Pickleball has become one of the fastest-growing sports in Canada. From beginners looking for a fun way to stay active to experienced athletes competing several times each week, more people than ever are stepping onto the court. Its combination of tennis, badminton, and table tennis makes it enjoyable for players of all ages, especially adults seeking a lower-impact alternative to tennis.
Although pickleball is considered easier on the body than many sports, injuries are becoming increasingly common. Quick lateral movements, sudden acceleration, abrupt stops, lunging for the ball, and repetitive overhead swings place significant stress on muscles, tendons, ligaments, and joints. Many injuries occur because players underestimate the physical demands of the game or return to play before fully recovering from a previous injury.
At Active Care Health in Thornhill, our physiotherapists and chiropractors regularly treat pickleball-related injuries. Whether you have developed Achilles tendon pain after several matches, strained your calf chasing a drop shot, or are dealing with persistent shoulder or elbow pain, early assessment and personalized treatment can help you recover safely while reducing your risk of reinjury.
Why Are Pickleball Injuries Becoming More Common?
The popularity of pickleball has exploded over the past few years, bringing many first-time players onto the court. While the sport appears gentle compared to tennis, it involves frequent explosive movements that can surprise players who have not conditioned their bodies for these demands.
Several factors increase the likelihood of injury:
- Limited warm-up before playing
- Tight calf and hamstring muscles
- Poor ankle mobility
- Weak hip and core muscles
- Previous sports injuries
- Playing multiple games without adequate rest
- Improper footwear
- Overuse from playing several days per week
Many recreational players participate in long tournaments or several matches in one day, placing repeated stress on tendons that may already be fatigued.
Achilles Tendon Pain from Pickleball
One of the most common injuries we see is Achilles tendon pain.
The Achilles tendon connects your calf muscles to your heel bone and generates the powerful push-off required for running, jumping, lunging, and changing direction. During pickleball, this tendon repeatedly absorbs high loads every time you sprint toward the kitchen line or quickly move sideways.
Symptoms
Common symptoms include:
- Pain just above the heel
- Morning stiffness
- Tenderness when touching the tendon
- Pain during the first few steps
- Swelling around the tendon
- Difficulty pushing off while running
Ignoring early symptoms often allows tendon irritation to progress into chronic tendinopathy that may require months of rehabilitation.
How Physiotherapy Helps
A physiotherapist identifies the source of tendon overload and develops a structured rehabilitation program that typically includes:
- Progressive strengthening exercises
- Eccentric calf loading
- Balance training
- Foot and ankle mobility exercises
- Walking and running progression
- Activity modification
Early treatment often shortens recovery time and helps prevent tendon rupture.
Achilles Tendon Rupture
An Achilles rupture is one of the most serious pickleball injuries.
Players often describe feeling as though someone kicked them in the back of the leg, followed by a popping sensation and immediate difficulty walking.
Signs include:
- Sudden sharp pain
- Audible pop
- Difficulty standing on toes
- Weakness pushing off
- Swelling
- Bruising
This injury requires immediate medical assessment. Some patients require surgery, while others may recover successfully with conservative treatment depending on the severity of the rupture.
Physiotherapy plays an essential role throughout recovery by restoring strength, flexibility, balance, and confidence before returning to sport.
Calf Strains and Muscle Tears
Calf strains frequently occur during sudden acceleration or when lunging forward for a low shot.
The calf muscles absorb large forces throughout every match. Tight muscles, fatigue, dehydration, and inadequate warm-up all increase injury risk.
Symptoms include:
- Sudden pulling sensation
- Sharp pain in the calf
- Swelling
- Bruising
- Difficulty walking
- Pain when pushing off
Minor strains may recover within several weeks, while larger tears require considerably longer rehabilitation.
Treatment may include:
- Early pain management
- Manual therapy
- Progressive strengthening
- Stretching
- Dry needling when appropriate
- Functional movement retraining
- Return-to-sport testing
Proper rehabilitation significantly reduces the chance of another calf injury.
Pickleball Elbow (Lateral Epicondylitis)
Although commonly called tennis elbow, this condition is increasingly affecting pickleball players.
Repeated gripping and backhand shots overload the wrist extensor tendons where they attach near the outside of the elbow.
Symptoms include:
- Pain on the outside of the elbow
- Weak grip strength
- Pain lifting objects
- Difficulty opening jars
- Increased pain after playing
Many players continue competing despite symptoms, allowing the condition to become chronic.
Physiotherapy treatment focuses on:
- Tendon loading exercises
- Grip strengthening
- Manual therapy
- Soft tissue treatment
- Activity modification
- Paddle grip assessment
Most patients improve without injections or surgery when treatment begins early.
Shoulder Injuries in Pickleball
The shoulder performs thousands of repetitive swings during pickleball.
Overhead serves, smashes, and repetitive forehand strokes can overload the rotator cuff muscles responsible for stabilizing the shoulder joint.
Common shoulder injuries include:
- Rotator cuff tendinopathy
- Shoulder impingement
- Biceps tendon irritation
- Shoulder bursitis
- Muscle strains
Symptoms
Players often report:
- Pain reaching overhead
- Night pain
- Weakness
- Clicking sensations
- Difficulty serving
- Pain during follow-through
Physiotherapy helps restore:
- Shoulder mobility
- Rotator cuff strength
- Scapular stability
- Postural control
- Sport-specific mechanics
Many shoulder injuries respond extremely well to conservative treatment when addressed early.
Wrist Injuries
Falls are one of the leading causes of pickleball injuries.
When players lose balance, they naturally extend an arm to break the fall, placing large forces through the wrist.
Other wrist injuries result from repetitive paddle use.
Common problems include:
- Wrist sprains
- Tendon irritation
- Joint inflammation
- Ligament injuries
- Fractures after falls
Persistent wrist pain should never be ignored because untreated ligament injuries may cause long-term instability.
Knee Pain After Playing Pickleball
The knee experiences repetitive twisting, pivoting, squatting, and rapid changes of direction throughout every match.
Common conditions include:
- Patellofemoral pain syndrome
- Meniscus irritation
- MCL sprains
- Quadriceps tendon irritation
- Osteoarthritis flare-ups
Players often notice:
- Pain climbing stairs
- Swelling
- Clicking
- Stiffness after games
- Difficulty squatting
Physiotherapy focuses on improving lower-body strength, movement mechanics, balance, and flexibility to reduce stress on the knee.
