Enjoy fitness and social time without pain or injury
Pickleball has become one of the fastest-growing sports in the country. The click-click of the balls on the court can be heard everywhere it seems. It’s fun, social, and accessible across ages and skill levels. It is also able to be played indoors during the winter months, which is exactly why so many of my clients are finding themselves on the court.
But like any physical activity, pickleball comes with its share of physical demands. As an occupational therapist and certified hand therapist (OT CHT), I often see how the sport impacts the hand, wrist, elbow, and shoulder, as well as how it ties into overall mobility and fall prevention. This is especially true when pushing the body beyond limits of conditioning. Pickleball seems like it can be hard to stop—even when something hurts.
Common Upper Extremity Concerns in Pickleball
Hand and Wrist:
Quick volleys and repeated gripping of the paddle can strain the small muscles and tendons of the hand and wrist. This may lead to overuse issues like tendinitis or even flare-ups of arthritis. Managing this involves pacing play, using paddles with ergonomic grips, and adding gentle stretching and strengthening exercises for the forearm and intrinsic hand muscles.
Elbow:
You may have heard of “tennis elbow,” but that outside of the elbow pain is not only caused by tennis. Pickleball can cause a similar problem and annoying pain. This irritation of the tendons on the outside of the elbow comes from repetitive swinging and impact, especially if we use the wrist too much due to weakness or stiffness in the shoulder. Strategies for management include rest, activity modification, use of supportive bracing, and progressive strengthening of the forearm muscles and shoulder stabilizers.
Shoulder:
Overhead shots and rapid directional swings challenge the rotator cuff and scapular stabilizers. Shoulder pain often develops when the shoulder blade isn’t moving in harmony with the arm. Focusing on shoulder and core strengthening, posture, and mobility work can help reduce strain. Warm-ups before play and cool-down stretches afterward are equally important for maintaining shoulder health. Even people who are very fit can have muscle imbalances that don’t allow the shoulder to function optimally. Restoring balance between muscle groups in the shoulder, believe it or not, can calm wrist, hand and elbow pain at times.
Beyond the Arm: Agility and Fall Prevention
Pickleball doesn’t just test your upper body, though, it also requires quick footwork, sudden stops, and direction changes. These demands make agility training a key part of staying safe on the court. Practicing balance, core strength, and reaction drills off the court can improve your ability to move efficiently and lower your risk of falls. I have seen many FOOSH injuries (fall on an outstretched hand) due to pickleball. Balance training such as something as simple as side-stepping drills, yoga practice or single-leg balance exercises can translate directly into better stability when you’re chasing down a shot.
How Occupational Therapy Can Help
At Katherine Jackson Occupational Therapy, PLLC, I work with clients to prevent and manage pickleball-related injuries. This includes:
- Custom exercise programs for strengthening and mobility
- Hands-on techniques to relieve pain and restore function
- Education on joint protection and activity modification
- Guidance for safe progression back to sport after injury
Pickleball is meant to be fun, and staying proactive about your body ensures you’ll enjoy the game for years to come. Let your summer activities continue during the fall and winter months, which is a challenge in the Chicago area with our weather! If you are having pain that is limiting you from play or if you are pushing through the pain, set up an appointment and we can get on top of things.
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