference, and a quick test is to hold the paddle and check that you can fit your index finger from the opposite hand in the gap between your fingertips and palm. If there’s no gap, the grip is too small. If there’s a wide gap, it’s too large.
Protect Your Eyes
Head injuries account for over 11% of pickleball emergency department visits, and the face accounts for nearly 5% more. A pickleball can leave the paddle at speeds well over 40 mph at the net, and a direct hit to the eye can cause serious damage. Protective eyewear designed for racket sports now falls under a specific safety standard (ASTM F3164-24), which covers impact resistance for racquetball, squash, tennis, and pickleball. Eyewear that meets this standard is tested to withstand paddle and ball impacts. If you already wear glasses, prescription-compatible sport frames are available that meet the same standard.
Stay Hydrated in the Heat
Outdoor pickleball in warm weather creates a dehydration risk that sneaks up on you, especially during tournaments or back-to-back games. Drink a couple of tall glasses of water at least two hours before you play so your body starts hydrated. Sip water during every break between games rather than waiting until you feel thirsty, because thirst is a lagging indicator. After heavy sweating, a sports drink can help replace the sodium and electrolytes you’ve lost.
Take breaks more often than you think you need when it’s hot. Heat illness can progress from mild cramping to heat exhaustion quickly, and older adults are especially vulnerable because the body’s cooling system becomes less efficient with age. If the temperature is extreme, consider playing in the early morning or evening when conditions are cooler.
Reduce Fall Risk on the Court
Falls drive a huge share of pickleball injuries, particularly the fractures that top the injury list. Wrist fractures happen when players instinctively reach out to catch themselves. A few habits lower your fall risk significantly. Move your feet to the ball rather than lunging or overreaching. Stay balanced with your weight centered over your hips, not leaning forward on your toes. Be aware of court conditions: wet outdoor courts, cracked surfaces, and balls rolling from adjacent courts are common hazards. If you do feel yourself falling, try to tuck and roll rather than bracing with an outstretched hand, which is how most wrist fractures happen.
Balance training off the court helps too. Single-leg stands, heel-to-toe walking, and lateral step-overs all improve the proprioception (your body’s awareness of where it is in space) that keeps you upright during fast play.