Pickleball Injuries After 50 in Metro Vancouver: What's Common and How to Stay on the Court

Pickleball is the fastest-growing racket sport in Metro Vancouver, and most of the people picking up a paddle are over 50. That combination, a quick lateral sport played largely by an older crowd, produces an injury pattern that is now well documented, and it is one physiotherapists can help you get ahead of.

Pickleball injuries split into two very different groups

When researchers looked at pickleball injuries arriving at emergency departments over the decade to 2022, the two biggest categories were almost even: fractures made up 32.7 percent of injuries and strains or sprains 30.8 percent, according to a 2025 epidemiologic analysis in the Orthopaedic Journal of Sports Medicine. Those two groups are not the same problem, and they do not have the same solution.

The first group is the sudden injury. You lunge for a dink at the kitchen line, catch a toe, and go down. Falls were the single most common mechanism in that emergency-department data, behind roughly two-thirds of the injuries studied. The second group is the overuse injury, the shoulder or calf that gets sore over weeks of play and eventually stops you. One builds in an instant. The other builds quietly. Knowing which one you are dealing with changes what you should do about it.

Older players show up in the injury data the most

Pickleball skews older, and so do its injuries. In that same emergency-department analysis, players aged 65 to 80 accounted for roughly three in five of the injuries recorded. A separate 2025 single-institution study in the Orthopaedic Journal of Sports Medicine put the median age of an injured player at 65.

Age matters here for reasons that have nothing to do with effort or fitness. Bone density, balance, and reaction time all shift with the decades, so the same trip that would bruise a 30-year-old can fracture a wrist at 70. The single-institution study also found that women were about twice as likely as men to sustain a fracture, a pattern the authors link to bone health after menopause. None of this is a reason to stop playing. It is a reason to prepare the specific systems, balance and bone-loading strength, that lower the odds of the injuries that actually send people off the court.

The overuse injuries we see most from racket sports

The sudden injuries get the attention, but the slow ones are more common in the clinic. In the single-institution study, the most frequent diagnosis was rotator cuff trouble, the shoulder impingement, strain, or tear that comes from repeated overhead serves and volleys, at 10.8 percent of injuries. Arthritis-related pain came next at 10 percent, then back pain or sciatica at 7.8 percent, then calf strains and tears at 5.7 percent.

Each of these has a well-worn rehab path, and most respond to loading the tissue rather than resting it indefinitely. Shoulder pain from serving is usually a rotator cuff problem worth assessing before it becomes a tear. A sharp calf pull, sometimes called "pickleball leg," sits on the same spectrum as Achilles tendon problems that need graded loading to settle. And the aching knee that flares after a long session is often osteoarthritis, which is very manageable with the right exercise program and rarely a reason to stop playing. The common thread is that these injuries reward early, specific attention and punish waiting until you cannot play at all.

The falls are the injuries worth preventing first

If you prevent one category of pickleball injury, make it the falls. They were the leading mechanism in the emergency-department data, and they cause the injuries that take the longest to come back from. The wrist was the most commonly fractured area, making up 29.2 percent of all fractures in that analysis, and the mechanism is almost always the same: a backpedal to chase a lob, a loss of balance, and a hand thrown out to break the fall.

Backpedalling is the single riskiest movement in recreational pickleball. The safer habit, turning and shuffling rather than walking backwards, is a coaching cue worth drilling until it is automatic. Underneath the technique sits the physical capacity to catch yourself: single-leg balance, hip and ankle strength, and the reaction speed to adjust when a shot pulls you out of position. Those are trainable at any age, and they are the same capacities that reduce fall risk off the court. If balance already feels like the weak link, that is worth rebuilding deliberately rather than hoping it holds.

Warm up with movement, not a stretch

The pre-game routine that lowers injury risk is a dynamic warm-up, not a set of held stretches. The goal is to raise tissue temperature and rehearse the movements the game demands: a few minutes of easy footwork, side-to-side shuffles, gentle lunges, arm swings, and some slow practice serves before you play for real. Static stretching, the kind where you hold a hamstring stretch for thirty seconds, is better saved for after play, when the muscles are warm.

Cold muscles asked to sprint sideways are how calf strains happen. A shoulder taken straight into hard overhead serves without a build-up is how the rotator cuff gets irritated. Five to ten minutes of movement first is unglamorous and it works. In our clinic, the players who avoid the mid-season overuse flare are almost always the ones who treat the warm-up as part of the game rather than something to skip when the court is free.

When to keep playing, and when to come in

Not every ache needs a physiotherapist. Muscle soreness that settles within a day or two, and stiffness that eases once you are moving, is the normal cost of a new sport and usually responds to sensible load management. The line worth watching is whether a symptom is improving week to week or entrenching.

Book an assessment if pain is sharp rather than achy, if it is not improving after a couple of weeks of backing off, if a joint is swelling or giving way, or if a specific movement, the serve, the lunge, the push-off, reliably reproduces it. Those patterns tend to need a plan rather than more rest. A physiotherapy assessment screens the injury, rules out anything that needs a physician, and builds the loading program that gets you back on court. Some symptoms are not booking questions at all: a fall with a possible fracture, chest pain or breathlessness during play, or any numbness, weakness, or loss of function is a same-day call to your physician or emergency, not a physio appointment.

Where people play near each studio

Pickleball courts have spread across Metro Vancouver, both public and private, and our five studios sit close to the busiest ones. Near our North Burnaby studio, Robert Burnaby Park is a well-used outdoor hub and a large indoor facility has opened nearby. Our Richmond studio is minutes from the outdoor courts at Hugh Boyd and South Arm parks and the dedicated indoor courts in the area. Players around our Coquitlam, New Westminster, and Lougheed studios have municipal courts within a short drive, and Pickleball BC keeps a current directory of where to play across the province.

The practical point is access. If you play regularly and something starts nagging, you do not have to let it slide until the offseason. Booking near the court you play on means you can get assessed, start the right loading work, and keep playing through most of it rather than sitting out. If you are not sure which of the five studios is closest or what a first visit costs, the rates and FAQ page covers coverage and booking.

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?

It depends on how it happened. Sudden injuries are led by falls, with wrist fractures the most common fracture. Overuse injuries are led by rotator cuff shoulder problems, followed by arthritis flares, back pain, and calf strains.

Why are pickleball injuries so common in people over 50?

The sport is played largely by an older crowd, and age shifts bone density, balance, and reaction time. In the emergency-department data, players 65 to 80 accounted for roughly three in five injuries. Preparing balance and strength lowers the risk considerably.

Do I need to stop playing pickleball if my knee or shoulder hurts?

Usually not. Most overuse injuries respond to a specific loading program while you keep playing at a modified level, rather than to complete rest. A physiotherapy assessment can tell you what is safe to continue and what needs to change.

How do I avoid falling during pickleball?

Replace backpedalling with turning and shuffling to chase lobs, since backwards walking is the riskiest movement. Underneath the technique, single-leg balance and hip and ankle strength give you the capacity to catch yourself, and both are trainable at any age.

Should I stretch before playing pickleball?

Warm up with movement rather than held stretches: easy footwork, shuffles, lunges, arm swings, and slow practice serves. Save static stretching for after play, when the muscles are warm.

When should I see a physiotherapist about a pickleball injury?

Book if pain is sharp, not improving after a couple of weeks, causing swelling or giving way, or reliably triggered by a specific movement. A fall with a possible fracture, or any numbness, weakness, chest pain, or breathlessness, is a same-day medical call instead.

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)
• Pickleball BC, Where to Play directory