UTHealth Warns Pickleball Players of Rising Foot and Ankle Injuries

UTHealth Houston's Department of Orthopedic Surgery at McGovern Medical School published a sharp warning to recreational players this week: pickleball's explosive growth is producing an equally explosive rise in foot and ankle injuries, and most of the damage is landing on players over 50.

With approximately 8.9 million Americans playing pickleball in 2022, more than double the number from three years prior, the sport has created an outsized patient load for foot and ankle clinics. John Z. Zhao, MD, assistant professor and foot and ankle surgeon with UTHealth Houston, points directly at the sport's mechanics: "Although pickleball is a fantastic sport for improving cardiovascular health, it involves sudden, high-impact movements that can lead to lower extremity injuries if players are not careful."

Dr. Zhao is blunt about the pattern he sees repeatedly: "I see it all the time, the weekend athlete going for a diving save and ending up with an Achilles tendon rupture." Those explosive movements place repetitive stress on the ankle ligaments, Achilles tendon, plantar fascia, and calf muscles, and many players start without proper conditioning, increasing the risk of both acute injuries and overuse conditions.

From ankle sprains to Achilles tendon ruptures, pickleball-related foot and ankle conditions have become increasingly common, especially among adults over 50 and recreational athletes returning to sports. While the sport has long been associated with adults over 50, the fastest growth is now among players under age 35. Adults aged 50 and older, however, still account for the majority of pickleball-related injuries treated in emergency departments.

Victoria Acebo, Ph.D., a psychologist and level 5.0 tournament-rated pickleball pro who coaches through her Austin-based Good Vibes Pickleball Retreats, knows that injury landscape personally. After three ACL reconstruction surgeries on her left knee, prevention is not an abstract concept for her. "Twisted ankles are common injuries I see," she says. "Quick starts, stops, and changes of direction are common on the pickleball court, so it's important to wear shoes with good ankle support and traction for quick lateral movements."

Dr. Zhao reinforces the conditioning piece: "Not only is it important to stretch before and after play, but incorporating regular flexibility work and staying within your limits is key to preventing injury." The UTHealth guidance specifically calls for warming up with light cardio and dynamic stretching before play, and wearing court-specific shoes with strong lateral support.

Acebo also leans on recovery gear to stay on the court. She is a dedicated user of the Incrediwear Knee Sleeve, noting: "From the very beginning when I started playing pickleball I was introduced to the Incrediwear sleeves." Her three gold medals, earned at events including the Carvana PPA Tour and the 002 Dink and Slam Tournament, were built on that foundation of careful recovery management. Players who want to reach her through Good Vibes Pickleball Retreats can contact her at OMpickle@icloud.com or 512-788-1238.

The clinical bottom line from UTHealth is straightforward: "With proper conditioning, stretching, footwear, and awareness, players of all ages can enjoy pickleball safely." For anyone already dealing with foot or ankle pain, the guidance is equally direct: "If you experience severe pain, swelling, or limited mobility, consult a healthcare professional for care as soon as possible." Early diagnosis and treatment can help prevent long-term complications and speed recovery. Appointments are available with Dr. Zhao and the orthopedic foot and ankle team at UTHealth Houston through McGovern Medical School.