In recent years, pickleball has transformed from a niche pastime into a national phenomenon. Touted for its accessibility, social appeal, and physical benefits, the sport has rapidly grown across all age groups and skill levels. But as more Americans take up paddles, a new concern is emerging—injury.
A recent nationwide study has cast fresh light on the physical cost of this otherwise joyful game. Conducted by a team of researchers across multiple institutions, this is the most comprehensive study to date examining injury patterns and risk factors among adult pickleball players in the United States. The findings, published in Sports Medicine – Open, are eye-opening. Nearly 7 in 10 players surveyed reported at least one injury in the past year. Among those, a significant portion experienced injuries severe enough to stop them from playing altogether, while others continued through persistent pain.
For those who play regularly—two to three times per week—these findings offer more than abstract data. They provide a practical blueprint for staying healthy and on the court.
The Scope and Method: Looking Beyond Emergency Rooms
The study surveyed 1,758 pickleball players across the country, all over the age of 18, who played at least once a month. Participants ranged widely in age, from their 30s into their 90s, though the average age was 63. Unlike prior studies that relied largely on hospital or emergency department data, this research used a broader, self-reported model that captured what the authors termed “all-complaint injuries.” This included both acute, time-loss injuries—those that caused players to stop playing—and ongoing, non-time-loss injuries such as chronic pain, soreness, or strain.
By adopting this more inclusive approach, the study was able to assess not only the frequency and type of injuries, but also subtle warning signs that might otherwise go unreported. The goal was to better understand the full spectrum of physical complaints that pickleball imposes—not just the catastrophic ones.
A Startling Prevalence of Pain
The study found that 68.5 percent of participants reported at least one injury in the past 12 months. Over 40 percent experienced an injury serious enough to stop them from playing for at least a day. Even more striking, over one-third reported current, ongoing pain associated with playing.
This should give pause to the casual assumption that pickleball is inherently “low impact.” While the sport is often described as gentler than tennis, it still requires frequent pivoting, lateral movement, quick acceleration and deceleration, and repetitive use of the shoulders, knees, and hips—all of which contribute to a cumulative burden on the body.
The most common injury site was the knee (29.1 percent), followed by the lower legs and feet (26.9 percent), shoulders (22.2 percent), back (19.9 percent), and elbows (18.4 percent). Injuries ranged from overuse conditions and chronic joint pain to ligament sprains and muscle strains. Fractures and concussions were rare but present, particularly among older female players.
Predicting Who Gets Hurt—and Why
In examining what separates injured players from those who remain relatively pain-free, the study identified several statistically significant predictors.
One of the most consistent factors was experience. Players with fewer than five years of regular play were 50 percent more likely to report injuries than those with more experience. This may reflect differences in movement efficiency, familiarity with court positioning, or conditioning.
Playing frequency also played a notable role. Those who played three or more times per week were 45 percent more likely to experience injuries than those who played less often. Interestingly, the elevated risk associated with frequent play appeared to be moderated by experience; more seasoned players seemed to handle higher volumes of play with fewer injuries.
Sex was another predictor. Men were 33 percent more likely to report injuries than women—a finding that may speak to differences in play intensity, risk tolerance, or biomechanics. Age also influenced risk: players aged 33 to 77 were significantly more likely to report injuries than the youngest cohort (18–32). However, those over 77 showed no increased risk, suggesting a self-selecting, possibly more cautious playing style among older adults.
But perhaps the most revealing finding was psychological: players who downplayed the importance of injury prevention were more than twice as likely to be injured. This may seem intuitive, but it quantifies a mindset that is often overlooked. Players who believed prevention was important—and likely took steps such as warming up or cross-training—experienced fewer injuries regardless of their age or skill level.
Lessons for the Regular Player
For the average pickleball enthusiast, these findings suggest a clear path forward. Injury is not inevitable, but it is common—and largely preventable.
The first and most actionable takeaway is to treat warm-ups and injury prevention routines not as optional, but as foundational. This may include mobility work, light cardiovascular activity before play, and strength training for the knees, hips, and core between sessions.
Second, players—especially newer ones—should be cautious about ramping up their playing frequency too quickly. The sport may feel deceptively low-stress compared to tennis or squash, but its movement demands are distinct and should be respected.
Third, players who are experiencing pain—particularly in common hotspots like the knees or shoulders—should not dismiss it. Many injuries identified in the study were chronic or overuse-related, which can worsen without intervention. Taking time to rest, cross-train, or seek physical therapy early may prevent a more serious injury later.
Finally, players should be encouraged to develop what the researchers called an “injury-conscious mindset.” Recognizing the real physical demands of the sport and planning accordingly—through gear choices, warm-ups, and recovery—can help prolong both playing time and enjoyment.
Looking Ahead
While this study does have limitations—its sample skewed older and lacked racial diversity—it offers a critical starting point for understanding the physical demands of a rapidly growing sport. With nearly 50 million Americans estimated to have played pickleball last year, the need for evidence-based injury prevention is no longer niche.
The researchers suggest that future efforts should focus on developing and testing warm-up routines, recovery protocols, and player education materials tailored specifically to pickleball. In the meantime, players themselves would do well to adopt a slightly more deliberate approach to the game—not one that dampens the joy of play, but one that acknowledges the realities of aging joints and accumulated strain.
Pickleball may be fun, social, and addictive. But it is also athletic. Respecting that reality is the first step toward making sure we can all play—not just next week, but for years to come.
The Hidden Toll of Pickleball: What a Landmark Study Reveals About Injury Risk
For a sport known for its accessibility, pickleball demands more from the body than many players realize. Yes, it’s less punishing than tennis in certain ways. But between the quick pivots, frequent squats, sudden bursts of speed, and overhead shots, it’s a full-body workout with real biomechanical stress.
And the injuries are starting to catch up.
A new nationwide study—the largest ever of its kind—offers the clearest picture yet of the physical toll pickleball is taking on its rapidly growing player base. Conducted by a team of researchers and published in Sports Medicine – Open, the study surveyed nearly 1,800 adult players from across the United States. What it found may resonate with anyone who’s had to ice their knee after a morning at the courts: injury is not the exception. It’s the rule.
Nearly 70% of players reported some form of injury over the past year. More than one in three had pain they were actively playing through. And for the 40% who sustained injuries serious enough to stop playing, the implications go beyond missed games—they speak to how we prepare, recover, and think about long-term health in a sport that’s often labeled “low impact.”
This research offers insight, but also a warning: the way we play needs to evolve, especially as more adults take up the sport later in life.
A More Complete Injury Picture
What makes this study significant isn’t just its scale—it’s how the researchers defined injury. Prior data has relied heavily on emergency department visits, capturing serious falls and acute trauma. That approach, while useful, misses the less dramatic but far more common complaints: tendon irritation, chronic soreness, low-grade strains, and joint pain that builds over time.
This study took a broader view. It asked players not just about major injuries, but about any physical issue related to playing: pain, discomfort, or limitation, whether or not it required medical care or time off.
That distinction matters. Of the 1,758 surveyed players:
- 68.5% reported at least one injury over the past year
- 40.8% had an injury that caused them to stop playing temporarily
- 35.9% were experiencing ongoing pain when surveyed
In short: injury, in some form, is part of the experience for most players.
Where It Hurts—and Why
Knees topped the list of injured areas, with nearly 30% of players reporting knee-related issues. This was followed closely by injuries in the lower legs and feet, shoulders, back, and elbows. These align with the sport’s core movement patterns: fast lateral movement, lunges, overhead swings, and the kind of stop-start activity that stresses both joints and connective tissue.
The most common injury types were:
- Overuse or chronic conditions (35.3%)
- Joint sprains (23.8%)
- Muscle strains or pulls (20.7%)
Fractures, concussions, and dislocations were rare but not absent. Notably, women were more likely to report fractures; men more frequently reported muscle strains.
Many of these injuries—especially overuse conditions—don’t happen all at once. They develop over time. Which is part of the problem: they’re easier to ignore, and harder to resolve once they become chronic.
Risk Factors: Who’s Most Vulnerable?
One of the study’s strengths is that it didn’t stop at injury counts. It also examined what makes some players more likely to get hurt than others. Several key patterns emerged:
- Newer players (under 5 years of experience) were 50% more likely to report injury than experienced ones.
- Frequent players (3+ times per week) were 45% more likely to get injured than those playing twice a week or less.
- Men were 33% more likely to report injuries than women.
- Players aged 33–77 had significantly higher injury odds than younger adults.
- And notably, players who did not view injury prevention as important were more than twice as likely to be injured.
That last point may be the most actionable. A player’s mindset—whether they take steps to warm up, recover, and strengthen—is not just a reflection of personality. It appears to be predictive of whether they’ll end up sidelined.
Playing Through Pain: A Cultural Shift Needed?
One of the more sobering statistics from the study was that over one-third of players reported current, ongoing pain. And many of them were still playing.
This isn’t just a matter of toughness or stubbornness. It reflects a gap in awareness. Pickleball is often treated as “safe enough,” particularly compared to high-impact sports. But that perception can lead players—especially older adults—to skip warm-ups, downplay aches, or treat soreness as a normal part of the game.
Over time, those choices accumulate. What begins as manageable discomfort becomes a persistent injury. The sport may not look intense on the surface, but it demands rotational torque, sudden deceleration, and muscular endurance in ways that challenge even conditioned bodies.
What This Means for Players
The takeaway isn’t that pickleball is inherently dangerous. On the contrary, it remains one of the most accessible and socially engaging forms of physical activity available to adults. But accessibility should not be confused with immunity.
If you play two or more times per week—especially if you’re over 40—this study offers several practical insights:
- Warm up deliberately. Light cardio and mobility work before play can reduce strain on joints and muscles.
- Respect recovery. Playing every day without rest increases the risk of overuse injury, particularly for newer or older players.
- Strengthen supporting muscle groups. Target the hips, core, and shoulders to build stability and reduce joint stress.
- Treat early symptoms seriously. Don’t wait until pain limits movement. Most overuse injuries can be managed—if caught early.
- Reframe how you view prevention. A short pre-game routine and awareness of load management may do more for your longevity than any paddle upgrade.
The Bigger Picture
As pickleball continues to grow—especially among middle-aged and older adults—it’s entering a new phase. The sport is no longer just a hobby; for many, it’s become a primary mode of exercise, competition, and community.
This shift calls for a more serious conversation about how we prepare to play. Injury prevention doesn’t mean turning every rec match into a training session. But it does mean recognizing that the sport places real demands on the body—and those demands deserve thoughtful preparation.
In a culture that celebrates play, we should also make space for sustainability. Longevity in pickleball isn’t just about staying active—it’s about staying healthy enough to keep showing up, week after week, game after game.
Read the whole study here…
