By now nearly everyone has played or at least heard of the new sports craze sweeping the nation: pickleball! There has specifically been a lot of increased interest from the 55 years and older age group. Pickleball is not only a great workout (rated as moderate intensity along with hiking and yoga) but also spurs a sense of community and comeradery that keeps bringing people back for more. For example, Dr. Kyle’s mother has been bitten by the pickleball bug and plays 5 days a week with a group of friends. To say she loves it is an understatement. 

Pickleball has not only proven to be good for our blood pressure, cholesterol, cardiovascular health, and mental health, but is a FANTASTIC way to exercise. Unlike walking, hiking, or biking which only demands movement in one direction and focuses on the lower extremities, pickleball incorporates lateral movement, plyometrics, core activation, balance, and the upper extremities. It’s a whole body workout and people of all ages enjoy it.

Like with any sport, an increase in directions and involvement of multiple extremities correlates to a higher rate of injury. Common upper extremity injuries include rotator cuff strains and tennis elbow. Lower extremity injuries usually involve glute tendonitis, patellofemoral pain syndrome, and ankle sprains. Luckily for pickleball fanatics, all of these conditions are either easily treated with physical therapy or are entirely preventable.

Upper extremity injuries

Our shoulder and elbow must work together while playing any racquet sport. Elbow pain usually originates from an instability and weakness in the shoulder joint. The lack of proximal stability in the shoulder joint increases the forces and load required in the elbow. This leads to tightness and pain in our wrist extensors and is referred to as “Tennis elbow.”

Most people’s wrist extensors are also inherently weak, so when asked to do more work if the shoulder isn’t providing adequate support, these muscles tend to get tight and painful. The most effective way to resolve elbow issues is to strengthen the joint itself as well as at the shoulder.

We’ve written an informative article on shoulder impingement and tendinitis, which can be read here. Below are some simple exercises that can strengthen your forearm muscles to help get rid of that pesky tennis elbow:

Lower extremity injuries

Pickleball demands a lot of lateral movement during play, which puts players at risk for lateral plane injuries. This includes glute pain or tendonitis, patellar maltracking or patellofemoral pain syndrome, and ankle sprains.

Like the upper extremity, most lower extremity injuries stem from a lack of proximal stability, which lies in the hip. The most common hip muscle where people experience weakness is the gluteus medius. This muscle is in charge of providing pelvic stability as well as hip and knee stability in the lateral plane.

As we are moving sideways to volley a rogue ball hit by our opponent, our glute medius fires to keep our hips and knees in correct alignment. If this muscle isn’t firing appropriately due to weakness or inhibition, this can manifest as hip or knee pain.

Here are two great exercises to get that glute med firing:


Last but not least, we need to bulletproof our ankles if we want to win that much sought after pickleball championship.. Again, ankle instability can stem from weakness in the hip and glutes. But we also want to make sure we have appropriate strength and balance at the joint itself.

Moving laterally always increases the risk for ankle sprains, with the most common being an inversion ankle sprain. This happens when the foot comes “in” relative to the ankle and you roll onto the outside of our ankle joint.

To prevent this from happening, you need to strengthen the muscles that cross the joint that work to prevent excessive lateral movement, specifically the inverter and evertor muscles. It’s also important to improve the proprioception in our ankles to assist with balance and stability to avoid ankle sprains. 

Here are two great exercises to bulletproof your ankles:

Want to find out more about how to prevent injury whilst playing pickleball? Download our free guide!

If you’re curious about more ways to prevent injury, talking with a Doctor of Physical Therapy is a great place to start. 

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