Bulletproof your Calves and Ankles on the Pickleball Court

by Pickleball, Alpine Fit PT, Dr Charlotte Robinson, Fitness, Physical Therapy, Running

The dreaded “Achilles pop”

If you’ve been in the pickleball game for a while now, odds are you know someone personally (or yourself!) who has pulled their calf muscle or injured their achilles tendon. Just two weeks ago, an old colleague of mine had an uncle that ruptured his achilles tendon while trying to make a forward move during a pickleball game. Looking back on 2023 statistics, the most utilized surgery for lower extremity injuries in pickleball was an achilles tendon rupture repair. So, why are we seeing a lot of calf/achilles injuries?

What leads to calf/achilles injuries?

The answer to that question is multi-faceted. A big component is that the average age of a pickleball player is in their 60s. As we age there are physiological changes that happen to our muscles and tendons, which put us more at risk for injury. The ankle joint is also a joint that tends to be limited in its mobility in most people. From my experience, I would say that 9/10 people that walk into my clinic have limited ankle mobility. This also puts us at risk of injuring the calf/achilles complex because if our ankle isn’t flexible enough to help absorb force, all that stress is placed on the calf and achilles. The last reason is that pickleball requires us to load our calves and achilles tendons a lot (about 6-8 times our body weight when we make a quick move), but how many of you are dedicating time to strengthening these structures?

What happens to our muscles and tendons as we age?

As mentioned above, there are physiological changes that happen to our muscles and tendons as we age. These changes do put us at an increased risk of injury, but they can also be combated to an extent.

As we age our muscles:

  • Decrease in muscle mass, making us weaker
  • Decrease in flexibility
  • Decreased in firing ability and force generation
  • Decrease in Type 2 muscle fibers (fast twitch fibers which are the ones helping us make that fast move for that rogue ball) 

As we age our tendons:

  • Have more disorganized collagen fibers
  • Are less resilient to inflammation and injury
  • Decrease in tendon elasticity
  • Have formation of other structures, such as fat pads, cartilage, and bone formation

All these changes create a perfect storm of weak and inflexible calves and achilles tendons, putting us at risk of injury in these areas. A common pickleball defensive maneuver, the split step, is meant to help load your achilles tendons to regenerate force into an explosive movement to retrieve a ball. But, if your achilles and calves are stiff and weak, this is where a lot of injuries happen. If you are caught hanging out on your heels and have to lunge for a short ball in front of you, this is also where we see calf and achilles injuries happen. It’s during these quick movements that place a lot of stress and requirement on the calf/achilles complex that these injuries are happening. 

Imagine a brand new thick bungee cord if you were to anchor it then attach it to a 20 pound weight. If we were to drop this 20 pound weight the bungee cord would stretch and absorb the load then recoil and recover. Now imagine that bungee cord has been sitting in your garage for 20 years, it’s losing its coloring, and has some cracks in the rubber from all the use it’s had over the years. If we do the same thing with this bungee cord, since the bungie is much more brittle, lost some of its strength, and isn’t as elastic, it’s much more likely to break when we drop that 20 pound weight. So the next question is, how do we stop this from happening to our achilles or calf?

Flexibility, elasticity, and mobility

The first thing we need to do is restore flexibility and elasticity to our muscles, tendon, and ankle joint. The range of motion in your calf/achilles complex and your ankle joint work hand in hand. If you have limited motion in your ankle, your calf and achilles will lose flexibility. If you have limited motion in your calf and achilles tendon, your ankle will lose flexibility. It’s a classic chicken or the egg situation, so we combat it by attacking from all angles. We’re going to improve flexibility of your calves and achilles tendon by stretching as well as mobilizing your ankle to improve range of motion.

Calf stretches:

Forward ankle lunge:

Lateral ankle lunge:

Strength

The next step that is also going to help with flexibility and elasticity as well, is strengthening. We specifically want to strengthen with an eccentric focus as this places more strain on our tendons and causes more strength gains and healthy collagen formation because it is more difficult. An eccentric exercise is where you are slowly controlling the elongation of a muscle against load or gravity. See the video below for the progression of calf eccentric strengthening as well as rebound calf raises!

Calf eccentric strengthening:

Rebound calf raises:

The end result

In conclusion, to protect our calves and achilles from injury we need to keep them as flexible and strong as possible. If we improve the range of motion in our ankle, this will also allow the calf and achilles to have more fluidity and range of motion throughout their contractions and relaxations. By improving the strength and elasticity of our calf and achilles, this allows our ankle to utilize its full range of motion and protects us from injury. This in turn will keep us healthy and playing on the courts, not worried about injuring ourselves when we get a sneaky short dink.

If you’re curious about more ways to prevent injury, talking with a Doctor of Physical Therapy is a great place to start.Click here to apply for your 30-minute free discovery visit today

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