Pickleball Shoulder Injury: Causes, Symptoms, and Treatment

Pickleball Shoulder Injury: Causes, Symptoms, and Treatment


Pickleball is a rapidly growing sport that combines elements of badminton, tennis, and table tennis. While known for its ease of entry, pickleball can lead to a variety of injuries, particularly in the shoulder. This blog delves into the causes, symptoms, and treatment options for pickleball shoulder injury, helping you stay pain-free and enjoy the game for years to come.

Basic anatomy of the shoulder

The shoulder is a complex joint with remarkable flexibility. It allows for a wide range of motion thanks to the interaction of bones, muscles, tendons, and ligaments. Key components include:

  • Humerus: The upper arm bone
  • Scapula: The shoulder blade
  • Clavicle: The collarbone
  • Rotator Cuff: A group of four muscles and tendons that stabilize the shoulder joint
  • Bursa: Fluid-filled sacs that cushion the rotator cuff and other structures

Role of the shoulder in playing Pickleball

The shoulder plays a critical role in every aspect of your pickleball game. It’s responsible for:

  • Swinging the paddle: Overhead smashes, forehands, and backhands all require significant shoulder movement.
  • Serving: A proper serve involves a full range of shoulder motion.
  • Quick movements: Reacting to shots requires rapid shoulder rotation and stabilization.

Causes of Pickleball Shoulder Injury

Several factors contribute to pickleball shoulder injury, highlighting the demands this sport places on the shoulders. Notably, strains, sprains, and fractures account for a significant portion of pickleball injuries – roughly 60%. Let’s explore the most common causes behind these injuries:

Overuse and Repetitive Motion

The repetitive nature of pickleball, particularly the overhead motions in serves, smashes, and other strokes, can irritate and inflame the rotator cuff tendons and bursa. This repetitive stress can lead to tendinitis and bursitis, limiting your ability to play at your best.

Improper Technique

Incorrect form while swinging the paddle or serving can put unnecessary stress on the shoulder joint and surrounding structures.

Sudden Increase in Activity

If you’re new to pickleball or haven’t played in a while, jumping back in with intense sessions can lead to overuse injuries.

Poor Conditioning and Lack of Warm-up

Weak core and shoulder muscles and neglecting a proper warm-up routine can increase the risk of shoulder pain.

Common Movements in Pickleball That Can Lead to Injury

Common Movements in Pickleball That Can Lead to Injury

Certain pickleball movements are more likely to cause shoulder strain:

Overhead Shots

Overhead activities, such as smashes and overhead clear, require significant shoulder extension and can stress the rotator cuff, making them a common injury concern among pickleball players.

Forceful Forehand and Backhand Strokes

Hitting the ball with excessive power can strain the shoulder muscles and ligaments.

Prolonged Play

Playing for extended periods without breaks can lead to fatigue and increase the risk of injury.

Other Risk Factors

  • Age: The shoulder tissues become less flexible and more susceptible to some common pickleball injuries as we age.
  • Previous Shoulder Injuries: Existing shoulder problems can be aggravated by pickleball.
  • Lack of Cross-Training: Focusing solely on pickleball without incorporating different activities can lead to muscle imbalances and overuse injuries.
  • Equipment: Using an inappropriate paddle size or grip can affect your swing mechanics and put stress on the shoulder.

Symptoms of Pickleball Shoulder Injury

Shoulder pain from pickleball can manifest in various ways:

  • Sharp or Dull Pain: Pain can be felt anywhere in the shoulder, often worsening with physical activity.
  • Swelling and Tenderness: The shoulder joint might become swollen and tender to the touch.
  • Stiffness: Limited range of motion and difficulty raising the arm.
  • Weakness: A feeling of weakness or instability in the shoulder.
  • Popping or Cracking Sounds: Clicking or popping sensations during movement can indicate tendonitis or bursitis.

Limitations in Movement or Performance:

  • Reduced Range of Motion: Difficulty reaching overhead or behind the back.
  • Decreased Performance: Loss of power and accuracy in your shots.
  • Difficulty with Specific Strokes: Pain might worsen with specific strokes like overheads or serves.
  • Pain When Lying on the Affected Shoulder: Sleeping on the affected side can be uncomfortable.

Treatment Options for Pickleball Shoulder Injury

Treatment Options for Pickleball Shoulder Injury

Treatment for pickleball shoulder pain depends on the severity of the injury. Here are some common approaches:

Rest and Home Remedies

  • Rest: Take a break from pickleball to allow the injured tissues to heal.
  • Ice Therapy: Apply ice packs to the affected area for 15-20 minutes at a time, several times a day.
  • Compression: Wear a compression sleeve to reduce swelling and inflammation.
  • Elevation: Elevate the arm above the heart to help minimize swelling.
  • Over-the-counter Pain Relievers: Consider pain medication like ibuprofen or acetaminophen for pain relief.

Physical Therapy and Exercises:

  • Physical Therapy: A physical therapist can create a personalized exercise program to improve shoulder strength, flexibility, and stability.
  • Stretching Exercises: Gentle stretches can help improve shoulder range of motion and reduce pain associated with pickleball
  • Strengthening Exercises: Strengthening exercises for the rotator cuff, core, and upper back muscles will improve overall shoulder stability and prevent future injuries. Consult a physical therapist for personalized pickleball shoulder exercises.

It’s important to note: While some pickleball shoulder exercises can be done at home, consulting a healthcare professional or sports physical therapy before starting any exercise program is important, especially if you have a diagnosed injury. They can ensure you’re performing the exercises correctly and safely to maximize benefits and minimize the risk of severe injury.

Prevention of Pickleball Shoulder Injury

Taking proactive steps can significantly reduce your risk of developing pickleball shoulder injury:

Proper warm-up and cool-down routines

  • Warm-up: Before playing, perform basic stretches like arm circles, shoulder shrugs, and light swings to increase blood flow and prepare your muscles for athletic activity.
  • Cool-down: After playing, dedicate time to static stretches to improve flexibility and reduce post-game soreness.

Correct technique and equipment

  • Technique: Seek professional instruction or watch instructional videos to ensure proper technique and swing mechanics that minimize stress on the shoulder joint.
  • Equipment: Choose a paddle with a weight and grip size that suits your build and playing style. A qualified coach or sporting goods professional can guide you in selecting the right equipment.

Regular strength and flexibility training

  • Strength Training: Regularly incorporate exercises that target the rotator cuff, core, and upper back muscles to build strength and stability.
  • Flexibility: Maintain good shoulder flexibility through regular stretching routines.

Listen to your body

  • Take Breaks: Avoid playing for extended periods without breaks. Listen to your body and take rest days when needed.
  • Pain is a Warning Sign: Don’t ignore shoulder pain. If you experience severe pain during play, stop immediately and seek professional advice.


Pickleball is a fantastic sport that people of all ages and activity levels can enjoy. By understanding the causes and symptoms of pickleball shoulder injury, implementing preventative measures, and seeking proper treatment for injuries, you can continue to enjoy the game for years.

Are you a Scottsdale pickleball enthusiast looking to prevent injuries and stay on top of your game? Schedule a consultation with Scottsdale Physical Therapy and Performance! Let our experts in physical therapy Scottsdale help you achieve optimal shoulder health and dominate the court pain-free.


Can I play pickleball with a rotator cuff tear?

Playing pickleball with a rotator cuff tear can worsen the injury. It’s important to seek medical attention and follow your doctor’s recommendations for treatment and rehabilitation before resuming play.

What muscles are sore from pickleball?

The shoulder muscles, particularly the rotator cuff muscles, are commonly sore after playing pickleball. Additionally, the forearm muscles used for gripping the paddle and core muscles used for stability can also experience soreness.

How do you test for a rotator cuff injury?

A doctor will conduct a physical examination and may order imaging tests like X-rays or an MRI scan to diagnose a rotator cuff injury.


Dr. Tyler Sinda

Tyler’s specialty is helping golfers, athletes and active individuals in Scottsdale find ways to allow them to continue to workout while rehabbing from injury.

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