Pickleball has rapidly grown in popularity across the United States, combining elements of tennis, badminton, and ping pong into a fast-paced, highly social sport. While often perceived as low-impact, the repetitive gripping, quick directional changes, and high-frequency paddle contact place significant stress on the hand and wrist.
As participation increases, so do injuries. The reality is simple: When you play hard and play often, injuries are going to happen. What matters most is having the right team in place to diagnose, treat, and guide recovery safely and efficiently.
A Specialist-First Approach to Pickleball Injuries
At Bone and Joint Institute, care begins with one of our orthopaedic hand specialists. These physicians are specifically trained in conditions affecting the hand, wrist, and upper extremity, allowing for precise diagnosis and individualized treatment planning from the start.
The increase in pickleball participation has been accompanied by a rise in hand and wrist injuries. Dr. Todd Wurth, board-certified hand and wrist specialist, explains: “Over the past several years, we’ve seen a significant increase in hand and wrist injuries related to pickleball. As more people play and play more frequently, the repetitive demands on the upper extremity can lead to overuse injuries.”
Unlike tennis, pickleball uses a smaller court and lighter paddle, leading to rapid volley exchanges at close range. These quick reactions require sustained grip strength and repeated wrist motion, which can strain tendons, irritate nerves, and stress the small joints of the hand. Repeated stress on the forearm may cause cumulative microtrauma, particularly in players new to frequent or intense play.
Early evaluation by a hand specialist helps determine whether symptoms stem from tendon inflammation, nerve compression, arthritis, ligament injury, or another underlying issue. Our specialists commonly diagnose conditions such as tendinitis and tendinopathy from repetitive wrist motion, lateral and medial epicondylitis (tennis and golfer’s elbow), thumb arthritis aggravated by paddle grip, wrist sprains and ligament injuries, nerve irritation causing numbness or tingling, and grip-related tendon conditions like trigger finger. Identifying the root cause early ensures players receive the appropriate level of care, whether conservative management, guided therapy, or surgical intervention when necessary.
Seamless In-House Treatment
Treatment may include custom orthoses, such as thumb, wrist, or finger supports, to reduce stress on irritated tissues, along with manual therapy to improve joint mobility and comfort. Targeted strengthening programs build endurance and flexibility in the hand and intrinsic muscles of the fingers and thumb, while progressive loading helps restore resilience in the forearm. If therapy is recommended, patients transition directly to our in-house occupational hand therapy team. This seamless continuum of care allows for close collaboration between orthopaedic specialists and occupational therapists, ensuring treatment plans remain coordinated, efficient, and personalized.
Our occupational therapists specialize in upper-extremity rehabilitation and work closely with the referring physician throughout every stage of recovery. Care is individualized to evaluate grip mechanics, joint mobility, tendon health, and movement patterns of the wrist and forearm. Because the hand does not function in isolation, therapists assess the entire upper extremity to identify contributing factors that may affect performance or delay recovery.
Whether a patient is pursuing conservative care or recovering from surgery, therapy is structured to support a safe and confident return to play.
Prevention: Protecting Your Game
While injuries are sometimes unavoidable, many can be minimized with proactive strategies. Gradual progression of playtime and intensity allows the body to adapt to increased demands. Using a paddle with the correct grip size and appropriate shock absorption can significantly reduce strain on the hands and wrists. Proper warmup routines, forearm stretching, and structured recovery practices further protect the upper extremity.
Education is a critical part of our approach. Players not only recover from injury but also learn how to move more efficiently, protect vulnerable joints, and reduce the likelihood of recurrence. Jeff Gandy, an occupational and hand-certified therapist, emphasizes the importance of pacing yourself: “It’s important to understand your limits and ease into the sport, especially if you’re just starting out. Everyone’s body responds differently to physical activity, so take the time to build up gradually. To reduce the risk of injury, be mindful of your age, current fitness level, and overall health. Listening to your body and progressing at a steady pace will help you stay safe and enjoy the sport long-term.”
Comprehensive Orthopaedic Care, Start to Finish
Players should seek evaluation if pain persists longer than one to two weeks, interferes with grip strength or movement, or is accompanied by swelling, numbness, tingling, weakness, or finger locking. Early assessment and intervention help prevent minor irritation from progressing into more serious injury. Pickleball offers excellent cardiovascular and social benefits, but its repetitive gripping and rapid wrist movements place unique demands on the upper extremity. At Bone and Joint, our orthopaedic hand specialists and dedicated occupational hand therapists provide a comprehensive, coordinated approach to care, from accurate diagnosis to full return to play.
Injuries may be part of the game. With the right specialists guiding your care, recovery can be too. For more information or to schedule an appointment with one of our hand and wrist specialists, visit boneandjointtn.org.
