Most pickleball injuries aren’t caused by a freak event. They’re caused by a belief.
A reasonable-sounding, widely shared belief that leads someone to train less, play more, or ignore something that was quietly getting worse. By the time the injury arrives, the decision that produced it was made weeks earlier.
Here are the eight we hear most, and what’s actually going on behind each one.
“It’s low impact. That’s why I picked it.”
Why people believe it: The court is small, the paddle is light, the ball is plastic, and everyone’s laughing.
What’s actually true: Pickleball involves repeated stops, starts, direction changes, lunges and overhead swings on a hard surface. That’s not low impact in any meaningful sense — it’s low continuous impact with frequent high-intensity bursts, which is a different thing entirely.
The injury data reflects it. National estimates of pickleball-related emergency department injuries rose from around 1,300 in 2014 to roughly 24,500 in 2023.
The reframe: Treat it as a sport requiring preparation, because it is one.
“I’ll get fit by playing.”
Why people believe it: It’s how most people approach recreational sport.
What’s actually true: Playing builds skill and cardiovascular fitness. It doesn’t build the specific tissue capacity the sport demands — calf and Achilles strength for push-offs, adductor strength for lunges, rotator cuff strength for overheads, and the leg strength and balance that stop a stumble becoming a fall.
Those come from strength training on the days you’re not playing.
The reframe: Play is the demand. Strength work is the preparation. Doing only the first is how tissue capacity ends up permanently behind what you’re asking of it.
“I only play doubles, so it’s not much running.”
Why people believe it: Doubles genuinely covers less ground than singles.
What’s actually true: Distance covered isn’t the risk. The risky elements are the sudden ones — the backpedal for a lob, the explosive first step, the lunge at the kitchen line. Doubles has all of them, plus one extra: less warning, because the ball arrives faster at the non-volley zone.
The reframe: Volume isn’t your main risk. Sudden loading is.
“The first game is my warm-up.”
Why people believe it: Court time is limited, people are waiting, and it feels efficient.
What’s actually true: The first game is when a cold calf meets a maximum-effort push-off. It’s also when a shoulder that hasn’t rotated all day performs its first overhead.
The reframe: Ten minutes. Easy movement, leg swings, lunges, arm circles, a few gradual accelerations, then dinking before points. It’s the highest return-on-time investment available in this sport, and almost nobody does it.
“I’ve been playing five days a week and I feel great.”
Why people believe it: They do feel great. That’s the problem.
What’s actually true: This is the single most common setup we see. Someone discovers pickleball, loves it, and goes from essentially no sport to four or five sessions a week within a month or two.
Cardiovascular fitness improves quickly. Tendons and bone adapt far more slowly. So there’s a window — typically several weeks to a few months in — where your enthusiasm and your lungs are well ahead of your Achilles, your plantar fascia, and your elbow.
That gap is where tendinopathies, plantar heel pain and stress injuries live.
The reframe: Build up. Two or three sessions a week initially, with rest days genuinely between them, adding volume gradually over months. Feeling good is not evidence that your tissues have caught up.
“It’s just a niggle. I’ll play through it.”
Why people believe it: It’s mild, it warms up during play, and stopping feels dramatic.
What’s actually true: Tendon problems in particular are notorious for warming up during activity and worsening afterwards and the following morning. That pattern is easy to misread as improvement.
Played through for weeks, a manageable irritation becomes a genuine tendinopathy — and tendinopathy is measured in months.
The reframe: Use the next-morning test. Play, then check in the following day. Back to baseline means the load was fine. Clearly worse means reduce it. That single habit prevents a large proportion of what we see.
“I used to play tennis, so I know what I’m doing.”
Why people believe it: Racquet skills genuinely do transfer.
What’s actually true: The skills transfer. The specific demands don’t map cleanly. The court is smaller, exchanges at the non-volley zone are faster and more reactive, and the movement pattern involves more short, sharp changes of direction with less running.
There’s also a common trap: former athletes tend to have the competitive instinct of their old sport with the current conditioning of their current life. That combination produces the reach that shouldn’t have been made.
The reframe: Treat it as a new sport with a shorter learning curve, not the same sport with different equipment.
“I’m too old to be doing strength training.”
Why people believe it: Decades of messaging suggesting older adults should stick to gentle activity.
What’s actually true: This has it backwards. The injury data shows older players account for the substantial majority of pickleball injuries — around 83% in one ten-year analysis — with falls the dominant mechanism and fractures roughly three times more likely than in younger players.
Strength and balance training are the interventions that address exactly that. Muscle mass and power decline with age when nothing is done about it, and that decline is what turns a stumble into a fall and a fall into a fracture.
The reframe: Strength training isn’t optional past 50 — it’s the thing that keeps you on the court. Two sessions a week covering legs, hips, calves and shoulders, progressed properly.
The One Nobody Says Out Loud
“I don’t want to look like I’m taking it too seriously.”
Warming up alone while others chat. Declining the fifth game. Letting a lob go. Doing calf raises at home. There’s a social cost to all of it in a sport whose culture is proudly casual.
It’s worth paying anyway. And in practice, one person warming up properly tends to make it normal within a few weeks.
Worth Getting Checked
Pain that persists more than two weeks despite backing off. Pain that’s worsening session to session. Anything that changes how you move. Swelling. A joint giving way or locking. Any fall onto an outstretched hand with wrist pain — wrist fractures are common here and frequently dismissed as a sprain.
Seek emergency care for chest pain or pressure, unusual breathlessness, dizziness or fainting during play, or a sudden pop with an inability to bear weight.
And a note on the cardiovascular side: the same national data recorded a small number of deaths from cardiac arrest during pickleball. The sport’s friendly reputation conceals real intensity. If you’re returning to activity after a long break or have cardiovascular risk factors, speak to your physician first.
The Common Thread
Every belief on this list leads to the same place: doing more of the sport and less of the preparation.
The players who are still playing in a decade aren’t the ones who were most careful on court. They’re the ones who built the strength, balance and capacity that let them stop being careful.
Get Ahead of It
Whether you’re new to the sport, ramping up, or already managing something that’s been grumbling for a month, an assessment is worth more than another few weeks of hoping.
Park Rehab offers a free discovery visit at no cost and no obligation. You’ll get an assessment of your strength, balance and movement, a clear picture of where your risk actually sits, and a practical program that fits around the amount you want to play.