Managing Shoulder Injuries in Pickleball

As the Medical Director for Major League Pickleball, Joshua Dines, MD, an orthopedic surgeon and sports medicine specialist at Hospital for Special Surgery, has seen the gamut of injuries that befall competitors at the top tier of what has become the nation’s fastest-growing sport.

The good news for those interested in taking to the court is that pickleball is relatively safe, even for the complete novice who doesn’t know a flabjack from a falafel. Indeed, the simplicity is the point – and a major part of the emerging sport’s appeal. 

“One of the things that’s great about pickleball is that if you’re the least bit athletic and you want to play, there's no reason you can’t,” says Dr. Dines. “I’d estimate that 75 percent of the world could have fun playing together. It’s not like tennis, where if someone’s much better than their opponent the game’s not fun for either person.”

A Lot of Pickleball Leads to a Lot of Overuse Injury 

Pickleball is so easy to play and so socially rewarding that people often find themselves on the court for hours at a time, several days a week, Dr. Dines says. 

The downside? That’s a recipe for overuse injuries. “We see a lot of biceps and rotator cuff tendonitis, particularly in people who haven’t been very active or who used to be active but haven’t played racket sports for years,” Dr. Dines says. In this common condition, the tendons—thick bands of rope-like tissue that attach bone to muscle—become inflamed and cause pain in the joint.  

As a result, the overwhelming number of pickleball problems Dr. Dines treats fall into the category of overuse injuries – shoulders and elbows that are hollering in pain from being worked too long. At the root of these aches is demographic truth: Most people who play pickleball have come to the sport after years of relative inactivity. Many also have no experience with racket sports.

The good news is that for overuse injuries, a short break from the action – along with judicious use of non-steroidal anti-inflammatory drugs, acetaminophen, and icing – is usually enough to get people back on the court. 

Other Types of Pickleball Injuries 

More serious injuries do occur, however, particularly among older participants in the sport. Again, the ease of the game often is to blame, Dr. Dines says, tempting players to push themselves too hard on the court. 

“There are a lot of drop shots, lobs and other movements that can be challenging for people who aren’t used to that kind of thing,” he says. “So we see a lot of people who trip and fall landing on their shoulder and tear the muscles in the joint, as well as other potentially more severe injuries.” 

Although the popularity of pickleball has increased among pretty much all age groups, Dr. Dines says he isn’t seeing a rash of injuries in the younger set. Meanwhile, if you’re thinking of taking up pickleball and want to reduce your risk of injuries (of all kinds), consider a little prehab. “The overwhelming majority of people should be able to play pickleball with no problem if they get better prepared for the sport,” he says. “Do some exercises to stabilize the shoulders and strengthen the rotator cuffs. And remember, it’s not like walking or jogging on a treadmill. It’s a more demanding experience when it comes to balance.”

At the end of the game, Dr. Dines says, the rising popularity of pickleball “is a great thing, as it is keeping people of all age groups active, competing and socializing.”