Common Pickleball Injuries We Treat

Pickleball has become one of the most popular recreational sports in Henderson, and for good reason. It is accessible, social, competitive without being brutal, and a genuinely good workout. The courts at Acacia Park and across the valley are packed on most mornings.

Henderson has become one of the best cities in the country for pickleball. There are now over 17 locations and 140 courts across the city, ranging from free public parks to dedicated indoor facilities like The Picklr on Horizon Ridge Parkway and Dill Dinkers on West Warm Springs Road. For a city that hits 110 degrees in the summer, the growth of indoor courts has been a big part of why the sport keeps growing year round here. Players are not waiting for cooler weather. They are just moving inside.

But along with the growth in players has come a noticeable increase in pickleball-related injuries walking through our door. Some of them are acute. Many of them are overuse injuries that built up slowly and got ignored until they became hard to play through.

Here is a look at the injuries we see most often, why they happen, and what actually helps.

Why Pickleball Injuries Are Increasing

The sport attracts a lot of players who are returning to regular athletic activity after a gap of years or decades. The body is willing, but the tendons, rotator cuffs, and knees are not necessarily ready for the repetitive loading that comes with playing four or five times a week.

Pickleball also involves a lot of quick lateral movements, sudden stops, and overhead shots. That combination is demanding on joints that may already have some mileage on them. And because the game does not feel as intense as tennis or running, players tend to do more of it, more frequently, without the same attention to recovery.

Indoor play removes the heat variable but does not remove the injury risk. Hard court surfaces, whether it is the acrylic flooring at a dedicated facility or a gym floor, still place significant impact load on the knees, ankles, and hips. Players who switch from outdoor to indoor courts sometimes notice different aches because the surface hardness changes how force travels through the lower body.

The Most Common Pickleball Injuries We Treat

Rotator Cuff Irritation and Shoulder Pain

The overhead dink and the drive shot both put significant demand on the rotator cuff. When those muscles are not adequately conditioned, or when mechanics are slightly off, the tendons take the brunt of the load.

Rotator cuff irritation usually starts as mild soreness that players work through. Over time, it can develop into chronic tendinopathy or partial tears that require more significant intervention. Getting it evaluated early saves a lot of treatment time later.

One thing we see often is players who had a previous shoulder injury, sometimes years ago from a different sport, that was never fully rehabilitated. Pickleball's overhead demands bring that old weakness back to the surface quickly.

Pickleball Elbow (Lateral Epicondylitis)

Often called tennis elbow, this is one of the most common complaints we see in pickleball players. The repetitive forearm motion involved in the backhand stroke loads the tendons on the outside of the elbow, and over time that loading exceeds the tissue's ability to recover.

It tends to be a slow build. Players notice it after playing, then during playing, then all the time. By the time it is affecting grip strength and daily activities, it has usually been building for months. Active Release Technique and targeted rehabilitation tend to work well for this once the underlying mechanics are also addressed.

Paddle grip size is also worth checking. A grip that is too small or too large changes how force loads through the forearm during contact. It is a simple thing that gets overlooked, but adjusting grip size is sometimes part of what allows the tendon to finally settle down.

Knee Pain

The lateral cuts and quick direction changes in pickleball put real demand on the knee, particularly the medial collateral ligament and the patellofemoral joint. Players with previous knee injuries or some degree of arthritis often find that pickleball accelerates their symptoms.

Hip mechanics and foot mechanics both play a significant role in knee loading. A thorough evaluation of the knee that does not look at how the hip and ankle are contributing will often miss part of the picture.

Footwear matters more than most players realize. Court shoes designed for lateral movement distribute impact differently than running shoes. Players showing up to indoor courts in running shoes are putting their knees and ankles at higher risk on every direction change.

Achilles Tendon Issues

The quick push-off movements in pickleball load the Achilles significantly. Achilles tendinopathy typically starts as stiffness and soreness in the morning that loosens up during activity, then returns afterward. That pattern is easy to dismiss early on, but it tends to worsen if the tendon loading is not reduced and the tissue is not given a chance to adapt.

In Henderson's summer heat, dehydration adds to this risk by reducing the pliability of the connective tissue around the Achilles. Players who are not replacing fluids and electrolytes adequately during outdoor play are dealing with a less resilient tendon from the start.

Even indoors, Achilles problems tend to develop gradually in players who ramp up their court time too quickly. A common pattern is someone who picks up pickleball, loves it, and goes from zero to playing five days a week in a month. The tendon does not have time to adapt to that load increase, and it lets you know.

Low Back Pain and Sciatica Flare-Ups

The bent-knee, forward-leaning ready position in pickleball places sustained demand on the lumbar extensors. Combined with rotational movements in the swing, this can aggravate existing low back conditions or trigger new ones.

For players who already deal with sciatica, the combination of prolonged spine loading and repetitive movement can cause significant flare-ups. These often do not respond well to rest alone. Understanding what is mechanically driving the sciatica, whether it is a disc issue, a piriformis problem, or something else, determines what kind of care will actually help.

Common Mistakes Pickleball Players Make

Playing through pain because it is not bad enough to stop yet
Skipping warm-up because there is not enough time before the court opens
Increasing playing frequency without increasing recovery time
Not replacing fluids and electrolytes during outdoor summer play in Nevada
Assuming pain will resolve on its own if they just rest for a week
Waiting months before getting an evaluation because it does not feel serious enough
Wearing running shoes instead of court shoes designed for lateral movement
Jumping from occasional play to daily sessions without giving the body time to adapt

What Actually Helps

Most pickleball injuries respond well to care when they are evaluated properly and treated early. Active Release Technique works particularly well for the tendon and soft tissue issues common in this sport. Chiropractic care addresses the spinal and joint mechanics that contribute to shoulder, back, and lower extremity problems. Targeted rehabilitation builds the strength and movement patterns that protect the tissue during play.

What does not help is waiting. Overuse injuries that get six months of play on top of them are significantly harder to address than the same injuries caught early.

If something has been bothering you and you keep hoping it will go away on its own, it probably will not. But it also does not have to sideline you for long if you get it looked at sooner rather than later.

Our team at Agape Health in Henderson works with a lot of pickleball players across the valley. We do thorough evaluations, not quick looks, and we build care plans around getting you back on the court as efficiently as possible. Call us at 702-410-5354 or come by 2790 W Horizon Ridge Pkwy, Suite 110.