Paddle up—keeping your family’s pickleball game injury-free
By: Terrill Julien, MD, orthopedist at Kaiser Permanente in Maryland
If pickleball seems to be popping up everywhere, it’s not your imagination. In 2023, the number of people playing the game grew by 52% over one year, and a whopping 224% in the prior three years.1 Played in every U.S. state, pickleball has a lot of appeal—it’s affordable, easy to set up, and fun to play. The sport charms people of all ages and athletic ability, and its enthusiasts—known as picklers—include the likes of Leonardo DiCaprio, the Kardashians, and Bill Gates (who’s been playing the game for more than 50 years).
Pickleball is America’s fastest-growing sport. However, more involvement in the activity means a growing number of pickleball injuries. Along with a brief background of the game, we’re serving a few tips to help keep pickleball matches injury-free for you and your family.
What is pickleball?
With fun lingo that includes dink, drive, drop, and kitchen, pickleball was invented in 1965 by three dads in Washington State. (It became the state’s official sport in 2022.) The family-friendly game combines aspects of tennis, badminton, and ping-pong. If your curiosity is piqued, you can learn more playtime basics at USA Pickleball, the organization that governs the sport.
How to prevent and manage pickleball injuries
Anyone who’s physically active, including pickleball newbies, can suffer from overuse injuries. These types of injuries happen when we continually load our muscles and joints and don't allow the body adequate time to heal and rest.
Surprisingly, compared to adults, children are more likely to suffer from overuse injuries because their bodies are growing and changing each year. Two of the most common injuries for young athletes involve elbow and shoulder pain—both due to repetitive stress from throwing-like motions. If you or your child experiences arm pain after playing pickleball, it’s most likely from lateral epicondylitis, sometimes known as pickleball elbow (or tennis elbow).
Older adults are more likely to sustain acute injuries when playing pickleball than children. This is due to factors like decreased muscle strength, flexibility, and balance that are common with age. Falls, which are more frequent in older adults, often lead to injuries like fractures, particularly in the wrist and ankle.
To prevent and recover from these injuries, players can follow several best practices:
• Always, always warm up—get some stretching in before picking up a paddle.
• Go at a slower pace, especially when getting started in pickleball or any other sport. (A doctor’s rule of thumb for beginners: Never increase the intensity of a workout by more than 10% each week.)
• Use the right equipment, which for pickleball is a short list: balls, paddles, and a net.
• Maintain a balanced fitness program that trains muscles in every part of the body. (It could be helpful to vary physical activities year-round, including strength, cardio, and flexibility training into workouts.)
• Be sure to cool down after each game. Also give the body proper rest, hydration, nutrition and recovery time.
Pickleball can serve as a fun, mood-lifting sport for whole-family fitness. With these pointers to prevent and recover from injury in your playbook, you and your family can pick up your paddles with confidence.
Learn more about the pickleball craze.
Kaiser Permanente partners with The St. James to support healthy athletes
Kaiser Permanente’s Mid-Atlantic Musculoskeletal Institute treats injuries and disorders of the spine and the entire musculoskeletal system. Our multidisciplinary team includes subspecialists who treat hands, shoulders, wrists, knees, hips ankles and the spine – and work closely with sports medicine surgeons and physical rehab therapists who work together to get you back in the game. Learn more about Kaiser Permanente’s sport medicine program and becoming a member.
1Sports & Fitness Industry Association (2024). 2024 State of Pickleball: Participation & Infrastructure Report, https://k-p.li/43nPARG. Accessed April 22, 2025.
Dr. Terrill Julien is an orthopedist at Kaiser Permanente in Maryland.