17 Common Pickleball injuries (Prevention & Treatment)

The pickleball injuries players report most: ankle sprains, tennis elbow, calf strain or tear, plantar fasciitis and rotator cuff trouble.

Quick starts and stops at the kitchen line also cause knee, wrist and back injuries, blisters and heat problems, and each entry explains the cause, the signs and how players reduce the risk.

Injury Rates and Numbers

The figures below come from injury surveillance data and peer reviewed studies. Each row names the population it was measured in, because rates from elite athletes and from recreational players are not comparable.

Finding	Measured in	Source
US emergency departments saw an estimated 66,350 pickleball injuries between 2013 and 2022, and the count rose significantly every year.	all ages, US emergency department patients (NEISS sample of 1,110 cases), January 1, 2013 to December 31, 2022	Yu J et al., Orthopaedic Journal of Sports Medicine (2025)
Falls caused 65.5 percent of all pickleball injuries seen in US emergency departments, making them by far the leading mechanism.	all ages, US emergency department patients, 2013 to 2022	Yu J et al., Orthopaedic Journal of Sports Medicine (2025)
Fractures were the most common pickleball diagnosis at 32.7 percent, just ahead of strains and sprains at 30.8 percent.	all ages, US emergency department patients, 2013 to 2022	Yu J et al., Orthopaedic Journal of Sports Medicine (2025)
Women accounted for 69.1 percent of all pickleball fractures, and the wrist was the single most injured body part at 12.7 percent of injuries.	all ages, US emergency department patients, 2013 to 2022	Yu J et al., Orthopaedic Journal of Sports Medicine (2025)
Among pickleball players aged 60 and over, strains and sprains led the diagnoses at 33.2 percent, followed by fractures at 28.1 percent.	US emergency department patients aged 60 years and older (weighted total 28,984 injuries), 2010 to 2019	Weiss H, Dougherty J, DiMaggio C, Injury Epidemiology (2021)

Overview

Injury	Body area	Typical time out
Ankle Sprains	Ankle	1 to 3 weeks, months if grade 3
Wrist Injuries (Sprains, Strains)	Hand and wrist	1 to 4 weeks, 3 months if fractured
Knee Injuries (ACL, Meniscus)	Knee	4 weeks to 12 months by injury
Elbow Injuries (Tennis Elbow)	Elbow	6 weeks to 6 months
Calf Strain or Tear	Lower leg	2 weeks to 3 months
Shoulder Injuries (Rotator Cuff, Impingement)	Shoulder	6 weeks to 4 months, longer post-op
Foot Injuries (Plantar Fasciitis)	Foot	3 to 12 months, play often continues
Back Injuries (Muscle Strains, Herniated Disc)	Lower back	1 to 3 weeks, 3 months with disc
Hand Injuries (Blisters, Calluses)	Hand	A few days to 2 weeks
Head Injuries (Concussions)	Head	1 to 4 weeks, symptom guided
Overuse Injuries (From Repetitive Motion)	Whole body	4 weeks to 6 months, modified play
Hip Injuries (Strains, Impingement)	Hip	2 weeks to 6 months
Sunburn and Dehydration	Skin and whole body	Hours to about 1 week
Heat Exhaustion/Heat Stroke	Whole body	1 to 3 days, weeks after heat stroke
Finger Injuries (Sprains, Dislocations)	Hand	2 to 8 weeks, longer if tendon torn
Eye Injuries (From Ball Impact)	Eye	Days to 4 weeks, longer post-op

Ankle Sprains

An ankle sprain overstretches or tears the ligaments on the outside of the joint, most often the anterior talofibular ligament, when the foot rolls inward under body weight. In pickleball this usually happens on a split step, a sideways push off toward a wide dink, or a backpedal toward a lob, where the foot lands on the edge of the shoe or on a ball lying on the court.

Symptoms

• Sudden pain on the outer ankle at the moment the foot rolls
• Swelling that builds within the first hours
• Bruising that later spreads toward the toes
• The ankle feels unsteady on uneven ground
• Putting full weight on the foot is painful

How serious it is: Sprains are graded 1 to 3: grade 1 stretches the ligament fibers, grade 2 tears them partly with clear swelling and instability, grade 3 is a complete tear with a joint that gives way. Pain level alone is a poor guide, since a grade 3 tear can hurt less than a grade 2 once the initial pain settles.

Typical time out: Roughly one to three weeks for a grade 1 sprain, four to eight weeks for a grade 2, and two to four months for a grade 3 or when a fracture is found alongside it. The wide range exists because return depends on regained balance and confidence on the ankle, not on healed tissue alone.

See a doctor if: See a doctor if you cannot take four steps on the foot, if the bone at the tip of the ankle or along the outer foot is tender to a fingertip, or if the joint looks visibly out of place.

What helps

• Short cooling in the first hours for pain relief, then early weight bearing within the limits of pain rather than days of full rest
• A lace-up brace or taping for the first weeks of return to court, which measurably lowers the chance of a repeat sprain
• Balance training on one leg, progressing from a firm floor to an unstable surface and then to eyes closed
• Strengthening the muscles running down the outside of the lower leg, since they stabilize the ankle actively
• Imaging only if bone tenderness, inability to bear weight, or persistent instability point to a fracture or a torn ligament

Wrist Injuries (Sprains, Strains)

The wrist links eight small carpal bones through short ligaments, and the forearm tendons cross it on their way to the fingers. In pickleball the wrist is loaded two ways: by the flick and stabilizing work during serves and volleys, and far more forcefully by falling onto an outstretched hand, which drives body weight through the joint in an instant.

Symptoms

• Pain on the thumb side or the little finger side when you load the wrist
• Swelling across the back of the wrist
• Weak grip, dropping the paddle or a cup
• Pain when you push up out of a chair or off the floor
• A click or catching feeling when you rotate the forearm

How serious it is: Mild strains involve stretched ligaments or irritated tendons and settle with load management. The important distinction is a fracture, most often of the distal radius or the scaphoid, which follows a fall and needs cast or surgical care; wrist injuries are the single most common pickleball injury seen in emergency departments, and fractures are frequent among them.

Typical time out: One to four weeks for a mild sprain or strain, six to twelve weeks after a distal radius fracture, and three months or more after a scaphoid fracture or surgery, because that bone heals slowly and unreliably.

See a doctor if: Get an x-ray if the wrist hurts after a fall and is tender in the hollow at the base of the thumb, if it looks bent or deformed, or if fingers feel numb.

What helps

• Learning to fall onto the forearm and roll rather than catching yourself on a stiff, outstretched hand
• A short period of splinting for comfort, then graded loading in a pain free range instead of prolonged immobilization
• Grip and forearm strengthening, including wrist rotation with a light weight held at one end
• A slightly larger grip size and a softer paddle setup, which lower the shock passed into the wrist on off center hits
• Imaging early after any fall with focal bone tenderness, since scaphoid fractures are often missed on a first x-ray

Knee Injuries (ACL, Meniscus)

The anterior cruciate ligament holds the shin bone from sliding forward and from twisting under the thigh bone, while the two menisci are cartilage wedges that cushion and guide the joint. Pickleball loads both in the same motion: a hard plant to change direction toward the sideline, or a pivot on a fixed foot when you reach for a ball on the kitchen line.

Symptoms

• A pop or tearing sensation at the moment of the twist
• Swelling inside the joint within a few hours
• The knee gives way when you turn on it
• Locking or catching so that the knee will not fully straighten
• Deep pain along the joint line when you squat

How serious it is: A partial cruciate injury may leave the knee stable and respond to rehabilitation, while a complete tear leaves it giving way on pivoting sports. Meniscus tears range from a small stable flap that settles down to a displaced bucket handle tear that physically blocks the joint and needs surgery.

Typical time out: Four to eight weeks for a minor meniscus irritation, three to four months after a meniscus repair depending on whether the tear was trimmed or stitched, and nine to twelve months after cruciate ligament reconstruction before returning to cutting and pivoting.

See a doctor if: See a doctor if the knee swells hard within hours, locks so you cannot straighten it, or buckles when you put weight on it.

What helps

• Early assessment when the knee swells fast after a twist, since the fluid pattern points to a cruciate or cartilage injury
• Rehabilitation built on quadriceps and hamstring strength, then on single leg control before any court work
• Landing and cutting drills that teach the knee to stay over the foot instead of collapsing inward
• Playing with your weight lower and your feet moving, so you do not reach with a planted, twisting foot
• Surgery discussed only after swelling settles and motion returns, since operating on a stiff knee gives worse results

Elbow Injuries (Tennis Elbow)

Tennis elbow, properly lateral epicondylar tendinopathy, is a degenerative change in the common extensor tendon where the wrist extensor muscles attach to the bony bump on the outer elbow. In pickleball it builds from repeated backhand contact and from stabilizing the wrist against off center hits, which loads that tendon on every stroke rather than from one single moment.

Symptoms

• Pain over the bony point on the outside of the elbow, sometimes running into the forearm
• It hurts to lift a kettle, a jug, or a full cup
• Gripping the paddle firmly reproduces the pain
• The elbow feels stiff in the morning and loosens as you move
• Shaking hands or turning a doorknob is uncomfortable

How serious it is: In the mild form pain appears only after play and settles overnight. In the established form it hurts during everyday gripping and lasts months, and long standing cases show tendon tissue that has changed structurally rather than being simply inflamed.

Typical time out: Six weeks to six months, and you rarely have to stop playing entirely; the range is wide because tendons respond to weeks of graded loading rather than to rest, and cases that have already lasted a year take longest.

See a doctor if: Have it checked if the pain sits on the inner elbow with numbness in the ring and little fingers, or if the elbow will not fully straighten.

What helps

• Slow, heavy eccentric and isometric wrist extensor loading, which is the treatment with the best evidence for this tendon
• Cutting the number of hard backhand drives for a few weeks rather than stopping play completely
• A thicker grip and a paddle with less vibration, so less shock reaches the tendon on mishits
• A counterforce strap below the elbow for symptom relief during play, as an aid and not a cure
• Corticosteroid injection reserved for exceptional cases: it eases pain for weeks but leaves worse outcomes at one year for tendinopathy

Calf Strain or Tear

A calf strain tears muscle fibers, most often where the inner head of the gastrocnemius meets its tendon sheet high on the inner calf. In pickleball it usually happens in the push off for a forward lunge or a sudden sprint from a standstill, when the knee straightens while the ankle is bent up and the muscle is stretched and firing at the same time.

Symptoms

• A sudden sharp pain, often described as being hit or kicked in the back of the leg
• A tender spot you can point to with one finger
• Limping, and pain when you rise onto the toes
• Swelling and bruising that appears over the following days, sometimes down at the ankle
• Tightness when you stretch the calf with the knee straight

How serious it is: Grade 1 involves a few fibers and lets you walk, grade 2 is a partial tear with a clear defect and limping, grade 3 is a full rupture with obvious loss of push off strength. A tear of the Achilles tendon itself feels similar but leaves you unable to rise onto the toes at all and is a different, more serious injury.

Typical time out: Two to three weeks for a grade 1 strain, four to eight weeks for a grade 2, and three months or more for a grade 3 or a tendon rupture. Calf strains recur often, so the range depends on whether you return with full single leg calf raise strength.

See a doctor if: Seek care if you cannot lift your heel off the floor on that leg alone, or if the calf becomes hot, hard, and swollen without an obvious injury, which can indicate a clot.

What helps

• Walking as soon as it is tolerable, with a temporary heel lift in both shoes to shorten the muscle and lower pain
• Progressive calf raises, starting with both legs bent knee and straight knee, then to single leg, then to hopping
• A clear return criterion: the same number of single leg calf raises on the injured side as on the healthy one
• Building back court sprinting and lunging gradually, because the first weeks after return carry the highest reinjury risk
• Ultrasound or MRI only when a full rupture is suspected or when recovery stalls

Shoulder Injuries (Rotator Cuff, Impingement)

The rotator cuff is four muscles whose tendons wrap the head of the upper arm bone and hold it centered in the shallow socket, with a bursa cushioning the space beneath the bony roof. Overhead serves, overhead smashes, and reaching high backhand volleys compress and load those tendons, and older tendons with reduced blood supply tolerate that repetition poorly.

Symptoms

• Pain on the outer upper arm rather than on the shoulder blade
• Reaching overhead or behind your back is painful
• You wake at night when you roll onto that shoulder
• Weakness lifting the arm out to the side
• A painful arc partway through raising the arm that eases at the top

How serious it is: Irritation and partial thickness tendon fraying usually improve with structured strengthening. A full thickness tear leaves lasting weakness rather than only pain, and traumatic tears in younger arms are treated more aggressively than the degenerative tears common with age.

Typical time out: Six weeks to four months for impingement or tendinopathy treated with exercise, and four to six months after rotator cuff repair, since the tendon must heal to bone before loaded overhead work is allowed.

See a doctor if: See a doctor if you cannot hold the arm out to the side after a fall, or if the shoulder aches at rest at night and will not settle.

What helps

• A progressive rotator cuff and shoulder blade strengthening program, which matches surgery for outcome in most non traumatic cases
• Serving lower and flatter for a period, and reducing the number of overhead smashes per session
• Improving thoracic spine and hip rotation so the shoulder is not the only joint generating the swing
• Physiotherapy early rather than after months of pain, because a stiff shoulder is much harder to rehabilitate
• Injection or imaging considered only if pain blocks the exercise program or true weakness suggests a full tear

Foot Injuries (Plantar Fasciitis)

The plantar fascia is a thick fibrous sheet running from the heel bone to the base of the toes that tensions the arch every time you push off. Pickleball loads it with hundreds of short stops, split steps, and forward lunges on hard court surfaces, and the tissue reacts with degenerative thickening at its heel attachment rather than with true inflammation.

Symptoms

• Sharp heel pain with the first steps out of bed
• Pain that eases after a few minutes of walking and returns after sitting
• A tender point on the inner side of the heel
• Aching in the arch late in a long session
• Worse barefoot on hard floors

How serious it is: Early cases hurt only in the first minutes of the morning and respond within weeks. Long standing cases hurt throughout the day and can take many months, and heel pain with numbness or a burning quality points to a nerve rather than the fascia.

Typical time out: You can usually keep playing in a reduced form. Expect three to twelve months to full resolution, with most improvement in the first three months of consistent loading work; stubborn cases run longer.

See a doctor if: Have it checked if the heel became painful suddenly after a hard landing, if it is painful to squeeze the heel bone from both sides, or if you have numbness in the sole.

What helps

• High load calf raises done with the toes propped up on a rolled towel, which loads the fascia directly and outperforms stretching alone
• Calf and Achilles flexibility work, since a tight calf raises tension in the fascia
• Supportive court shoes with a cushioned heel, plus a prefabricated arch insert for symptom relief
• Cutting session length and the number of hard stops for several weeks rather than stopping altogether
• A night splint for cases where the first steps in the morning are the dominant complaint

Back Injuries (Muscle Strains, Herniated Disc)

Most pickleball back pain comes from the muscles and small facet joints of the lumbar spine reacting to repeated bending, rotating, and rapid extension. A disc herniation is different: the soft inner core of an intervertebral disc pushes through its outer ring and presses on a nerve root, which sends pain down the leg rather than keeping it in the back.

Symptoms

• Pain and stiffness low in the back after play, worse the next morning
• Spasm that makes it hard to straighten up
• Pain shooting into the buttock or down one leg past the knee
• Numbness or tingling in a strip of the leg or foot
• Coughing or sneezing sends a jolt down the leg

How serious it is: A simple muscular strain hurts locally and settles in days to weeks. A disc herniation with nerve compression is defined by leg pain, numbness, or weakness rather than back pain alone, and true weakness such as a foot that drags is the serious form.

Typical time out: One to three weeks for a muscular strain, six weeks to three months for a disc herniation with leg pain, since most settle without surgery but nerve symptoms fade slowly.

See a doctor if: Get urgent care if you have numbness around the groin or buttocks, trouble passing or controlling urine, or clear weakness in a leg or foot.

What helps

• Staying active with walking and gentle movement, since bed rest slows recovery for back pain
• Trunk endurance work for the deep abdominal and back muscles rather than repeated sit ups
• Hip mobility work, so rotation for the serve and the reach comes from the hips instead of the lumbar spine
• Reducing overhead smashes for a period, because the arched back position loads the facet joints
• Imaging reserved for persistent nerve symptoms or red flags, since scans of pain free people also show disc changes

Hand Injuries (Blisters, Calluses)

Blisters form when repeated shear between the paddle grip and the skin separates the outer skin layer from the one beneath and fluid fills the gap. Calluses are the slower answer to the same friction, a thickened protective layer along the palm and the base of the fingers where the grip presses hardest during long rallies.

Symptoms

• A hot, stinging spot on the palm or finger base during play
• A raised fluid filled bubble, sometimes with blood inside
• Thickened yellowish skin where the grip sits
• A callus that cracks and becomes painfully sore at the edge
• You change your grip to avoid the sore spot

How serious it is: Most are a nuisance rather than an injury. It matters if a blister opens and the surrounding skin turns red, warm, and spreads, which means infection, or if a deep callus splits down to raw skin.

Typical time out: Usually none: a few days to two weeks to heal, and you can normally keep playing with the area padded. Allow longer if the skin has split or become infected.

See a doctor if: See a doctor if redness spreads out from the blister, if it produces pus, or if you have diabetes or poor circulation in the hands.

What helps

• Leaving an intact blister closed and covering it with a hydrocolloid pad, which protects the roof and speeds healing
• Fixing the cause: a fresh overgrip, a grip size that fits the hand, or a lighter hold on the paddle between shots
• A half glove or taping over the recurring pressure point
• Filing a thick callus down gently after soaking, so it does not build into a hard ridge that cracks
• Keeping hands dry with a fresh towel, since damp skin blisters far more readily

Head Injuries (Concussions)

A concussion is a functional disturbance of brain cells after the head is shaken, whether by a direct blow or by a fall in which the head strikes the court. In pickleball the usual routes are a backward fall while chasing a lob, a collision with a partner on a shared middle ball, and a paddle strike in doubles, since falls are by far the leading mechanism of pickleball injury overall.

Symptoms

• Headache or a feeling of pressure in the head
• Dizziness or a sense that the room is moving
• Feeling slowed down, foggy, or unusually irritable
• Nausea, and sensitivity to light or noise
• Trouble concentrating or remembering the moments around the impact

How serious it is: Loss of consciousness happens in only a minority of concussions and is not what defines them; symptoms alone are enough. Most resolve within weeks, but symptoms that worsen over the hours after the impact suggest bleeding inside the skull and are an emergency.

Typical time out: A minimum of one to two weeks before full return to play in adults, and four weeks or longer if symptoms persist. Return is stepwise: light activity once symptoms allow, then non contact drills, then play, and any return of symptoms means dropping back a step.

See a doctor if: Call emergency services for repeated vomiting, worsening headache, a seizure, confusion that deepens, unequal pupils, or anyone who cannot be fully woken.

What helps

• Stopping play immediately and not returning the same day, no matter how quickly the head clears
• Relative rest for the first day or two, then light aerobic activity below the symptom threshold, since prolonged dark room rest delays recovery
• Reducing screen time and cognitive load early on, without total avoidance
• Medical assessment for anyone on blood thinners or over about 65 after a head impact, because the risk of a bleed is higher
• Vestibular and neck physiotherapy when dizziness or neck pain persist beyond the first weeks

Overuse Injuries (From Repetitive Motion)

Overuse injuries occur when tendon, bone, or muscle is loaded again before it has adapted from the last session, so tissue breakdown outpaces repair. Pickleball invites this because sessions are social and long: players commonly go from two games a week to daily play within a month, which is exactly the jump tendons and bones tolerate worst.

Symptoms

• Pain that begins after play, then creeps into the start of play, then into daily life
• Stiffness in the affected area first thing in the morning
• A tender spot that has been there for weeks without one clear injury moment
• The pain follows the volume: more court time, more pain
• Loss of power in a stroke or a push off

How serious it is: In the early stage pain appears only after activity and performance is unaffected, which is fully reversible. Later stages hurt during play and then at rest, and a bone stress reaction that is played through can progress to a stress fracture.

Typical time out: Rarely a full stop. Expect four weeks to six months of modified play depending on the tissue: muscle recovers in weeks, tendon in months, and bone stress injuries need six to twelve weeks of protected loading.

See a doctor if: See a doctor for pain that wakes you at night at rest, or for a sharply localized bone pain that hurts when you hop on the leg.

What helps

• Increasing playing volume in steps rather than jumping from occasional games to daily sessions
• Scheduling at least one full day off court per week, and separating hard from easy days
• Loading the painful tendon deliberately with slow, heavy exercise instead of avoiding it entirely
• Using a simple pain rule: discomfort during play that settles within 24 hours is acceptable, pain that lingers longer means the load was too high
• Getting imaging when a bone stress injury is suspected, since those are the overuse problems that must not be played through

Hip Injuries (Strains, Impingement)

Hip strains tear fibers of the groin adductors or the hip flexors where they attach near the pelvis, while femoroacetabular impingement is a bony shape in which the head and neck of the thigh bone contact the socket rim and pinch the labrum, the cartilage ring around the socket. Pickleball loads both with wide lateral lunges toward the sideline and deep squatting positions at the kitchen line.

Symptoms

• Groin pain when you lunge sideways or bring the knee up
• A deep pinch at the front of the hip when sitting low or squatting
• Stiffness putting on socks or getting out of a car
• Clicking or catching deep in the joint
• Pain on the outer hip when lying on that side

How serious it is: Muscle strains are graded 1 to 3 like other strains and improve with graded loading. Impingement and labral irritation are structural and tend to come and go with playing volume, while true hip joint arthritis brings progressive loss of rotation as well as pain.

Typical time out: Two to six weeks for a grade 1 groin strain, six to twelve weeks for a more substantial tear, and three to six months for impingement managed with rehabilitation or after hip arthroscopy.

See a doctor if: Seek care if you could not bear weight after the injury, if the hip locks, or if groin pain follows a fall in an older player, since a hip fracture can still allow limited walking.

What helps

• Adductor strengthening, in particular the Copenhagen exercise, which has good evidence for preventing and treating groin problems
• Hip abductor and gluteal strength work to control the leg during sideways pushes
• Improving hip rotation range so lunges do not end at the bony limit of the joint
• Better court positioning, so you step to the ball rather than reaching into an extreme lunge
• Physiotherapy assessment for groin pain lasting more than a few weeks, since several structures produce similar pain

Sunburn and Dehydration

Sunburn is UV damage to the outer skin layers, and outdoor courts add reflected light from a pale hard surface to the direct sun. Dehydration develops when sweat losses over a long session outpace what you drink, which reduces blood volume, raises heart rate at any given effort, and makes the body less able to shed heat.

Symptoms

• Skin that is red, hot, and tight, appearing hours after play
• Thirst, a dry mouth, and dark, scanty urine
• Headache and light headedness on standing
• Feeling flat and heavy legged late in a session
• Muscle cramps in the calves or thighs

How serious it is: First degree sunburn is red and painful and heals in days, while blistering burn is a second degree injury that scars and raises long term skin cancer risk. Mild dehydration only reduces performance, but continued fluid loss in heat becomes heat exhaustion.

Typical time out: Hours to a day for mild dehydration once you rehydrate, and three to seven days of shade and cover for a significant burn. Blistering burns need one to two weeks and full sun protection.

See a doctor if: See a doctor for widespread blistering, fever and chills after sun exposure, or if you stop passing urine and feel confused.

What helps

• Broad spectrum SPF 50 applied twenty minutes before play and again every two hours, with a cap and UV filtering sunglasses
• Scheduling play for the early morning or evening in summer rather than the middle of the day
• Drinking to thirst across the session and adding electrolytes for sessions beyond an hour in heat
• Weighing yourself before and after a hot session as a simple check of how much fluid you actually lose
• Cooling the skin and applying a plain moisturizer for a burn, and covering the area completely on following days

Heat Exhaustion/Heat Stroke

Heat exhaustion is circulatory strain: blood is diverted to the skin for cooling while sweat losses reduce blood volume, so not enough reaches the brain and muscles. Heat stroke is the next stage, in which core temperature climbs past the point the body can control and brain function is affected. Long doubles sessions on hard courts that radiate heat, often in older players, are the classic setting.

Symptoms

• Heavy sweating with cool, clammy, pale skin
• Dizziness, weakness, and nausea
• A fast, weak pulse and a pounding headache
• Muscle cramps and a sense of exhaustion out of proportion to the effort
• In heat stroke: confusion, slurred speech, or collapse, sometimes with hot, dry skin

How serious it is: Heat exhaustion improves within an hour of cooling and fluids and leaves no lasting damage. Heat stroke is defined by an altered mental state and is a medical emergency in which organ damage begins within minutes.

Typical time out: One to three days after uncomplicated heat exhaustion. After heat stroke, expect several weeks off with a medically supervised, stepwise return, because heat tolerance stays reduced for some time.

See a doctor if: Call emergency services immediately for confusion, disorientation, fainting, or a seizure in the heat, and begin cooling while you wait.

What helps

• Stopping play at the first sign, moving to shade, lying down with the legs raised, and drinking cool fluid
• Active cooling for suspected heat stroke: cold water immersion or wet cloths with fanning, started before transport
• Acclimatizing over one to two weeks when the season turns hot, with shorter early sessions
• Rotating players and taking a shaded break between games rather than playing straight through
• Light colored, loose, breathable clothing, and extra caution for players on blood pressure or diuretic medication

Finger Injuries (Sprains, Dislocations)

Finger sprains stretch or tear the collateral ligaments at the side of a knuckle, and a dislocation forces the joint surfaces apart, most often at the middle joint. In pickleball these come from a fall in which a finger catches the court, from a ball or paddle striking an extended finger, and from paddles colliding in tight doubles play at the net.

Symptoms

• Immediate pain and rapid swelling at one knuckle
• The finger looks crooked or sits at an angle
• You cannot fully bend or straighten it
• Tenderness on one side of the joint when pressed
• The joint stays thickened for months after the pain fades

How serious it is: A simple sprain keeps the joint stable and settles. A dislocation must be reduced, and it matters whether the fingertip joint is involved: an inability to straighten the tip means a torn extensor tendon, and an inability to bend it means a torn flexor tendon, which needs surgical attention.

Typical time out: Two to six weeks for a sprain, four to eight weeks for a reduced dislocation with buddy taping, and eight to twelve weeks or longer for tendon injuries and fractures involving the joint surface.

See a doctor if: Get medical care if the finger is visibly deformed, if you cannot straighten or bend the tip actively, or if it feels numb or looks pale.

What helps

• Removing rings immediately, before swelling makes it impossible
• Professional reduction of a dislocation and an x-ray afterward rather than pulling it straight yourself
• Buddy taping to the neighboring finger for support while you keep moving the joint early
• Starting gentle bending and straightening within days, since finger joints stiffen quickly when held still
• Hand therapy if the joint is still stiff or swollen after a few weeks, because that stiffness becomes permanent

Eye Injuries (From Ball Impact)

A pickleball is hard and light and travels fast at close range, so a hit at the net can strike the eye directly rather than being stopped by the bony rim. The result ranges from a bruised lid to bleeding in the front chamber of the eye, a scratched cornea, a torn retina, or a fracture of the thin bone in the eye socket floor.

Symptoms

• Immediate pain and watering after the impact
• Blurred or double vision
• Floaters, flashes of light, or a shadow across part of the field of view
• Visible blood in the white of the eye or a level of blood over the iris
• Light hurts, and the eye will not open comfortably

How serious it is: A bruised lid without visual change is minor. Any change in vision, blood inside the eye, an irregular pupil, or pain on eye movement puts the injury in the serious category and needs same day specialist assessment.

Typical time out: A few days for a bruise. Two to four weeks off court after bleeding in the front chamber of the eye, since rebleeding is a real risk, and longer after retinal or socket surgery as directed by the ophthalmologist.

See a doctor if: Go to an eye specialist or emergency department the same day for any loss or change of vision, blood inside the eye, an oddly shaped pupil, or flashes and floaters.

What helps

• Wearing polycarbonate protective eyewear rated for racket sports, which is the only measure that reliably prevents these injuries
• Not rubbing or pressing the eye, and shielding it with a cup rather than a pad if the globe may be open
• Same day examination whenever vision has changed, since retinal tears are treatable when caught early
• Awareness at the kitchen line in doubles, where reaction distance is shortest and most impacts happen
• Everyday glasses replaced with impact rated lenses for play, because standard lenses can shatter

First Aid for Soft Tissue Injuries: PEACE and LOVE

Sports medicine has moved on from RICE. The current guidance, published in the British Journal of Sports Medicine in 2019, splits care into the first days after the injury and everything that follows.

PEACE, the first two to three days

• Protect: unload the area and limit movement that hurts, but only briefly.
• Elevate: keep the limb above heart level when you can.
• Avoid anti-inflammatories: they may blunt the healing you need.
• Compress: a bandage or taping limits swelling.
• Educate: your body heals this on its own; passive treatments rarely speed it up.

LOVE, from day three onward

• Load: return to movement as pain allows, early loading builds tissue.
• Optimism: expectations shape recovery more than most people assume.
• Vascularization: easy cardio that does not hurt brings blood to the area.
• Exercise: restore strength, mobility and balance before returning to play.

Ice still helps with pain in the first hours. What changed is the evidence that long icing and routine anti-inflammatory drugs slow tissue repair.

How to Lower Your Risk in Pickleball

• Train balance and falling. Falls cause about two thirds of the pickleball injuries that reach US emergency departments, so single leg balance work, and practicing how to go down onto a forearm and roll instead of catching yourself on a stiff hand, address the largest single risk in the sport.
• Chase lobs by turning and running rather than backpedaling. Almost every backward fall in pickleball starts with a player shuffling backward with the eyes up, which is the position from which you land on the wrist or the back of the head.
• Wear court shoes, not running shoes. Running shoes have a soft, high heel built for forward motion and roll under sideways loads, while a court shoe has a wide, flat outsole that supports the lateral pushes and hard stops the game is made of.
• Build strength for the legs and hips off court twice a week. Calf raises, split squats, and adductor work directly protect the calf, the knee, and the groin, which are the structures that fail on the lunge to the sideline.
• Raise playing volume in steps. New and returning players often go from two social games to daily sessions within weeks, and tendons and bones need months to adapt to that; add one session at a time and keep a day off court each week.
• Wear impact rated eyewear and call the middle ball out loud in doubles. Both problems are close range and short reaction time, and both are almost entirely preventable rather than treatable.
• Play in the cooler parts of the day in summer, drink through the session, and use SPF 50, since heat illness and burn build over a long social session without an obvious moment of injury.

When to Stop and Get Medical Help

Most of the injuries on this page are treated at home. These signs are not.

• You cannot put weight on a leg or take a few steps after the injury, or a bone feels tender to a single fingertip, which points to a fracture.
• The joint is visibly out of shape, points the wrong way, or will not move at all.
• Numbness, tingling, or a limb that turns pale and cold after the injury, which suggests nerve or blood vessel involvement.
• Any head impact followed by confusion, repeated vomiting, a worsening headache, a seizure, or someone who cannot be fully woken.
• Any change in vision, blood inside the eye, or flashes and floaters after being struck by the ball or a paddle.
• Confusion, slurred speech, or collapse in the heat, which is heat stroke and needs emergency services plus immediate cooling.
• Chest pain, unusual breathlessness, or fainting during play, which is not a sports injury question and needs emergency assessment.

Sources

• Yu J et al., Orthopaedic Journal of Sports Medicine (2025)
• Weiss H, Dougherty J, DiMaggio C, Injury Epidemiology (2021)

This article is general information, not medical advice. If you are hurt, a doctor or physiotherapist who can examine you is worth more than any web page. Last reviewed: August 2026.

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