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<p class="publish-date" style="font-size:13px; color:#999; margin-bottom:16px;">Published: May 13, 2026 · Last updated: May 13, 2026</p>
<div class="ac-glance" style="background-color: #ffffff; padding: 20px; border: 2px solid #b0bec5; border-radius: 8px; margin: 20px 0;"><strong>This week's brief at a glance:</strong><ul style="margin: 12px 0; padding-left: 24px;"><li style="margin-bottom:6px;">Roughly 70 percent of regular pickleball players are 60 or older, and the sport accounts for a fast-growing share of orthopedic and ER visits in that age group (Cleveland Clinic, 2026)</li><li style="margin-bottom:6px;">The 4 most common injuries are Achilles tendon ruptures, rotator cuff and shoulder strains, wrist fractures from falls, and ankle sprains (Cleveland Clinic, 2023)</li><li style="margin-bottom:6px;">A structured 10-minute warm-up, court-appropriate shoes, and a paddle in the right weight range reduces injury rates by an estimated 50 to 70 percent in recreational adults (Cleveland Clinic, 2024)</li></ul></div>
<p>Pickleball is the fastest-growing sport in America, and it is being driven almost entirely by adults over 50. The combination of low cost, short rallies, and a forgiving learning curve has pulled millions onto courts. The combination of explosive lateral movements and middle-aged tendons has pulled a fast-growing share of them onto orthopedic exam tables.</p>
<p>The injuries are predictable. Four account for the majority of ER visits and orthopedic referrals in pickleball players over 50. Knowing what they are, why they happen, and how to prevent each one keeps most people on the court instead of in the surgical suite.</p>
<h3>Achilles Tendon Rupture</h3>
<p>The single most common serious pickleball injury is a sudden Achilles tendon rupture. It happens during a quick forward lunge or a backward step, often with no prior warning, and feels like being shot in the back of the calf. Most ruptures in this group happen to people who have been moderately active but not specifically training their calves or doing regular plyometric work.</p>
<p>According to (<a href="https://newsroom.clevelandclinic.org/2026/04/29/why-pickleball-injuries-are-so-common" target="_blank" rel="noopener">Cleveland Clinic, 2026</a>), the recommended prevention is a 5-minute dynamic warm-up before every session (walking lunges, leg swings, slow-tempo calf raises) plus 2 to 3 sessions per week of eccentric calf strengthening when not playing. Skipping the warm-up doubles the risk in cohort studies.</p>
<h3>Rotator Cuff and Shoulder Strain</h3>
<p>The repetitive overhead serve, smash, and reach motion strains shoulder tissues that often have age-related thinning by the 50s and 60s. Tears can range from minor strains that heal in a few weeks to full-thickness rotator cuff tears that need surgical repair.</p>
<p>(<a href="https://newsroom.clevelandclinic.org/2023/07/19/avoiding-injuries-while-playing-pickleball" target="_blank" rel="noopener">Cleveland Clinic, 2023</a>) recommends choosing a paddle in the 7.5 to 8.5 ounce range for most adult recreational players. Heavier paddles accelerate shoulder fatigue. Pre-session shoulder mobility drills (cross-body stretches, sleeper stretches) plus general strengthening for the rotator cuff and rear deltoid keep tissue resilient. Shoulder pain that persists more than 2 weeks warrants an evaluation rather than another tournament.</p>
<h3>Wrist Fractures From Falls</h3>
<p>The instinct when you lose balance is to catch yourself with an outstretched hand. The dominant fracture pattern in pickleball falls is the distal radius, the wrist bone that breaks when force travels up an extended arm. Adults with lower bone density (especially postmenopausal women not on hormone therapy) are at substantially higher risk.</p>
<p>Prevention is partly bone density (a topic worth checking via DEXA if you have not), partly footing (court-appropriate shoes with lateral support, not running shoes), and partly technique (do not chase shots into the no-man's-land where momentum carries you forward and trips you up). Falling skills (the "PLF" parachute landing fall, taught in martial arts and at some senior gyms) measurably reduce wrist injury when falls happen.</p>
<h3>Ankle Sprains</h3>
<p>Lateral ankle sprains are the most common pickleball injury overall but usually the least severe. Quick side-to-side movement on a hard court, especially when fatigued or in worn-out shoes, twists the foot inward and stretches the lateral ankle ligaments. Most are manageable with rest, ice, compression, and 1 to 2 weeks of modified activity.</p>
<p>(<a href="https://health.clevelandclinic.org/is-pickleball-good-exercise" target="_blank" rel="noopener">Cleveland Clinic, 2024</a>) notes that a court-appropriate shoe with good lateral support (not a running shoe, which is built only for forward motion) is the single biggest prevention factor. Pre-wrapping previously sprained ankles with athletic tape or a brace for the first month of return-to-play after a sprain reduces re-injury significantly.</p>
<h3>What Makes Pickleball Different From Tennis</h3>
<p>Tennis players have a larger court and longer rally setup times, which gives the body more setup before each movement. Pickleball has a tighter court, shorter rallies, and a higher rate of explosive movements per minute, which is why injury rates per playing hour are higher in pickleball than tennis. The fix is not to play less. The fix is to prepare the body for the sport's actual demands. For more on building lower-body resilience and joint protection, see our piece on <a href="/articles/why-60-is-the-best-age-to-start-strength-training-not-30">why 60 is the best age to start strength training</a>.</p>
<div class="ac-action-plan" style="background: linear-gradient(135deg, #fffcf4 0%, #fff8ed 100%); border-left: 5px solid #9A6841; border-radius: 12px; padding: 28px 24px; margin: 32px 0; box-shadow: 0 2px 12px rgba(0,0,0,0.06);"><div style="display: flex; align-items: center; gap: 10px; margin-bottom: 20px;"><svg width="24" height="24" viewBox="0 0 24 24" fill="none" stroke="#9A6841" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"><path d="M9 5H7a2 2 0 00-2 2v12a2 2 0 002 2h10a2 2 0 002-2V7a2 2 0 00-2-2h-2"/><rect x="9" y="3" width="6" height="4" rx="1"/><path d="M9 14l2 2 4-4"/></svg><span style="font-family: Georgia, serif; font-size: 22px; font-weight: 700; color: #313743;">Your Coach's Recommendations</span></div><div style="display: flex; gap: 14px; margin-bottom: 16px; align-items: flex-start;"><div style="min-width: 36px; width: 36px; height: 36px; background: #9A6841; border-radius: 50%; display: flex; align-items: center; justify-content: center; color: #fff; font-weight: 700; font-size: 16px; flex-shrink: 0;">1</div><div><div style="font-weight: 700; color: #313743; font-size: 15px; margin-bottom: 2px;">Spend 10 Minutes Warming Up Before Every Session.</div><div style="color: #6b7280; font-size: 13.5px; line-height: 1.5;">Walking lunges, leg swings, slow calf raises, arm circles, gentle shoulder rotations. Five minutes minimum. Cold tendons are why Achilles tendons rupture in pickleball. Warm tendons rarely do.</div></div></div><div style="display: flex; gap: 14px; margin-bottom: 16px; align-items: flex-start;"><div style="min-width: 36px; width: 36px; height: 36px; background: #9A6841; border-radius: 50%; display: flex; align-items: center; justify-content: center; color: #fff; font-weight: 700; font-size: 16px; flex-shrink: 0;">2</div><div><div style="font-weight: 700; color: #313743; font-size: 15px; margin-bottom: 2px;">Wear Court Shoes, Not Running Shoes.</div><div style="color: #6b7280; font-size: 13.5px; line-height: 1.5;">Court shoes have a flatter sole, lateral support, and a non-marking outsole. Running shoes are built for forward motion and roll under lateral cuts. The shoe alone reduces ankle sprain risk meaningfully.</div></div></div><div style="display: flex; gap: 14px; margin-bottom: 20px; align-items: flex-start;"><div style="min-width: 36px; width: 36px; height: 36px; background: #9A6841; border-radius: 50%; display: flex; align-items: center; justify-content: center; color: #fff; font-weight: 700; font-size: 16px; flex-shrink: 0;">3</div><div><div style="font-weight: 700; color: #313743; font-size: 15px; margin-bottom: 2px;">Add 2 Strength Sessions a Week Off the Court.</div><div style="color: #6b7280; font-size: 13.5px; line-height: 1.5;">Calf raises, rotator cuff work, hip mobility, single-leg balance. 30 minutes twice a week. The strongest predictor of staying injury-free is having a stronger and more resilient body than the sport asks of you.</div></div></div><div style="border-top: 1px solid #e5ddd4; margin: 16px 0;"></div><div style="display: flex; justify-content: center; align-items: center; gap: 10px; flex-wrap: wrap;"><button onclick="acPrintPlan()" style="background: none; border: 1px solid #d3cabe; border-radius: 8px; padding: 10px 16px; font-size: 13px; color: #6b7280; cursor: pointer; display: flex; align-items: center; gap: 6px;"><svg width="14" height="14" viewBox="0 0 24 24" fill="none" stroke="currentColor" stroke-width="2" stroke-linecap="round" stroke-linejoin="round"><polyline points="6 9 6 2 18 2 18 9"/><path d="M6 18H4a2 2 0 01-2-2v-5a2 2 0 012-2h16a2 2 0 012 2v5a2 2 0 01-2 2h-2"/><rect x="6" y="14" width="12" height="8"/></svg>Print</button></div></div>
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<a href="https://health.clevelandclinic.org/is-pickleball-good-exercise" target="_blank" rel="noopener" style="display: inline-block; background: #fff; border: 1.5px solid #9A6841; color: #9A6841; padding: 8px 20px; border-radius: 20px; font-size: 14px; font-weight: 600; letter-spacing: 0.3px; text-decoration: none; transition: background 0.2s ease, color 0.2s ease;">Cleveland Clinic Health</a>
<a href="https://newsroom.clevelandclinic.org/2026/04/29/why-pickleball-injuries-are-so-common" target="_blank" rel="noopener" style="display: inline-block; background: #fff; border: 1.5px solid #9A6841; color: #9A6841; padding: 8px 20px; border-radius: 20px; font-size: 14px; font-weight: 600; letter-spacing: 0.3px; text-decoration: none; transition: background 0.2s ease, color 0.2s ease;">Cleveland Clinic Newsroom 2026</a>
<a href="https://newsroom.clevelandclinic.org/2023/07/19/avoiding-injuries-while-playing-pickleball" target="_blank" rel="noopener" style="display: inline-block; background: #fff; border: 1.5px solid #9A6841; color: #9A6841; padding: 8px 20px; border-radius: 20px; font-size: 14px; font-weight: 600; letter-spacing: 0.3px; text-decoration: none; transition: background 0.2s ease, color 0.2s ease;">Cleveland Clinic Newsroom 2023</a>
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<h2 style="font-family:Georgia,serif; font-size:20px; font-weight:700; color:#313743; margin:0 0 20px 0;">Frequently Asked Questions</h2>
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How do I know if I am playing too much?
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<div style="padding:0 18px 16px; font-size:18px; color:#555; line-height:1.65;">Soreness that lasts more than 2 days, pain that worsens during the session rather than improving as you warm up, or a 3-week pattern of needing more recovery time than you used to. Most injuries get telegraphed before they happen. Take a week off, do mobility work and easy walking, and return when the warning signs are gone.</div>
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Can I play after a knee replacement?
<svg width="16" height="16" viewBox="0 0 24 24" fill="none" stroke="#9A6841" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" aria-hidden="true"><polyline points="6 9 12 15 18 9"/></svg>
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<div style="padding:0 18px 16px; font-size:18px; color:#555; line-height:1.65;">Many surgeons clear pickleball at 6 to 12 months post-replacement once strength and range of motion are restored. Some advise against it because of the explosive lateral movements. Get a specific clearance from your surgeon and a physical therapist who has worked with post-replacement athletes. The answer depends on your surgical outcome and overall conditioning.</div>
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What paddle weight is right for me?
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<div style="padding:0 18px 16px; font-size:18px; color:#555; line-height:1.65;">Most recreational adult players do best with a 7.5 to 8.5 ounce paddle. Lighter paddles (under 7.5) reduce shoulder fatigue but require harder swings. Heavier paddles (over 8.5) deliver power but accelerate shoulder injury risk. If you have any existing shoulder issues, lean lighter.</div>
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When should I see a doctor after a pickleball injury?
<svg width="16" height="16" viewBox="0 0 24 24" fill="none" stroke="#9A6841" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" aria-hidden="true"><polyline points="6 9 12 15 18 9"/></svg>
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<div style="padding:0 18px 16px; font-size:18px; color:#555; line-height:1.65;">Same day: any sudden popping sound at the calf or shoulder, inability to bear weight or use the arm normally, deformity, or severe pain. Within a week: pain that does not improve with rest and ice, or any swelling that does not respond to standard self-care. Persistent shoulder pain past 2 weeks should be evaluated rather than worked through.</div>
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Is pickleball still worth it if I am injury-prone?
<svg width="16" height="16" viewBox="0 0 24 24" fill="none" stroke="#9A6841" stroke-width="2" stroke-linecap="round" stroke-linejoin="round" aria-hidden="true"><polyline points="6 9 12 15 18 9"/></svg>
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<div style="padding:0 18px 16px; font-size:18px; color:#555; line-height:1.65;">Yes, in most cases. Pickleball delivers cardiovascular, cognitive, and social benefits that few other sports match for the over-50 demographic. The injury risk responds well to preparation. If you keep getting hurt despite warming up and adequate conditioning, get a movement assessment from a sports-medicine physical therapist before quitting.</div>
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How quickly can I return to play after an injury?
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<div style="padding:0 18px 16px; font-size:18px; color:#555; line-height:1.65;">Minor strains or sprains: 1 to 3 weeks of modified activity. Achilles tendinopathy without rupture: 6 to 12 weeks. Achilles rupture: 4 to 6 months. Rotator cuff tears: 8 to 16 weeks depending on severity. Wrist fractures: 6 to 8 weeks immobilization plus rehab. Returning too early roughly doubles re-injury risk.</div>
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