Study Maps Common Pickleball Injuries, Revealing Knee, Wrist, and Shoulder Risks

The biggest risk at a high-volume pickleball retreat is not a bad match, it is a body part that cannot finish the week. A new cross-sectional study in Injury Epidemiology reviewed 164 pickleball-related injuries seen at a tertiary academic outpatient orthopedic and physical medicine and rehabilitation clinic from 2019 through 2023, and the pattern was clear: the knee, foot and ankle, wrist and hand, and shoulder took the hardest hit.

That detail matters because the study went well beyond a simple injury count. It identified lateral epicondylitis at the elbow, rotator cuff tears, distal radius fractures from falls, Achilles tendon tears, radicular pain and spinal stenosis, medial meniscus tears, and hamstring or iliopsoas injuries. Hand and wrist injuries were more common among female players, and non-paddle-side upper-extremity injuries showed up more often in the hand and wrist than in the shoulder or elbow. For anyone booking an intensive retreat, that points to a familiar mix of danger zones: awkward falls, quick stops, repeated swings and sharp lateral cuts.

The practical lesson for retreat organizers is straightforward. Sessions that stack back-to-back court blocks without enough warmup or recovery time are asking more of the knees, ankles and shoulders than the clinic data suggests many players can comfortably absorb. Dynamic warm-ups, strength work for the core, legs and rotator cuff, and mobility drills are not side notes; they are the most direct ways to reduce the odds of a trip-ruining injury before it starts. Court spacing also matters, because crowded layouts raise the chance of collisions and rushed recovery steps after a scramble at the kitchen.

The scale of the sport makes that prevention work even more urgent. The Sports & Fitness Industry Association said 24.3 million Americans played pickleball in 2025, up from about 4.2 million in 2020. USA Pickleball reported 104,828 members in 2025, more than 2,300 new court locations added, and 82,613 known courts nationwide. As the player base has grown, so has the injury burden: one national emergency-department analysis found estimated injuries rising from 1,313 in 2014 to 24,461 in 2023, while another NEISS-based study counted 66,350 nationally estimated injuries from 2013 to 2022, with most cases in adults 65 to 80 and falls leading the list.

For retreat players, the message is direct: the most valuable program feature may not be another hour of court time, but a smarter schedule that protects knees, wrists and shoulders from a week that ends too early.