Blog 1: Everything Pickleball
Part 1: Understanding Pickleball Injuries - Why Your Body is Breaking Down
Pickleball looks deceptively simple. The court is smaller, the pace seems manageable, and the ball moves slower than tennis. But don't let that fool you — pickleball creates a unique injury profile, especially for players in their 40s, 50s, and 60s who are returning to racket sports or adding it to their already active lives.
The problem isn't the sport itself. It's the mismatch between what your body is prepared to do and what pickleball demands. Follow along in this 3 part series SPECIFICALLY written for pickleball players by Dr. Keirstyn at Endurance Therapeutics!
The Unique Demands of Pickleball:
Explosive Lateral Movement on a Small Court:
Traditional racket sports require long rallies with predictable movement patterns. Pickleball is different:
- Constant directional changes on a compressed court
- Quick lateral shuffles requiring explosive ankle and hip stabilization
- Short bursts of power without the conditioning baseline for it
- A pace that feels manageable but demands precise footwork
The Deceptive Intensity:
Most pickleball players think they're playing a "low-impact" sport. In reality:
- Court positioning requires split-second lateral movements
- The net is only 7 feet away, demanding quick reactions
- Competitive play involves 20-30+ directional changes per game
- Recovery between points is short, not allowing full rest
The Achilles Tendon: The Biggest Problem:
Here's what makes pickleball unique for Achilles injuries: it demands explosive calf activation without the foundational strength most recreational players have.
Why Achilles Ruptures Happen in Pickleball:
Your Achilles tendon is responsible for:
- Propelling you forward and backward
- Controlling lateral weight shifts
- Absorbing impact from quick directional changes
- Decelerating your movement
You can imagine if a 50-year-old who hasn't done serious sports in 20 years suddenly plays pickleball 2-3x per week, their Achilles is being loaded in ways it hasn't experienced in decades. Especially if you add poor ankle mobility -- you've now created the perfect storm:
- Limited ankle dorsiflexion (your ankle doesn't bend forward enough)
- Calf muscles work overtime to compensate
- Achilles tendon bears excessive load
- One explosive push-off during a game creates forces the tendon can't handle
- Rupture happens
The scary part? Many ruptures occur without prior warning. You might feel a minor twinge or tightness, but it often doesn't progress to "tendinopathy" before rupturing. The tissue simply fails under sudden load.
Age Factor: Players 40-60 have naturally decreased collagen production and tissue elasticity. Combined with lower training volume, this creates vulnerability.
Knee Injuries: Strength and Mobility Gaps
Pickleball knee injuries come from multiple sources.
The Movement Demand:
Pickleball requires:
- Rapid deceleration (stopping quickly to position for next shot)
- Lateral cutting (moving side-to-side on a small court)
- Forward/backward shuttle movements
- Rotational forces through the knee during shooting
Why Weak Hips and Glutes Cause Knee Pain:
When your hip abductors and external rotators are weak:
1. Your femur (thigh bone) drifts inward during lateral movements
2. Your knee tracks inward instead of staying aligned
3. Forces distribute unevenly across the joint
4. Meniscus, cartilage, and ligaments take excessive stress
Most recreational pickleball players don't have the hip and glute strength for what the sport demands. They compensate by relying on their knees, which can lead to:
- Patellofemoral pain (pain in the front of knee)
- Medial knee pain (pain on the inside of knee)
- Meniscus irritation
- General knee instability
The Problem: You can feel fine for weeks, then one movement creates sharp pain. By then, the damage has been building.
Hip Injuries: The Forgotten Stabilizer
Hip injuries in pickleball often go unnoticed until they become serious.
Why Hips Fail in Pickleball:
Your hips generate the power for:
- Quick lateral movements
- Explosive pushing off the ground
- Deceleration during direction changes
- Rotational movements during shots
Weak hip stabilizers (glute medius, glute minimus) create:
- Hip flexor overuse and tightness
- Labral stress (the cartilage ring in your hip socket)
- Hip impingement (pinching sensation in the hip)
- Compensatory lower back pain
The Silent Issue: Hip weakness often doesn't produce obvious pain — instead, you notice decreased mobility, a feeling of instability, or pain that radiates to the knee or back. Many players don't connect these symptoms to hip weakness.
Shoulder Injuries: The Overhead Epidemic
Pickleball involves more overhead shots than most people realize. Serves, smashes, and defensive overhead strokes create repetitive rotator cuff stress.
The Overhead Mechanics:
When you hit an overhead shot:
- Your rotator cuff muscles (supraspinatus, infraspinatus, teres minor, subscapularis) stabilize your shoulder
- Your scapula (shoulder blade) must position correctly
- Your thoracic spine must rotate to transfer power
- Your arm accelerates rapidly then decelerates abruptly
Why Rotator Cuff Issues Develop:
1. Poor scapular positioning — your shoulder blade doesn't move smoothly, forcing your rotator cuff to work overtime
2. Limited thoracic rotation — your upper back can't rotate fully, forcing your shoulder to compensate
3. Repetitive overhead stress — playing 2-3x per week creates cumulative microtrauma
4. Lack of shoulder stability training — most recreational players never strengthen their rotator cuff
The Result: You develop impingement (pinching of the tendons), inflammation, or even small rotator cuff tears. Pain develops gradually, often during or after play, and persists.
Connection to Your Rotator Cuff Fix: This is exactly why the rotator cuff maintenance we discuss in detail is critical for pickleball players.
Ankle and Foot Issues: The Foundation Problem
Beyond Achilles ruptures, pickleball players deal with:
- Ankle sprains from lateral cutting
- Plantar fasciitis from repetitive pushing off the ground
- Foot pain from inadequate footwear or arch support
The Root Cause: Poor ankle mobility and weak foot intrinsic muscles limit your ability to control movement on the court.
Warning Signs You're Heading Toward Injury
Don't Ignore These:
- Achilles tightness that requires extra warmup each session
- Calf cramping or soreness that doesn't resolve with stretching
- Ankle stiffness in the morning
- Hip or glute soreness after playing
- Knee swelling or stiffness the day after play
- Shoulder pain with overhead shots
- Feeling "unstable" or "off balance" on the court
The Pattern: If you need 15+ minutes of warmup before feeling ready to play, something is wrong. Your body shouldn't require excessive preparation.
How Chiropractic Care with Dr. Keirstyn Helps Pickleball Players
We're Not Just Treating Pain — We're Preventing Ruptures and Tears
Initial Assessment at Endurance Therapeutics:
- Evaluate ankle mobility (critical for Achilles health)
- Assess hip strength, mobility and stability
- Check shoulder and scapular mechanics
- Identify movement compensations
- Restore joint mobility that's been lost
- Address soft tissue restrictions limiting movement
- Improve movement patterns before they cause injury
- Enhance performance and court positioning
Preventive Value:
Monthly check-ins during playing season catch issues early
Movement screening identifies weakness patterns before they become injuries
Education on proper warmup and conditioning prevents Achilles ruptures and joint damage
The Real Story:
Most pickleball injuries we see could have been prevented with proper conditioning, mobility work, and movement assessment. We can identify the weak links in your chain before they fail.
To learn more about what Dr. Keirstyn can provide to help you with any injuries or stay injury free reach out to us today or book online!
Next up is Blog 2 Everything Pickleball -- Building Your Pickleball Body -- Training for Court Performance.