Pickleball Injuries: Most Common Types, How They Happen and Early Warning Signs

Pickleball looks deceptively gentle.

The court is smaller than tennis. The paddle is lighter. The rallies are fast, social and addictive. And yet, in my clinic, pickleball has quietly become one of the most common causes of overuse injuries I see. The elbow, forearm, shoulder and lower limb are particularly affected.

Many people are surprised that a sport which feels so easy can lead to persistent pain. What most don’t realise is that pickleball places repetitive, specific loads on the same tissues. These injuries rarely start suddenly. They begin quietly, as tightness, fatigue or a dull ache that is easy to dismiss.

Recent coverage from CBC News highlights that as pickleball’s popularity surges, so too are injuries related to the sport. Health professionals and studies are reporting a noticeable rise in pickleball-related injuries presenting to clinics and emergency departments, especially in communities where the sport has exploded in participation. Common complaints include knee, shoulder, wrist and eye injuries, often linked to repetitive movements, sudden changes in direction and increased play time. Experts attribute the rise in injuries to more players taking up the sport, including older adults and people new to regular physical activity, and warn that injuries can sometimes be serious, requiring extended recovery or even surgery in severe cases. You can read the full article here.    

Watch the YouTube video below to learn from medical experts about the most common injuries in pickleball and how to prevent them.

Here’s a clear overview of the most common pickleball injuries, how they develop, and the early signs you shouldn’t ignore. This information is important for players who want to prevent long-term damage and continue enjoying the sport safely.

Injury	How the injury develops	Typical symptoms	What often happens if ignored
Tennis elbow (lateral epicondylalgia)	Repetitive gripping of the paddle, sustained wrist extension during backhand shots, limited forearm load tolerance.	Outer elbow pain, forearm tightness, aching after play, weak grip.	Pain becomes persistent and interferes with daily tasks; recovery can take months.
Golfer’s elbow (medial epicondylalgia)	Repeated forehand shots, overgripping, sudden increases in play volume.	Inner elbow pain, pulling or burning sensation through the forearm.	Chronic tendon irritation and ongoing loss of strength.
Forearm muscle overload or strain	Repetitive wrist and finger movements without adequate recovery.	Tightness, fatigue, aching or burning sensation	Compensation into wrist or elbow pain.
Rotator cuff tendinopathy	Repeated overhead shots, shoulder fatigue, reduced stability.	Shoulder pain lifting the arm, weakness, night discomfort.	Progressive loss of function and persistent shoulder pain.
Shoulder impingement	Poor shoulder control with overhead or reaching movements.	Pinching pain, reduced range, discomfort after games.	Increasing stiffness and pain with daily activities.
Wrist tendinitis	Rapid paddle flicking, repetitive wrist motion.	Wrist pain, stiffness, swelling.	Difficulty gripping and using the hand day to day.
Achilles tendinopathy	Sudden acceleration and stopping, repeated court movements.	Heel or lower calf pain, morning stiffness.	Thickened, painful tendon with prolonged recovery.
Plantar fasciitis	Repetitive foot impact, inadequate footwear support.	Heel pain, especially with first steps in the morning.	Ongoing foot pain affecting walking and sport.
Knee strain or meniscal irritation	Lunging, twisting and sudden changes of direction.	Knee pain, swelling, instability.	Reduced confidence and altered movement patterns.
Lower back strain	Repeated rotation, fatigue, limited hip mobility.	Back tightness, stiffness, pain after play.	Recurring flare ups and reduced tolerance to activity.

I want to share a real example. This is exactly what one of my clients, Peter, wrote about his experience. I’ve left it just as he wrote it because his story speaks for itself:

"1/10/25 - I was playing pickleball, and the pain in my right arm and elbow became progressively worse, forcing me to discontinue. Back at the village while attempting to play lawn bowls, I tried to pick up a lawn bowl from the top with a grasp and a really sharp pain shot up my forearm, Pete has just got himself a dreaded tennis elbow.

2/10/25 - I had a prior organised appointment with Lena (my regular Myotherapist) at Inner Outer Health. Once I described my arm condition to her, we decided to concentrate on that for this appointment. It was 40 minutes of gritted teeth as Lena deep massaged her magic into the tissue of my right forearm. With that done, I organised a repeat appointment for a week hence. I left Lena armed with exercise and stretching instructions specific to the condition; these I did religiously and, of course, NO PICKLEBALL.

8/10/25 - Second appointment with Lena, similar process as for the first, another 40 mins of gritted teeth; the difference was that this time I could feel some of the "anger" in my arm dissipate significantly. Instructions were to continue with exercises without pushing it too hard. More confident, we made the next appointment for two weeks hence and NO PICKLEBALL.

23/10/25 - Third appointment, arrived at Inner Outer Health much more confident. The improvement in my arm at three weeks out was pretty amazing. I'd heard of people with tennis elbow taking months to rectify, with some people resorting to cortisone injections. Here I was at three weeks, say, 70%. Another 40 minutes of arm specific work, much less painful, and at the end, I felt the improvement. Now it was for me to continue with the exercises, upping the intensity but not by too much too fast as to reaggravate. Now it was up to me, but resumption of pickleball was to be done gradually and when NO pain was experienced.

23/10/25 - 11/11/25 - I continued with exercises gradually, upping the weights and introducing some variations. Virtually no pain now.

12/11/25 - My return to pickleball. I eased into it, and after two or three sets with absolutely no pain, I became a little more confident that it was really fixed.

19/11/25 - Played pickleball pretty well continuously for almost two hours, absolutely no problems. Thank you, Lena. So, from the onset of severe "tennis Elbow" while playing pickleball to resumption of pickleball was 6 weeks, I believe that timeframe was pretty amazing.

Conclusion, targeted specialist myotherapy from Lena very early in the saga, a regime of stretching and exercises specific to the forearm and a discontinuance of the activity that kicked it off allowed me to resume the sport that I have come to enjoy much sooner than I thought possible.
I still do the stretches and exercises daily to ensure that my arm stays in good shape.

Thank you, Peter Perryman, for taking the time to share his experience so thoughtfully. It shows clearly that early, targeted myotherapy can dramatically shorten recovery and prevent a small issue from becoming a long-term problem.

Most pickleball injuries are not sudden or dramatic. They are load related tissue irritations that worsen when the body is repeatedly asked to do the same thing without enough support or recovery.

When these issues are addressed early, tissues settle faster, strength and tolerance return more easily, and time away from the sport is often minimal. When ignored, pain lingers, compensation patterns develop, and recovery becomes longer and more frustrating.

Pickleball should support your health, confidence and enjoyment, not quietly wear your body down. If you notice pain, tightness or recurring discomfort, even if it feels minor, that is a sign to get it checked. Early intervention can make the difference between a short interruption and a long term issue, helping you stay active, move well, and continue enjoying the sport you love.

If you’re experiencing pain, stiffness, or an injury from pickleball, or you’d simply like guidance to prevent one, I’d love to help.

You’re welcome to reach out or book online a myotherapy session to get personalised support, so you can get back on the court feeling confident, strong, and pain-free.