30 Seconds of Therapy: Safely Starting Pickleball – Injury Prevention Tips for Physical Therapists (Part 1)

Pickleball has become one of the fastest-growing sports, with millions of players participating worldwide. While the sport was once associated mostly with older adults, the average dedicated player is now around 35 years old, and participation continues to grow across all age groups.

For physical therapists, this trend presents both an opportunity and a challenge. Patients are eager to stay active through pickleball, but many underestimate the physical demands and injury risks associated with the sport.

Understanding how to guide patients properly—from starting safely to recognizing when to stop—is essential for injury prevention.

How to Help Patients Start Pickleball Safely

Before patients begin regular play, physical therapists should first assess movement readiness. Pickleball requires more athletic movement than many beginners expect.

Evaluate areas such as:

• Balance and single-leg stability

• Hip and core strength

• Ability to accelerate and decelerate

• Lateral movement control

Once readiness is assessed, encourage patients to start with short playing sessions (30–45 minutes) and gradually increase frequency. Emphasize that footwork and positioning matter more than paddle technique, especially for beginners. Teaching simple movement strategies like pivoting instead of backpedaling can significantly reduce fall risk.

When Patients Should Stop or Modify Activity

Physical therapists should educate patients to recognize early warning signs of injury.

Players should stop playing or modify activity if they experience:

• Sudden calf or hamstring tightness

• Sharp shoulder or elbow pain

• Loss of balance or dizziness

• Persistent swelling in joints

• Pain that changes movement mechanics

Ignoring these symptoms often leads to more serious injuries such as muscle strains, tendon injuries, or falls resulting in wrist fractures. Early rest and evaluation allow therapists to correct movement problems before they worsen.

Why Preparation Is Important

Although pickleball appears low-impact, the sport requires:

• Quick acceleration and deceleration

• Lateral agility

• Short bursts of sprinting

• Rapid direction changes

Many recreational players have not performed these movements in years, which explains the rise in injuries. This is why physical therapists should encourage strength and agility training alongside playing. Even simple programs focusing on lower-body strength, balance, and core stability can significantly reduce injury risk.