Serving Up Safety: How to Prevent Pickleball Injuries in NYC

Pickleball is no longer a niche sport—it’s a movement. And in Manhattan, where courts are popping up from the Upper West Side to East River Park, it’s become a favorite for fitness enthusiasts of all ages. With its unique blend of tennis, badminton, and ping-pong, pickleball delivers high energy and low intimidation. But here’s the catch: despite its approachable vibe, pickleball injuries are on the rise, particularly in adults over 40.

At Manhattan Sports Therapy, we’re seeing more New Yorkers walk in with paddle-related aches and sprains—proof that even this fun, social game can take a toll if you’re not prepared. Whether you’re brand new to the game or already in your competitive era, here’s how to stay safe, prevent injuries, and keep your game going strong.

Pickleball by the Numbers

You’re not imagining it—pickleball has exploded in popularity. According to the Sports & Fitness Industry Association, it’s the fastest-growing sport in the U.S. for the third year in a row, with over 36.5 million people trying it in 2023. New York City has embraced it with open arms, with new courts opening in Chelsea, Midtown, and even rooftop spaces across Manhattan.

But with that growth comes a new wave of overuse injuries, sprains, and strains. In fact, recent health reports estimate that pickleball injuries could cost Americans over $250 million annually in medical expenses, particularly in older demographics. So if you’ve recently picked up a paddle, you’re smart to want to prevent injuries before they bench you.

The Most Common Pickleball Injuries We See in NYC

1. Ankle Sprains and Foot Injuries
Quick lateral movements and awkward landings make ankle sprains one of the most common injuries on the pickleball court. Poor footwear or uneven court surfaces can make matters worse.

2. Shoulder Strain or Rotator Cuff Injuries
Repeated overhead swings can lead to shoulder fatigue, strain, or rotator cuff injuries—especially in players who haven’t built up strength or mobility.

3. Pickleball Elbow (like Tennis Elbow)
Overuse of the forearm muscles can result in inflammation around the elbow joint, similar to tennis elbow. It’s usually a result of improper technique or playing too frequently without rest.

4. Knee Injuries
Fast direction changes can cause stress on the knees, particularly the ACL (anterior cruciate ligament), or flare up existing issues like arthritis or patellofemoral pain.

5. Lower Back Strain
Poor posture during play or lack of core stability can lead to lower back tightness or spasms—especially in weekend warriors and new players over 40.

6. Falls and Fractures
Older adults are at a higher risk for wrist, hip, or arm fractures due to falls, often from slipping or tripping during play.

5 Smart Ways to Prevent Pickleball Injuries

1. Prioritize Warmups and Stretching
Before stepping onto the court, do 5 to 10 minutes of active warm-up. Include high-knee steps, shoulder rolls, and gentle trunk twists to get your muscles engaged. Follow with dynamic stretches that target hips, hamstrings, shoulders, and calves.

Bonus Tip: Most people forget to warm up their wrists and forearms—but these areas are critical for controlling your paddle and preventing pickleball elbow.

2. Choose the Right Footwear
Don’t wear your running shoes on the court. Court shoes are designed with lateral support and stable soles to handle quick side-to-side movements. Slippery or worn-out shoes increase your risk of rolling an ankle or falling.

If you’re playing often, consider rotating two pairs of court shoes and replacing them every 300–500 miles of wear.

3. Work on Your Strength and Conditioning
Strong muscles protect your joints. In Manhattan, we often see busy professionals jumping into pickleball games without cross-training. But a simple weekly routine including core work, leg strengthening, and shoulder stabilization can dramatically reduce your risk of injury.

At Manhattan Sports Therapy, we customize performance-based physical therapy plans for athletes of all ages, including pickleball players.

4. Learn Proper Technique Early
Recreational players often adopt “creative” playing styles that lead to strain. Investing in a few lessons with a certified coach can help you:

• Master proper footwork
• Learn how to absorb force with your knees and hips
• Use paddle grip and positioning to avoid wrist and elbow strain

You’ll not only protect your body, but also elevate your game in the process.

5. Rest and Recover
New Yorkers don’t like to slow down, but rest is non-negotiable. Overuse injuries like tendonitis or stress fractures happen when you play too often without allowing your body to recover.

• Take at least one full rest day per week
• Use a foam roller or massage gun after games
• Hydrate and eat properly to replenish joint tissue and muscle recovery

And if you feel pain—stop. Playing through a minor injury often turns it into a bigger one.

What to Do If You’re Already Injured

If you’re experiencing swelling, limited range of motion, or pain that persists beyond a day or two, it’s time to get checked out. At Manhattan Sports Therapy, we offer:

• Diagnostic evaluations using digital imaging
• Sports medicine and orthopedic consults
• Chiropractic care and soft tissue therapy
• Customized physical therapy programs
• Injury prevention coaching

Our goal is not just to help you heal—we work to improve your mechanics and prevent future injury so you can play better, longer.

Pickleball Is for Everyone—Just Play Smart

We love seeing New Yorkers stay active, social, and engaged in new sports. Pickleball is a great way to do all of that—but it’s not injury-proof. With a little preparation and the right recovery strategy, you can enjoy all the benefits without the setbacks.

If you’ve been sidelined with an injury, or want to prevent one before the season heats up, contact the team at Manhattan Sports Therapy. We’re proud to serve active adults, recreational athletes, and competitive players throughout NYC with leading sports injury care and rehab—right here in the heart of Manhattan.

Ready to protect your pickleball performance? Let’s talk.
Call Manhattan Sports Therapy today to schedule an appointment or personalized injury prevention session. Your serve—and your joints—will thank you.