pickleball Archives - WPH Physio

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Pickleball might look light and easy from the sidelines, but biomechanically it’s a reactive, full-body sport. You need quick feet, fast reactions, rotation, reaching, lunging, and paddle control.

Your whole body works together as a chain when you play, this is called the kinetic chain. Power starts from your legs pushing into the ground, travels through your hips and core, up into your shoulder, down your arm, and finally to your wrist and paddle.

Because so many parts of the body work together, if one area is weak, stiff, or tired, another area ends up doing more work than it should. That’s when niggles start to show up. This is why a small niggle in the wrist can actually begin in the shoulder, or Achilles pain can come from poor hip control.

Here’s an easy breakdown of the biggest movements in pickleball, the muscles that help you perform them, and what can go wrong when the chain breaks down and one part isn’t pulling its weight.

Quick Movements, Acceleration & Lunging

Muscles involved

Calves — push-off and quick direction changes
Quadriceps — shock absorption and knee control
Hamstrings — deceleration and braking
Glutes — hip stability and direction changes
Core — keeping the trunk stable while the legs move fast

Pickleball footwork is fast and unpredictable. Sudden accelerations, stops and lunges rely on these muscle groups to absorb force and keep joints aligned. These movements rely heavily on the calves for push-off power, the quadriceps for knee control, the hamstrings for braking, and the glutes and core for stability. If any of these muscles are weak or overloaded, the force of sudden direction changes shifts to the joints and tendons.

Weak calves force the Achilles tendon to work harder every time you push off or lunge, which is one of the most common sources of Achilles tendinopathy.

Weak glutes allow the knee to collapse inward during lunges or sidesteps, placing significant stress on the kneecap, patellar tendon, or even the meniscus.

When the hips don’t stabilise properly, the knee rotates excessively, the ankle compensates, and the Achilles becomes overloaded.

Pain might show up in the knee or heel, and players often think their Achilles or knee is the “problem,” but the true cause often sits much higher in the kinetic chain.

Groundstrokes (Forehand & Backhand)

Muscles involved

Obliques — generate turning force
Deep core (TA) — provide trunk stability
Glutes — initiate rotation from the lower body
Thoracic spine mobility — allows smooth twisting

Rotation should come from the hips and trunk, not just the arm. When the obliques, deep core or glutes are weak, pickleball players compensate by “arm-swinging” instead of rotating through the body. If your obliques, deep core, or glutes don’t generate rotational power, the shoulder must lift higher and reach further to compensate.

The rotator cuff becomes overworked, leading to irritation, impingement, or tendon overload. A stiff thoracic spine adds another layer, if your upper back can’t rotate, the shoulder must compensate through awkward angles.

When shoulder strength isn’t enough to generate power, players begin flicking their wrist harder to make up for it, which rapidly overloads the wrist tendons and even the TFCC (a common source of ulnar-sided wrist pain). This is why wrist, elbow, and even shoulder pain often stem from poor trunk rotation, not from a “wrist issue” at all.

Overhead Shots (Serves & Smashes)

Muscles involved

Rotator cuff — keeps the shoulder joint stable
Scapular stabilisers (lower traps, serratus anterior) — allow smooth overhead motion
Deltoid + biceps — add power
Thoracic spine mobility — positions the shoulder blade correctly

Effective overhead mechanics rely on a stable, well-controlled shoulder blade. If the lower traps and serratus anterior, the muscles that stabilise the scapula, are weak, the shoulder blade won’t rotate properly. This forces the rotator cuff to work much harder to keep the humeral head centred, which can quickly lead to cuff tendinopathy, impingement, or biceps tendon irritation. When the shoulder can’t generate enough power due to instability or poor posture, pickleball players begin relying on the forearm and wrist to produce force, causing wrist flicking, forearm tightness, and tendon overload. If the shoulder blade is unstable, everything downstream from it, elbow, forearm, wrist, is forced into compensation.

Net Play (Dinks, Volleys)

Muscles involved

Forearm flexors/extensors — grip and wrist control
Rotator cuff — stabilises shoulder for fine movements
Scapular muscles — keep the shoulder positioned
Core stability — maintains posture and keeps upper limb stable

Even small, precise paddle movements depend on a stable shoulder and trunk. If the rotator cuff or scapular muscles aren’t doing their job, the wrist ends up compensating by gripping harder and moving less efficiently. Over time, this creates extra tension in the forearm and increases the risk of tendinopathy, TFCC irritation, and elbow pain. Many players assume these are just “wrist problems,” but usually the wrist is only where the pain shows up — the real issue starts at the shoulder and scapula. That’s why treating the wrist alone often isn’t enough; the stability above it also needs to be addressed.

Takeaway

Across most common pickleball injuries, the same patterns keep showing up: weakness, poor control, tight muscles or fatigue in one part of the body often causes another part to compensate, which can quickly lead to overuse or joint problems.

The place that hurts is rarely the place causing the problem.

A physiotherapist looks at the whole system — strength, stability, mobility, technique, and footwork — to find where the breakdown is happening. When all parts are working together, players move more efficiently, generate more power, and stay injury-free on the court.

Don’t Wait — Listen to Your Body

A small niggle is your body warning you.
Ignore it long enough, and it becomes a problem that takes you off the court for weeks (or longer).

Early Signs You Shouldn’t Ignore

Morning stiffness
Pain that warms up but returns later
Sharp or catching sensations
Swelling
Soreness lasting more than 24 hours after playing

The sooner you address these, the faster and easier the recovery.

Final Tips for Staying Injury-Free

Warm up properly: dynamic movements, shoulder activation, calf warm-ups
Strength train 2–3x/week (glutes, rotator cuff, calves, core)
Increase playing time gradually
Rotate your shoes regularly
Rest or modify at the FIRST sign of a niggle
See a physio early, you’ll save yourself months of frustration

If you are struggling with an injury after pickleball, or any sport for that matter, call us on 0298753760 or you can book online.

FAQ’s

Is pickleball a high risk sport

The intense cardiovascular demands of darting back and forth across the pickleball court can pose challenges for individuals with pre-existing heart conditions. Additionally, the rapid, sudden movements required on the hard surface of the pickleball court increase the risk of fractures, especially for pickleball players with low bone density or osteoporosis.

Is pickleball actually a good workout?

Yes, playing pickleball is an excellent form of exercise, delivering a cardiovascular and aerobic workout that enhances heart health, balance, flexibility, and muscle strength. As one of America’s fastest growing sports, pickleball offers a moderate-intensity fitness routine that can be easily adjusted to a higher intensity by increasing the speed and vigor of play.

This makes pickleball a popular choice for improving overall fitness, endurance, and coordination while enjoying a fun, social racket sport.

What are the negatives of pickleball?

Like any physical activity, pickleball poses health risks, especially for older adults and beginners.

Common injuries of pickleball include muscle strains, tennis elbow (lateral epicondylitis), rotator cuff injury, and ankle injuries. Players can experience pain in the knees, elbows, shoulders, and other joints due to sudden lateral movements and overuse.

Falls on the hard pickleball court can lead to wrist injuries, hand injuries, bone fractures such as Colles fractures, and other upper extremity injuries.

Additionally, playing pickleball can exacerbate existing conditions like hip arthritis and knee arthritis, making injury prevention and proper physical therapy essential for maintaining long-term joint health.

How not to get hurt before playing pickleball?

Warm up properly before playing pickleball to prevent common injuries in pickleball.

To reduce injury risk and improve performance in this rapidly growing sport, experts recommend dynamic warm-up exercises rather than traditional static stretching. Incorporating dynamic stretches such as walking lunges, arm circles, and high knee lifts to activate the muscles used in pickleball are good examples.

Additionally, a short jog or 30 seconds of jumping jacks can increase blood flow and prepare your musculoskeletal system for the quick, sudden movements on the pickleball court.

Proper warm-up is essential for pickleball players to prevent common injuries like muscle strains, knee sprains, and shoulder injuries.

What are the most common pickleball injuries?

Muscle strains and overuse injuries in pickleball are among the most common pickleball injuries experienced by players. These injuries often manifest as persistent shoulder pain or knee pain that gradually develops due to repetitive motions and excessive strain during play.

Unlike acute injuries, there may not be a single identifiable moment of trauma, making early recognition and proper treatment essential to prevent worsening symptoms and future injuries.

Pickleball might look light and easy from the sidelines, but biomechanically it’s a reactive, full-body sport. You need quick feet, fast reactions, rotation, reaching, lunging, and paddle control.

Here’s an easy breakdown of the biggest movements in pickleball, the muscles that help you perform them, and what can go wrong when the chain breaks down and one part isn’t pulling its weight.