Pickleball: Preventing Shoulder and Elbow Injuries

Pickleball is a rapidly growing sport known for its blend of tennis, badminton, and ping-pong. It has gained immense popularity in recent years and with it, a big uptick in musculoskeletal injuries that are being seen in orthopaedic surgery offices world-wide. As with any racquet sport, the shoulder and elbow are particularly susceptible areas to injury. In this blog post, we'll explore the common causes of shoulder and elbow injuries in pickleball and provide valuable tips to prevent these issues, ensuring a safe and enjoyable playing experience for enthusiasts of all levels.

Understanding the Risk:

The dynamic and repetitive nature of pickleball involves a combination of overhead shots, quick movements, and repetitive swinging motions. These movements can put stress on the shoulder and elbow joints, leading to overuse injuries. The fast pace of the game can lead to off balance movements and falls on a hard surface, resulting in contusions, fractures, dislocations, and muscle/tendon strains or ruptures.

Common Shoulder and Elbow Injuries:

  1. Rotator Cuff Strain: Overhead shots in pickleball can strain the rotator cuff muscles, leading to pain and limited range of motion. Falls onto outstretched arms can similarly strain or even cause full tears of the rotator cuff resulting in difficulty raising your arm (link to rotator cuff section understandortho.com)
  2. Tennis Elbow (Lateral Epicondylitis): The repetitive gripping and swinging motion of the paddle can lead to inflammation and pain on the outer part of the elbow at the origin of the common extensor tendons.  (link to tennis elbow section understandortho.com)
  3. Golfer's Elbow (Medial Epicondylitis): While less common, the inward swinging motion and repetitive gripping can also cause discomfort on the inner side of the elbow at the origin of the common flexor pronator tendons ( (link to golfers elbow section understandortho.com)
  4. Shoulder Impingement and Biceps Tendinitis: Overhead serves and smashes can result in shoulder impingement or irritation of the long head of the biceps, causing pain when raising the arm and with lifting.

Preventive Measures:

  1. Warm-up: Begin each session with a proper warm-up routine to increase blood flow and prepare your muscles for the activity.
  2. Strengthening Exercises: Incorporate shoulder and forearm strengthening exercises into your fitness regimen to build muscle support around these joints with particular emphasis on a TheraBand scapular stabilization and rotator cuff strengthening program.
  3. Proper Technique: Focus on using the correct technique and form to reduce strain on the shoulder and elbow during shots.
  4. Stretching: Engage in regular stretching to improve flexibility and reduce the risk of muscle imbalances.
  5. Paddle Selection: Choose a paddle with the right grip size and weight that suits your playing style and minimizes strain on your joints.
  6. Rest and Recovery: Allow sufficient time for recovery between matches and practice sessions to avoid overuse injuries. Hydrate well. Ice areas of discomfort after activity. 
  7. Cross-Training: Engage in cross-training activities that promote overall fitness and reduce the risk of overexertion in specific muscle groups.

Injury Management:

If you do experience discomfort or pain in the shoulder or elbow, it's crucial to address it promptly. Rest, ice, compression, and elevation (RICE) can provide relief and keep you out of Orthopaedic offices. If the pain persists, seeking medical attention and working with a physical therapist can help recover, rehabilitate, and keep you on the court.


Pickleball offers a fantastic way to stay active and have fun, but it's essential to be mindful of the potential for shoulder and elbow injuries. By incorporating proper warm-up routines, strengthening exercises, and maintaining good technique, you can significantly reduce the risk of these injuries. Remember that prevention is key to enjoying pickleball to the fullest while keeping your joints healthy and pain-free. Please feel free to reach out to my office (jasonskleinmd.com) if you have any questions or concerns or if you need an in-office consultation following injury.

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