Common Upper Body Injuries in Pickleball: How to Avoid Shoulder, Wrist, and Elbow Strain

You hop on Reddit, sore shoulder wrapped in ice, searching threads about injuries in pickleball—and instantly feel like everyone who’s ever picked up a paddle has ended up in a sling. That’s survivorship bias in action: the tendency to only see the stories of those who’ve had problems, while the quiet majority plays pain-free. 

In reality, most players enjoy the game without ever needing physical therapy or cortisone shots. Still, shoulder, wrist, and elbow strains are real risks—especially if you’re new, pushing too hard, or just playing with poor form. In this article, you’ll learn how to avoid the most common upper-body injuries in pickleball by following a few smart, simple rules that keep you on the court and out of the clinic.

What are the most common injuries in pickleball?

Pickleball is fun, fast-paced, and easy to learn—but it’s still a physical sport, and that means injuries do happen. While most aches and pains are mild, some patterns show up more often than others, especially in the upper body.

Here are some of the most common injuries in pickleball:

• Shoulder strains and rotator cuff irritation

• Tennis elbow (lateral epicondylitis)

• Golfer’s elbow (medial epicondylitis)

• Wrist tendonitis

• Muscle tightness in the neck and upper back

While these are manageable with rest and care, some of the worst pickleball injuries can be much more serious. These include full rotator cuff tears, wrist fractures from falls, and severe tendon ruptures that may require surgery. Though less frequent, these injuries can keep players off the court for months and cause long-term discomfort if not treated properly.

That’s why understanding how to prevent sports injuries is so important—and exactly what we’ll cover in the next sections.

How do you prevent shoulder injuries in pickleball?

Shoulder pain in pickleball often comes from overuse, poor mechanics, or simply trying to hit the ball too hard. The most common shoulder injuries include rotator cuff strains, impingement, and inflammation in the biceps tendon. These usually develop over time, especially in players who don’t warm up properly or rely too much on their arm instead of engaging their whole body.

To prevent shoulder issues, focus on building strength and mobility. Light resistance band exercises can help stabilize the shoulder joint, while dynamic stretches before playing improve range of motion. Also, don’t skip your warm-up—getting blood flowing to the shoulder muscles before you serve or smash is crucial.

A big reason many upper-body injuries in pickleball happen is that people play with poor technique. If you’re swinging mostly from your arm instead of rotating your torso and engaging your legs, your shoulder ends up doing all the work. A quick lesson with a coach or even watching slow-motion videos online can make a world of difference in your mechanics.

Shoulder health comes down to respect—respect the limits of your body, and it’ll reward you with a lot more court time.

Why does my wrist hurt from pickleball?

Wrist pain is one of those annoyingly common complaints that can sneak up on pickleball players of all levels. It’s usually the result of repetitive motion, especially during quick flicks, volleys, and dinks. Tendonitis, sprains, and overuse injuries are all common culprits, and they can make even holding the paddle uncomfortable if ignored.

To avoid wrist strain, grip technique matters. A death grip on the paddle puts unnecessary pressure on your joints. Loosening your hold slightly and using a paddle with the right weight and grip size can make a big difference. Warming up your wrist with slow circular motions or light resistance exercises before you play also helps prep the joint.

One of the more overlooked causes of injuries in pickleball is fatigue. When your forearm muscles get tired, your wrist takes on more of the load. This is especially true for newer players or those playing long sessions without breaks. That’s when minor strains can turn into something more serious.

Also, keep in mind that pickleball injuries in seniors often include wrist issues due to aging joints and slower reflexes during falls. A wrist brace or guard can offer additional support, especially if you’ve had prior issues or are returning from injury. Preventing wrist pain starts with awareness—and making smarter choices before and during your game.

Pickleball elbow exercises

Pickleball elbow, much like its cousin, tennis elbow, usually stems from overusing the muscles and tendons in your forearm. All those quick swings and snap shots can create tiny tears where the tendons attach to the outer elbow, leading to pain and stiffness that only gets worse if ignored.

Strengthening and stretching exercises can help prevent and manage this condition. One of the most effective moves is the wrist extensor stretch: hold your arm out straight, palm down, and gently pull your fingers back with your opposite hand. You can also build endurance with wrist curls and reverse wrist curls using light dumbbells or resistance bands.

Grip-strengthening tools like stress balls or therapy putty can help reinforce the small muscles in your forearm. These muscles act as shock absorbers during each swing, so training them reduces overall strain on your elbow. Consistency here matters more than intensity—slow, regular sessions will keep your arm in good form.

If you're wondering how to prevent pickleball elbow, it’s really a mix of preparation and protection. Stretch before and after you play, build strength in your arms and wrists, and don’t ignore the early signs of discomfort. Small daily habits often make the biggest difference when it comes to long-term elbow health.

Wrap up

Pickleball is supposed to be fun, not something that sidelines you with pain. By understanding the strain your shoulders, wrists, and elbows can face on the court, you’re already a step ahead of most players. The good news? With a little care, smart technique, and a few simple exercises, most common aches and pains can be avoided altogether.

Injuries in pickleball don’t have to be part of your story. Whether you’re just starting out or playing several times a week, taking injury prevention seriously will keep you healthy, active, and enjoying the game longer. Your body will thank you every time you pick up that paddle without pain.

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All the surgeons at Orthopedic Institute of NJ treat patient with pickleball injuries. The majority of the injuries result from overuse, falling, or twisting. Many injuries can be prevented with proper rest, stretching, and strengthening of the muscles to help support the joints. We are here to help you get back in the game.

Christian J. Zaino, MD, Orthopedic Surgery, Hand & Wrist
Hand & Upper Extremity Center