Falls and Wrist Fractures in Pickleball: Why They Happen and How to Lower the Risk

The most common way to get hurt playing pickleball is not a pulled muscle or a sore shoulder. It is a fall. And when players fall, the part that most often breaks is the wrist. Understanding why that happens, and what actually lowers the odds, is the difference between a bruised ego and a broken bone that keeps you off the court for months.

Falls are the leading way pickleball players get hurt

When researchers reviewed a decade of pickleball injuries arriving at US emergency departments, falls were the single most common mechanism, behind 65.5 percent of the injuries studied. That is not a small edge over the other causes. It means roughly two in every three pickleball injuries serious enough to reach an emergency department started with someone losing their balance and going down.

Fractures made up 32.7 percent of injuries in that same analysis, close behind strains and sprains at 30.8 percent, according to the 2025 epidemiologic study in the Orthopaedic Journal of Sports Medicine. The fractures are the ones worth working hardest to prevent, because they take the longest to recover from and they are the ones a fall tends to produce. As we cover in our overview of pickleball injuries after 50, the sudden injuries and the slow overuse ones are two different problems. Falls sit firmly in the sudden category.

Why the wrist takes the hit

When you fall, instinct throws a hand out to catch you. It happens faster than any decision, and it puts the full force of the fall through an outstretched arm and into the wrist. Clinicians call this a fall on an outstretched hand. It is the classic mechanism behind a broken wrist, specifically a fracture of the distal radius, the end of the forearm bone just before the hand.

The data matches the instinct. In that emergency-department analysis, the wrist was the most commonly fractured site, making up 29.2 percent of all fractures. Nearly one in three pickleball fractures happened at the wrist, and the reason is the same nearly every time: a hand thrown out to break a fall.

Age and bone health shape who this happens to. A separate 2025 single-institution study in the Orthopaedic Journal of Sports Medicine put the median age of an injured pickleball player at 65, and found that women were about twice as likely as men to sustain a fracture (odds ratio 2.03). The authors link that pattern to changes in bone density after menopause. None of this is a reason to stop playing. It is a reason to train the specific things that keep you on your feet.

Stop backpedalling, turn and shuffle instead

The single riskiest movement in recreational pickleball is walking backwards to chase a lob. Backpedalling is slow, it puts your weight behind your heels, and it is the position you are least able to recover from when a foot catches. Most falls we hear about started exactly this way: a ball floated deep, the player walked backwards to reach it, and went down.

The safer habit is to turn your hips, take a drop step, and shuffle to the ball facing sideways rather than walking backwards. It feels less natural at first, and it is worth drilling until it becomes automatic, because the moment you need it is not the moment to think about it. Coaches teach this as a core movement skill for a reason. It keeps your centre of gravity over your feet and lets you move with control rather than reaching backwards off balance.

Balance and reaction training lower the odds

Technique keeps you out of the worst positions. The physical capacity to catch yourself is what saves you when technique is not enough. That capacity is trainable at any age, and the evidence for it is strong. A 2019 Cochrane review of exercise for preventing falls in older people pooled 108 trials and more than 23,000 participants and found that exercise reduced the rate of falls by about a quarter (23 percent). The programs that worked best were built around balance and functional exercise, which on their own cut the fall rate by roughly 24 percent.

That points to what to train. Single-leg balance, hip and ankle strength, and quick change-of-direction footwork are the capacities that let you recover a stumble before it becomes a fall. Reaction speed matters too, because a fall on the court usually starts with an unexpected shift, a ball that pulls you wide or a foot that lands wrong. These are the same capacities that reduce fall risk off the court, so the work pays off in more than your pickleball game. If balance already feels like the weak link, that is worth rebuilding deliberately rather than hoping it holds, and the broader off-court version of this work is covered in our guide to balance and falls prevention as you age.

Check the court and your shoes before you play

Some falls come down to the surface and the footwear, not the player. A wet outdoor court, a slick indoor floor, loose debris, or a crack near the baseline is worth a quick look before you start, especially on public courts where conditions change with the weather. Coastal Metro Vancouver play means outdoor courts are often damp in the morning and after rain, and a damp court is a slip risk.

Footwear matters as much as the court. Running shoes are built for moving forward, not sideways, and their softer, taller soles roll more easily on the quick lateral pushes pickleball demands. Court shoes with a flatter, grippier sole give you a more stable base for side-to-side movement. It is a small change that lowers the odds of the ankle roll or slip that starts a fall.

What recovery from a broken wrist involves

A broken wrist is not a quick injury, and it is worth knowing that going in. Depending on how the bone breaks, treatment may be a cast or surgery, and that decision belongs to an orthopaedic surgeon and your physician, not a physiotherapist. What physiotherapy handles is the rehabilitation that comes after, and getting that part right shapes how well the hand and wrist work again.

The rehabilitation goals are consistent whether the fracture was treated in a cast or with surgery: settle pain and swelling, restore movement in the wrist and hand, and rebuild the strength and grip you lost while it was immobilised. There is no single agreed-upon exercise protocol, so the program is built around where your recovery is and what your hand needs to do. A 2024 systematic review and meta-analysis in BMC Musculoskeletal Disorders found that starting rehabilitation early after distal radius fracture surgery improved upper-limb function and reduced pain compared with delayed rehabilitation, though it did not change wrist-specific function on its own. In our clinic, that means we do not wait longer than the surgeon's protocol allows to begin the movement and loading work.

A physiotherapy assessment after the cast comes off or the surgeon clears you is where that program starts. The therapist checks range of motion, tests grip and strength, screens for stiffness in the fingers and forearm, and builds a graded plan to get the wrist back to the tasks you need, from opening a jar to holding a paddle again. Recovery timelines depend on the fracture, your age, bone health, and how early rehab starts, so your therapist will set expectations after seeing how the wrist is moving.

When a fall is a medical call, not a physio booking

Not every fall breaks a bone, but some do, and telling the difference on the court is hard. If a wrist is obviously deformed, badly swollen, will not bear weight or grip, or is severely painful after a fall, that is an emergency-department visit for imaging, not a physiotherapy booking. The same is true for any fall involving a head strike, loss of consciousness, or a hip you cannot stand on.

Physiotherapy comes in after the fracture has been diagnosed and managed, or when a fall leaves you sore and shaken but without a break. If you are not sure whether a nagging wrist after a stumble needs imaging or just needs rehab, that is a reasonable thing to ask, and any of our five studios can screen it and point you the right way. Booking and coverage details are on our rates and FAQ page.

This article is general information, not personal medical advice. A regulated practitioner can confirm whether the patterns described apply to you.

Frequently asked questions

What is the most common pickleball injury?

Falls are the most common mechanism, behind about two-thirds of pickleball injuries reaching US emergency departments in a 10-year analysis. Among fractures, the wrist is the most commonly broken site.

Why do pickleball players break their wrists so often?

When you fall, instinct throws a hand out to catch you, sending the force of the fall through the wrist. This fall-on-an-outstretched-hand mechanism is the classic cause of a broken wrist, and it explains why the wrist accounts for nearly a third of pickleball fractures.

How can I avoid falling during pickleball?

Stop walking backwards to chase lobs. Turn your hips and shuffle sideways instead, which keeps your weight over your feet. Train single-leg balance, hip and ankle strength, and quick footwork, since balance and functional exercise reduce fall rates in older adults.

Do I need surgery for a broken wrist from pickleball?

It depends on how the bone breaks, and that decision belongs to an orthopaedic surgeon, not a physiotherapist. Some wrist fractures are treated in a cast and others need surgery. Physiotherapy handles the rehabilitation that follows either one.

How long does it take to recover from a broken wrist?

Recovery depends on the fracture, your age, bone health, and how early rehabilitation starts, so there is no fixed timeline. Research suggests starting rehab early after surgery improves function and reduces pain, and your therapist will set expectations after assessing how the wrist is moving.

Should I go to physio or the emergency department after a fall?

If a wrist is deformed, badly swollen, or cannot grip or bear weight after a fall, go to the emergency department for imaging first. Physiotherapy comes in once a fracture has been diagnosed and managed, or when a fall leaves you sore but without a break.

Sources

• Increasing Incidence of Pickleball Injuries Presenting to US Emergency Departments: A 10-year Epidemiologic Analysis of Mechanisms and Trends, Orthopaedic Journal of Sports Medicine (2025)
• Evaluation of Pickleball-Related Injuries at a Single Institution From 2017 to 2022, Orthopaedic Journal of Sports Medicine (2025)
• Exercise for preventing falls in older people living in the community, Cochrane Database of Systematic Reviews (2019)
• Impact of early rehabilitation therapy on functional outcomes in patients post distal radius fracture surgery: a systematic review and meta-analysis, BMC Musculoskeletal Disorders (2024)