Pickleball Injuries: What Every New Player Over 50 Needs to Know (and How to Avoid the Six Most Common Ones)

The sport that exploded — and the injuries that followed

Pickleball has gone from a niche American sport to the fastest-growing recreational sport in Australia in three years. Cabramatta, Liverpool, Fairfield and surrounding suburbs have new courts springing up at community centres and tennis clubs every few months. The good news: it's social, it's accessible, it's low-skill-floor, and it gets people moving. The not-so-good news: in our clinic and in physio clinics across Sydney, the pickleball injury list is the fastest-growing referral source for over-50s. Most of these injuries are preventable.

Why the injury profile is what it is

Pickleball injuries cluster heavily in the over-50 demographic for three reasons:

• The player demographic skews 50+ — many people are returning to sport after a decade or two off.
• The court is small (13.4m × 6.1m), which means lots of rapid stop-starts and lateral cuts in a small space — much more directional change per minute than tennis.
• The paddle is lighter than a tennis racquet, which encourages a tight grip and wrist-dominant strokes, both of which contribute to elbow and wrist problems.

You don't get injured because pickleball is dangerous; you get injured because the gap between 'fitness for everyday life' and 'fitness for stop-start court sport' is wider than people realise.

The six injuries we see most

1. Lateral ankle sprains

The number-one acute injury. Side step, plant the foot on the edge, roll the ankle. Most are Grade I–II and respond to early loading, balance retraining and a 2–4 week progressive return to play — but recurrent sprains are the real problem when people don't rehab the first one. If you've sprained an ankle and it 'never feels the same,' you have functional ankle instability and you'll sprain it again.

2. Calf strains ('tennis leg')

Identical mechanism to tennis — push-off on the back leg with the knee extended and the ankle dorsiflexed, ping. See our dedicated calf strain post for the full rehab plan. Heavy calf raises twice a week, year-round, prevent the majority of these.

3. Pickleball elbow (lateral epicondylitis)

Same condition as tennis elbow, slightly different mechanism. The paddle's small grip combined with wrist-dominant strokes overloads the common extensor origin at the lateral elbow. People play through pain for months, then come in unable to lift a kettle. See our tennis and golfer's elbow guide for the rehab timeline.

4. Achilles tendinopathy and ruptures

Achilles tendinopathy creeps up — morning stiffness, tightness when you stand up after sitting, eventually pain during pickleball. Achilles ruptures are less common but high-impact: the classic story is a 55-year-old male returning to sport, pushing off from the kitchen line, hearing a 'pop' and unable to walk. See our Achilles rupture post — early surgical opinion within 14 days matters.

5. Rotator cuff and shoulder overload

Overhead smashes and serve mechanics load the rotator cuff. Players over 50 often have pre-existing tendinopathy or subacromial irritation that pickleball exposes. Pain develops over weeks, sleep is disrupted, the smash gets weaker. See our rotator cuff and shoulder impingement post.

6. Lower back pain

Repeated reaching for low dinks and volleys in the 'kitchen' (the no-volley zone) puts the lumbar spine in flexion-with-rotation, which over time irritates discs and facets. Players with a history of low back trouble feel this within a couple of months. See our lower back pain guide.

The 'pre-pickleball' prep plan

If you're starting pickleball and you've been mostly sedentary or just walking, do two weeks of preparation before your first session:

• Calf raises — single leg, 3 sets of 10–15, every second day. Add weight when easy.
• Ankle balance work — single-leg stand, eyes closed, 3 × 30 seconds each leg.
• Hip mobility — lunges, 90/90 hip rotations, side lunges.
• Grip and forearm work — wrist curls, towel wrings, dead hangs from a bar.
• Rotator cuff prep — external rotation with a band, 3 × 12.
• A 10-minute brisk walk and a few short accelerations three times in the week before your first session.

On the day: the 8-minute warm-up

• 2 min easy movement — walk around the court, light skipping.
• 3 min dynamic — leg swings, side lunges, calf raises, arm circles, gentle trunk rotation.
• 2 min progressive paddle — dinks, then short rallies, gradually adding pace.
• 1 min lateral movement — side shuffles, short stops and starts.

This isn't fancy. Most injuries happen in the first 15 minutes of play when the body isn't warm. Eight minutes prevents most of them.

Gear matters

• Court shoes — tennis or volleyball court shoes, not runners. Lateral support is what protects your ankle.
• Paddle grip — slightly larger grip reduces forearm strain. Wrap or replace the grip if it's slippery.
• Eye protection — pickleballs at the kitchen line move fast. Protective eyewear is worth considering.

When pain becomes injury

• Pain that gets worse during a session, not better.
• Morning stiffness lasting more than 10 minutes after pickleball days.
• Any 'pop' or sudden pain during play.
• Symptoms that persist beyond 7–10 days of relative rest.

That's the point to see a physio — not after three months of playing through it.

Book a pickleball-ready assessment

We run individual screening sessions for new and returning pickleball players — calf and ankle capacity, shoulder and grip baseline, technique review for the common pain drivers. Walk in once, get a 4-week plan to be court-ready. Book at Evolve Physio & Mastery, Cabramatta. We see players from across Liverpool, Fairfield, Bankstown, Canley Heights and Southwest Sydney.

References: USA Pickleball Association injury surveillance 2023; Forrester 2020 'Epidemiology of pickleball-related injuries' (Injury Epidemiology); Greiner 2024 emerging injury patterns in masters racquet sports.