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Pickleball is one of the fastest-growing sports in the United States, and its popularity is especially high among players aged 55 and older. It’s fun, social, and provides excellent exercise. However, as more older adults pick up the paddle, the number of injuries has also risen. Knowing what the most common injuries are, why they occur, and how to prevent them can help keep you healthy and on the court
Why Injuries Are More Common in Older Players
Aging brings natural changes that affect performance, balance, and recovery, and these changes influence how older adults experience sports like pickleball. Muscle fibers shrink and lose elasticity, reducing overall strength and flexibility. Joints may stiffen with wear and tear, making it harder to move fluidly across the court. Bone density gradually declines, leaving players more vulnerable to fractures after a fall. At the same time, balance and coordination can become less reliable, while reaction time slows, increasing the chance of slips or missteps. Recovery also takes longer because tissues repair more slowly than they once did. Understanding these age-related shifts is the first step toward preventing injuries and adapting play to maintain long-term health and enjoyment.
Reduced Muscle Strength and Flexibility
As people age, muscle fibers shrink and lose mass, a process known as sarcopenia. At the same time, connective tissues such as tendons and ligaments lose elasticity, making them less able to absorb sudden stresses. The result is reduced strength, power, and flexibility compared to earlier years. This natural decline makes it harder to stretch deeply, pivot quickly, or move explosively without overloading a muscle or joint. For pickleball players, this means that common actions, like a fast side step to reach a wide shot, a sudden lunge at the kitchen line, or a quick twist of the torso, can put excessive strain on muscles that are tight or undertrained. Without proper conditioning, these everyday game movements increase the likelihood of strains, pulls, or even t.
Bone Density Decline
Osteoporosis is a widespread condition among older adults, particularly women after menopause, due to hormonal changes that accelerate bone density loss. As bones become thinner and more brittle, they lose their ability to withstand the same levels of stress as in younger years. This means that a fall that might cause only bruising or soreness in a younger athlete could result in a serious fracture in someone over 55. Wrists and hips are the most vulnerable areas because they are often the first points of contact during a fall—people instinctively reach out with their hands or land on their side. Hip fractures, in particular, can be life-altering, leading to long recovery times, reduced mobility, and even long-term health complications. For pickleball players, the risk is heightened by the quick stops, pivots, and potential slips that are part of the game. Preventive measures such as weight-bearing exercise, balance training, and bone density screenings can make a significant difference in lowering fracture risk and keeping players safe on the court.
Slower Reflexes and Balance Challenges
Reaction time decreases naturally with age as the nervous system processes signals more slowly and muscles respond less quickly to sudden demands. On the pickleball court, this delay can make it harder to judge the speed and trajectory of the ball, increasing the chance of missteps while rushing to return a shot. Even a split-second hesitation can result in an awkward landing, leading to twisted ankles, strained knees, or falls. In addition, age-related changes in the inner ear and vision often contribute to balance issues, further raising the risk of stumbling or losing footing during fast exchanges at the net. For older players, this combination of slower reflexes and diminished balance can create a perfect storm for injury. However, targeted training, such as footwork drills, single-leg balance exercises, and reaction time games, can help sharpen responsiveness and reduce the chance of injury while keeping play enjoyable and safe.
Overuse Injuries and Recovery Time
Younger athletes bounce back quickly from repeated play because their muscles and connective tissues repair themselves more efficiently, and their energy reserves replenish faster. Older players, however, require more time for recovery due to slower cellular repair processes and decreased circulation that delivers fewer nutrients to healing tissues. Without built-in rest days, the tiny micro-tears in muscles, tendons, and ligaments caused by normal play can accumulate rather than heal, gradually turning into chronic conditions such as tendonitis, bursitis, or persistent joint pain. What may start as mild soreness after a game can progress into an injury that sidelines a player for weeks. For those over 55, recovery is just as important as training—incorporating strategies like alternating high- and low-intensity days, using proper post-game stretching, applying ice or heat as needed, and ensuring quality sleep can all speed healing. Listening to your body and respecting signs of fatigue or stiffness will go a long way toward preventing long-term issues and keeping you on the court consistently.
Improper Technique and Equipment
Using running shoes instead of court shoes or playing with a paddle that is too heavy can place unnecessary strain on joints, muscles, and tendons. Running shoes are designed for forward motion, not the constant side-to-side movement required in pickleball. Without the proper lateral support, players are at higher risk of rolling an ankle or stressing the knees during quick directional changes. Similarly, a paddle that is too heavy for a player’s strength level forces the shoulder, elbow, and wrist to absorb excess load with every swing. Over time, this can lead to overuse injuries such as rotator cuff strain or elbow tendonitis. Poor serving or stroke technique compounds these issues by forcing awkward body mechanics—swinging with a locked elbow, twisting from the lower back instead of rotating the hips, or gripping the paddle too tightly can all accelerate joint wear and increase the likelihood of injury. By investing in the right footwear, selecting a paddle with an appropriate weight and grip size, and taking the time to learn proper mechanics from a coach or instructional program, older players can significantly reduce unnecessary stress on their bodies and extend their time on the court.
Sudden Activity Spikes
Many older adults start pickleball after years—or even decades—of relatively low activity. While the sport feels approachable, the sudden jump from a mostly sedentary lifestyle to playing several days a week can put unexpected stress on the body. Muscles that haven’t been conditioned for regular exertion are weaker and less flexible, leaving them more vulnerable to strains and tears. Tendons and ligaments also lose resilience over time and may not be ready for the repetitive demands of swinging a paddle or sprinting across the court. This rapid increase in activity can also strain the cardiovascular system, leading to fatigue that further raises the risk of missteps or falls. For many new players, the excitement of learning the game leads them to overcommit—playing long sessions or multiple matches in a row before their body has adapted. The result is often sprains, strains, or chronic overuse issues that could have been avoided with a slower, more gradual build-up. By starting with shorter sessions, allowing rest days between games, and complementing pickleball with light strength and mobility training, older players can condition their bodies safely and enjoy the sport without being sidelined by preventable injuries.
The Most Common Pickleball Injuries in Players 55+
These are the injuries that show up most often in older pickleball players:
Sprains and Strains
Ankle sprains and muscle strains—especially in the hamstrings, calves, and shoulders—are among the most frequent injuries seen in pickleball. These typically occur when players push their bodies into positions they are not fully prepared for. A sudden lunge to reach a low ball, an abrupt change of direction while tracking a shot, or a quick sprint across the court can overload muscles and ligaments, particularly if they haven’t been warmed up properly. Ankle sprains often happen when a player lands awkwardly or pivots without stable footing, stretching the ligaments beyond their capacity. Similarly, hamstring and calf strains can develop when tight muscles are forced to contract explosively, such as when accelerating to the net or reaching for a drop shot. Shoulder strains are common from overextending during serves or overhead smashes, especially when technique relies too heavily on arm strength rather than full-body mechanics. These injuries may sideline a player for weeks, but they are often preventable with consistent warm-ups, stretching, balance training, and gradual conditioning that prepares the body for the demands of quick and unpredictable movements on the court.
Overuse Injuries
“Pickleball elbow,” which closely resembles tennis elbow, is caused by repetitive paddle swings that strain the tendons on the outside of the elbow. Over time, the small tears from repeated stress create inflammation and pain that worsens with gripping or swinging. This condition often develops gradually, starting as mild discomfort but progressing into sharp pain that can interfere with daily activities like lifting or typing. Shoulder tendonitis is another frequent issue, typically from overuse of the rotator cuff muscles during overhead shots, serves, or smashes. When these tendons are repeatedly stressed without adequate rest or strengthening, they become inflamed and painful, limiting shoulder mobility. Achilles tendon pain is also common among older pickleball players, especially those who increase their playing frequency too quickly. The explosive movements, sudden stops, and quick sprints across the court put tremendous strain on the Achilles tendon, which naturally weakens with age. Without proper rest and recovery, these overuse injuries accumulate quietly and worsen over time, sometimes leading to partial tears that require long rehabilitation. Preventing them requires a balanced approach: taking rest days, cross-training with low-impact exercise, strengthening supporting muscles, and paying attention to early warning signs instead of pushing through pain.
Fractures
Falls are one of the most serious concerns for older pickleball players, as they often result in significant injuries. When a player loses balance and instinctively reaches out to catch themselves, the wrists and forearms absorb the impact, leading to fractures of the radius or ulna. These injuries are painful, require long healing times, and may even need surgical repair in severe cases. Hips are another high-risk area, especially in players with low bone density due to osteoporosis. A hip fracture can be life-changing, often requiring hospitalization, rehabilitation, and months of restricted mobility. Beyond bones, falls can also cause soft tissue injuries, concussions, or chronic fear of returning to the court, which limits social and physical activity. Risk factors include uneven surfaces, poor footwear, reduced vision, and slower reflexes. Preventing fall-related injuries involves more than just careful play—it means strengthening leg muscles, practicing balance exercises, wearing court-specific shoes, and ensuring the court is well lit and free of hazards. Many players also benefit from bone density screenings and medical guidance to reduce fracture risk. By addressing both physical preparation and environmental safety, older athletes can greatly reduce the dangers associated with falls while enjoying the game with confidence.
Joint Pain and Arthritis
Many older players already live with mild arthritis in their knees, hips, or shoulders—a natural part of aging where cartilage gradually wears down and joints become less cushioned. The repetitive movements of pickleball, such as squatting low for volleys, twisting at the waist, or reaching overhead, can place extra stress on these joints and aggravate inflammation. Without pacing themselves or adjusting their playing style, older athletes may notice swelling, stiffness, or lingering soreness after games. Over time, this can discourage them from staying active, which ironically makes arthritis worse, since inactivity weakens supporting muscles and reduces joint mobility.
The good news is that pickleball can still be played safely with arthritis if players take preventive steps. Wearing supportive shoes, using knee or elbow braces, and playing on cushioned courts can all reduce impact. Switching to a lighter paddle helps ease shoulder strain, while learning proper technique distributes force more evenly across the body. Most importantly, pacing play—such as limiting back-to-back matches, incorporating rest days, and mixing pickleball with low-impact exercise like swimming or cycling—helps joints recover. Strengthening surrounding muscles, especially the quadriceps, hips, and shoulders, provides better joint support and lessens pain during play. With these adjustments, pickleball remains a safe and enjoyable sport for those managing arthritis.
Fall-Related Injuries
Balance loss can result in hard falls, causing injuries that range from simple bruises to more severe outcomes like concussions or fractures. As people age, natural changes in vision, inner ear function, and proprioception (the body’s awareness of its position in space) can make balance more fragile. On the pickleball court, this means that even a small misstep while backpedaling or reaching sideways can result in a tumble. Slippery courts, uneven surfaces, or poor footwear further magnify these risks, leaving players vulnerable to falls. The danger is not just physical pain—falls can shake a player’s confidence and cause them to hesitate or limit their activity in the future.
Fortunately, there are several strategies to counteract balance-related risks. Wearing proper court shoes with strong lateral support and non-slip soles provides stability for quick directional changes. Regular balance training, such as single-leg stands, yoga poses, or tai chi, helps strengthen the muscles and reflexes needed to stay upright during play. Improving leg strength with exercises like squats and lunges also provides a more solid foundation. Finally, ensuring courts are well lit, dry, and clear of stray balls or clutter minimizes environmental hazards. By combining physical preparation with a safe playing environment, older pickleball players can significantly reduce fall risks and stay confident on the court.
How to Prevent Pickleball Injuries
The good news is that with preparation and smart habits, most injuries can be reduced or avoided:
Warm-Up and Cool-Down
Spend at least 10 minutes warming up before hitting the court. A good warm-up should raise your heart rate slightly, loosen your joints, and activate the muscles you’ll rely on during play. Start with a brisk walk or light jog around the court to get the blood flowing. Add dynamic movements such as arm circles, hip rotations, leg swings, and gentle side shuffles to prepare your shoulders, hips, and legs for quick changes in direction. You can also include bodyweight exercises like lunges or squats to fire up the large muscle groups.
After games, take time to cool down with static stretches that lengthen the muscles and reduce stiffness. Hold each stretch for 20–30 seconds, focusing on key areas that take the most stress in pickleball: shoulders, calves, hamstrings, quadriceps, and hips. Gentle yoga poses such as downward dog or seated hamstring stretches are also excellent options. Cooling down not only helps improve flexibility but also lowers your heart rate gradually and decreases post-game soreness. Making warm-ups and cool-downs a consistent habit will go a long way toward preventing injuries and keeping you feeling fresh for the next match.
Strength and Flexibility Training
Strengthening your legs, core, and shoulders is essential for stability, power, and injury prevention on the pickleball court. Lower-body exercises such as squats, lunges, and step-ups build strength in the quadriceps, glutes, and hamstrings, which support quick lateral movements and protect the knees. Incorporating calf raises also strengthens the ankles, reducing the risk of sprains. For core stability, planks, side planks, and rotational exercises with a resistance band enhance balance and protect the lower back during twisting motions. Shoulders benefit from resistance band work like external rotations and overhead presses, which build endurance and stability in the rotator cuff muscles.
In addition to strength training, flexibility and mobility exercises play an equally important role. Yoga and Pilates are excellent options for older players because they improve range of motion, lengthen tight muscles, and increase body awareness. Poses such as downward dog, warrior lunges, and seated twists target the hips, hamstrings, and shoulders—areas that commonly tighten up during pickleball. Pilates, with its focus on controlled movements and core engagement, strengthens smaller stabilizing muscles that often get overlooked in traditional training. By combining strength-building workouts with flexibility practices, older athletes can reduce stiffness, improve fluidity of movement, and lower the risk of injury.
Improve Balance and Agility
Do simple drills like single-leg stands, heel-to-toe walking, and agility ladder work to reduce falls and improve coordination. These exercises target balance, proprioception, and footwork—skills that often decline with age but are crucial for pickleball. For example, standing on one leg for 30–60 seconds forces stabilizing muscles in the ankles, knees, and hips to engage, improving joint stability. Heel-to-toe walking, where you slowly place one foot directly in front of the other, sharpens coordination and strengthens the muscles that help maintain posture during quick movements on the court.
Agility ladder drills, such as side shuffles, in-and-out steps, or diagonal runs, replicate the lateral movements of pickleball and teach the body to move quickly without losing control. These drills also enhance reaction time, which helps prevent trips and falls during fast-paced rallies. Players can progress gradually, starting with basic steps and advancing to more complex patterns as confidence grows. Adding tools like balance boards or resistance bands can further challenge stability and build strength. Practiced regularly, these drills improve not only safety but also performance, giving players more confidence to move dynamically during games.
Use the Right Gear
Court shoes with lateral support are crucial for side-to-side play because they are specifically designed to handle the quick directional changes of pickleball. Unlike running shoes, which are built for forward motion, court shoes provide stability on the edges of the foot, reducing the likelihood of ankle sprains and knee strain during pivots and shuffles. The right shoe should also have a non-marking sole with good traction to prevent slips on indoor courts and durable rubber outsoles for outdoor play. Cushioning is another key factor, as it helps absorb shock and protects aging joints from repeated impact.
Choosing the right paddle is equally important. A paddle that is too heavy can overload the shoulder, elbow, and wrist, especially in older players who may already be managing arthritis or tendonitis. On the other hand, a paddle that is too light may require excessive swing speed, creating strain in a different way. The ideal paddle balances weight, grip size, and material. For many players over 55, a midweight paddle in the 7.5–8.2 oz range provides enough power without sacrificing control. Grip size should match hand size—too small leads to over-gripping, while too large increases wrist strain. Modern paddles made of graphite or composite materials offer both responsiveness and reduced vibration, lowering the risk of overuse injuries.
By investing in quality court shoes and a paddle suited to your body and playing style, older athletes can minimize stress on their joints, improve comfort, and extend their longevity in the sport.
Focus on Technique
Work with a coach to refine serving and stroke mechanics, since proper form is one of the most effective ways to protect your body from overuse injuries. Many older players naturally compensate for reduced strength or mobility by swinging harder or relying too much on the arm, which places unnecessary stress on the shoulder, elbow, and wrist. A coach can help adjust your technique so that you use your entire body in a more efficient way—rotating through the hips and core rather than muscling the ball with your arm. This not only reduces strain on joints but also improves consistency, accuracy, and shot placement.
Serving, in particular, is a common source of injury when performed with poor mechanics. Overextending during overhead serves or snapping the wrist aggressively increases the risk of tendonitis and shoulder impingement. A coach can introduce modifications such as using a more compact swing, engaging the legs for power, and following through with proper alignment. Similarly, refining forehand and backhand strokes can prevent awkward twisting of the spine or shoulders. Even small adjustments, like loosening grip pressure or using a shorter backswing, can have a big impact on long-term joint health. By prioritizing technique and seeking guidance, players can both elevate their game and significantly reduce the likelihood of repetitive stress injuries.
Make the Court Safe
Ensure playing surfaces are clean, dry, and well lit, as even small hazards can lead to serious falls. Outdoor courts may accumulate leaves, sand, or moisture that increase the risk of slipping, while indoor courts can be affected by dust or condensation. Regularly checking the court before play and quickly wiping up spills or moisture can make a big difference in safety. Stray balls should always be removed before resuming play—tripping over one is a surprisingly common cause of falls and ankle injuries.
Hydration is equally critical, especially for older adults who may not feel thirst as strongly as they once did. Dehydration can lead to muscle cramps, dizziness, or slower reaction times, all of which increase the risk of injury. Players should keep water courtside and take small, frequent sips throughout the game. When playing outdoors, sun protection is another layer of injury prevention. Sunscreen, hats, and sunglasses reduce glare, prevent heat exhaustion, and protect skin from harmful UV exposure. By combining good court maintenance with proper hydration and sun safety, players create a safer environment that supports both performance and long-term health.
Rest and Recovery
Take one to two rest days per week to give your muscles, joints, and connective tissues time to repair and rebuild. Unlike younger athletes, older players need longer recovery windows because their bodies process inflammation and cellular repair at a slower pace. Rest days don’t mean complete inactivity—gentle walks, stretching, or swimming are excellent ways to promote blood flow and support recovery without adding stress.
Foam rolling and self-massage are valuable tools for easing muscle tension and improving circulation. Targeting tight areas like the calves, quads, and shoulders can help reduce soreness and keep tissues supple. Applying ice to sore joints or inflamed tendons after a game helps control swelling, while heat therapy on non-game days can relax stiff muscles and improve mobility. Most importantly, never ignore persistent pain. Pain that lingers for more than a few days or worsens with play is often a warning sign of a developing injury, not just normal soreness. Seeking early evaluation from a physical therapist or doctor can prevent minor issues from turning into chronic conditions. By prioritizing rest and recovery as part of the training process, older pickleball players can extend their time on the court and avoid long-term setbacks.
Sample Prevention Routine
Weeks 1–2: Build the Foundation
During the first two weeks, focus on easing into play rather than diving in too aggressively. Keep sessions light—play shorter games, avoid diving for difficult shots, and prioritize form over intensity. Add mobility work such as dynamic stretches, hip openers, and shoulder rotations to loosen stiff joints. Off the court, begin gentle strength exercises like bodyweight squats, wall push-ups, and light core work to prepare your body for more demanding movements.
Weeks 3–4: Add Agility and Balance
As your body adapts, gradually increase the length and intensity of your play. Incorporate simple agility drills like lateral shuffles, cone step-overs, or ladder drills to simulate court movements. Balance exercises such as single-leg stands or heel-to-toe walking help reduce fall risk and improve coordination. Continue building strength with resistance bands or light weights to reinforce the muscles around the knees, hips, and shoulders.
Weeks 5–6: Controlled Intensity
Begin introducing more challenging rallies and moderate competitive play, but always monitor fatigue. Focus on smooth transitions between offense and defense rather than pushing yourself to extremes. At this stage, refine your technique with a coach or experienced partner to eliminate bad habits that increase injury risk. Off the court, add targeted exercises like calf raises, step-ups, and rotator cuff strengthening to further support joints and tendons.
Ongoing: Balance, Recovery, and Consistency
After six weeks, move into a long-term maintenance routine. Balance pickleball with two or three non-court workouts per week, including strength, flexibility, and balance training. Always schedule rest days to allow recovery. Make warm-ups and cool-downs part of every game, and listen to your body for early signs of overuse injuries. If you feel persistent soreness or stiffness, scale back play and focus on recovery tools like foam rolling, stretching, or physical therapy exercises.
By gradually building strength, agility, and endurance in phases, older players can safely improve performance, prevent injuries, and enjoy pickleball for years to come.
What to Do If You Get Hurt
Stop immediately if you feel pain—continuing to play often turns a minor issue into a major injury. Pain is the body’s warning signal that something isn’t right, and ignoring it can lead to longer recovery times or permanent damage. For minor sprains, strains, or bumps, follow the RICE method:
• Rest the injured area to prevent further stress.
• Ice it in 15–20 minute intervals to reduce swelling.
• Compression with a wrap or sleeve can provide support and limit swelling.
• Elevation above heart level helps reduce fluid buildup.
If the pain is severe, swelling is significant, or movement is limited, seek medical attention promptly. Fractures, dislocations, or major ligament tears need professional evaluation, and early treatment is essential for the best recovery outcomes. Don’t try to “walk it off” or wait it out if the injury feels serious.
Once cleared by a healthcare provider, follow any prescribed rehabilitation protocols. This may include physical therapy exercises to restore strength, range of motion, and flexibility. Returning to pickleball too soon increases the risk of re-injury, so progress gradually, starting with light practice, then easing back into full games. Listening to your body and respecting its limits ensures you can recover fully and continue playing for years to come.
Final Thoughts
Pickleball is a fantastic sport that promotes physical health, mental sharpness, and community connection, especially for players over 55. Beyond the fun and camaraderie, it offers cardiovascular benefits, helps maintain strength and balance, and supports healthy aging. While it’s true that injuries are more common in this age group, the risks should not overshadow the rewards. With the right prevention strategies, older athletes can continue to thrive on the court.
By committing to preparation, warming up before games, using proper equipment, and adopting smart recovery habits, you can drastically reduce your chances of being sidelined by common injuries. Just as importantly, building strength and flexibility off the court gives your body the resilience it needs to handle the demands of play. And when setbacks do happen, listening to your body and respecting the recovery process will ensure a safe return
Pickleball isn’t just a pastime, it’s a way to stay active, social, and engaged well into your golden years. With a thoughtful approach, players can look forward to not just staying in the game, but enjoying it with confidence, energy, and the satisfaction that comes from knowing they’re taking care of both their body and spirit.
References
• https://www.ama-assn.org/public-health/prevention-wellness/what-doctors-wish-patients-knew-about-preventing-pickleball
• https://health.ucdavis.edu/news/headlines/pickleball-injuries-are-on-this-rise-here-are-tips-to-avoid-them-while-playing/
• https://www.novanthealth.org/healthy-headlines/pickleball-study-finds-fracture-risk-is-highest-in-seniors
• https://pmc.ncbi.nlm.nih.gov/articles/PMC11758564/
• https://aaos-annualmeeting-presskit.org/2024/research-news/new-study-identifies-increased-fracture-risk-for-older-pickleball-players/
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