Uh oh, you’ve caught the pickleball bug—welcome to the club! It’s all fun and games until your knees start reminding you that you’re not a teenager anymore. Between the quick pivots, sudden stops, and those moments when you *almost* dive for the ball (but wisely decide against it), pickleball can be surprisingly tough on your joints. The last thing you want is to trade your paddle for an ice pack—or worse, a surgeon’s waiting room followed by months of physical therapy. 

Luckily, with a little prep work, you can keep your knees happy and stay in the game. Let’s talk about how to use preventive, holistic physical therapy that you can do at home to strengthen, protect, and future-proof your knees so you can dominate the pickleball court without hobbling off it!

Why Pickleball Can Be Hard on the Knees

Quick Lateral Movements, Impact, and Overuse:

Pickleball’s fast-paced nature requires quick direction changes, sudden stops, and frequent jumping, placing stress on the knees. Over time, repetitive strain from the sport, especially without proper preparation, can lead to inflammation or injury in the knee joint. For some of you more seasoned players, there might be some previous wear and tear from years of living life to the fullest. That might hasten the inflammation or injury to your knees if you aren’t careful. 

Surface and Playing Conditions:

The type of surface you play on (hard court vs. softer surfaces) can impact knee strain. Harder courts increase the impact on your joints, while softer surfaces might reduce impact, but present other risks (like ankle twists).

5 Key Strategies to Strengthen and Protect Your Knees  

1. Strengthen Your Quadriceps & Hamstrings

The quadriceps (front of the thigh) and hamstrings (back of the thigh) are critical for knee stability. They are uniquely placed on the front and back of your leg to provide strength and stability for your knees. Strengthening these muscles helps stabilize the knee during those sudden movements.

Strengthening them can also help to balance any muscle imbalance you might have— if one side of your leg is stronger than the other, that can pose problems and lead to injury. Also, as a note to many of the women out there, women tend to be more quadriceps dominant and slightly weaker in the hamstrings. Be sure to give those hamstrings some love in your training sessions to strengthen that backside support. 

Pro tip: When strengthening these muscles, opt for compound movements (movements that involve many muscle groups). This is crucial for your brain to recruit and utilize your muscles to the best of your ability. Think of it this way, if a basketball team were to practice drills all the time, but never actually put them to use in a game type setting, it’s hard to make it really work and flow properly. Same thing with your body, practice using many muscles at the same time. These exercises could include deadlifts, squats, lunges, jumping, and more. If you experience some pain while doing some of these exercises, check out our other blog on the topic. You could also modify these exercises and not go as deep into the movements.

2. Improve Hip Stability

Strong and stable hips prevent excess strain on the knees. Poor hip stability can lead to improper alignment and additional stress on the knee joint. If you think of your hips as the foundation of most of your body’s movement, you can see how crucial it is to have a solid foundation. And keeping with our analogy, if you have a crack in your foundation, something from the basement to the roof might be affected, if not all of the above. If your hips are weak or unstable, you might experience pain or injury anywhere down your leg or up your back.

Have we made it clear enough that your hips play a pretty big role in your injury prevention? There are many different muscles that contribute to strength and stability in the hips, including your glutes, inner thighs, outer legs, hip flexors, and some core muscles. Exercises like glute bridges, clamshells, and leg lifts can help improve hip strength and stability.

Pro tip: Don’t forget that you are only as strong as you are mobile. Being intentional about stretching and mobilizing your hips might just be the trick to not only preventing injury, but maybe even playing a little better too. Check out this IG video demonstrating some great hip mobility exercises.

   3. Enhance Ankle Mobility

Good ankle flexibility and mobility can reduce the load on your knees, especially during lateral movements. If you think about it, all of your body weight puts pressure on your ankle joints, and you want them to be sure and steady underneath you in daily life, let alone sports like pickleball.  Unless you’ve had a bad ankle sprain recently, it’s sometimes easy to forget how much our ankles do for us. 

Try calf raises, ankle circles, and mobility drills to keep your ankles limber and responsive, allowing for better shock absorption during gameplay. You can even try a two-for-one exercise of a deep squat. This helps you create mobility in your ankles as well as your hips. Try to get lower and lower each time, holding onto something if needed to not fall over. 

   4. Strengthen the Lateral Muscles  

Strengthening the muscles around the knee supports the ligaments and reduces the risk of injury. These stability muscles are truly the unsung heroes of injury prevention and stabilization. Most of the time, we don’t even know how they are working to protect our knee joints. The muscles on the outside of your legs are collectively known as the abductors. Conversely, the muscles of your inner thigh are your adductors. These muscles work synergistically to provide you with stable knees as you lunge to the side to make that killer play. They also just might save your knee when you take an unexpected turn on the court. 

Exercises like side planks, clamshells, and lateral lunges are great for targeting the abductors and adductors while also keeping with our compound movement theme. Additionally, using resistance bands can target the muscles that stabilize the knee joint. Think of putting a band right above your knees, lowering into a hovering squat, and walking laterally, pressing your knees out with each step. The clamshells or side planks could also be done with a band to increase difficulty.   

  5. Warm Up & Cool Down Properly

A proper warm-up before playing increases blood flow to the muscles and prepares your joints for the activity ahead, reducing the risk of injury. Focus on dynamic stretches, such as leg swings and hip rotations. Lead up to practicing some of the more explosive elements in the game (like jumping, lunging, side-shuffling, and sprinting) to activate your brain and get your muscles ready for big movements.

After the game, cool down with gentle static stretches for the legs, hips, and knees to prevent tightness and improve flexibility. Remember to not play favorites when it comes to stretching. When you stretch your quads, make sure to also stretch your hamstrings. Same thing goes for your adductors and abductors too. That will also help you to keep the pain away from stiffness and tightness. 

Tips for Safe Pickleball Play

• Proper Footwear: Choose shoes with good arch support and cushioning to absorb shock from quick lateral movements. Make sure the shoes have non-slip soles to prevent accidental slipping on the court.
• Surface Awareness: Be mindful of the playing surface. Hard courts can increase knee stress, so consider playing on softer surfaces or taking breaks if you’re feeling joint discomfort.
• Gradual Intensity Increases: Start slowly and gradually increase the intensity and duration of your pickleball sessions. Overdoing it can lead to overuse injuries. Listen to your body and take rest days as needed. We know it is hard, especially if you have a bet going with your friends, or even if you have a pretty fiery competitive side to you, but pacing and doing a proper warmup will save your knees now, and for the future you that kind of wants to keep doing it for a while.

Let’s be real—pickleball is addicting, and the last thing you want is to be sidelined because your knees decided to stage a protest. The good news? We have given you resources in this blog to set you up for a successful pickleball season ahead. Think of it as insurance for your pickleball obsession—because no one wants to swap their paddle for an ice pack and a spot on the couch. So do your squats, stretch those legs, and play smart… your future knees will thank you (and so will your doubles partner). 

If you are someone who has already been plagued by a case of the pickleball knee injury, please feel free to reach out and talk with one of our holistic physical therapists here at Mitchell Holistic Health in Onalaska, WI. Our goal is to truly get you out of the clinic and back into real life without expensive imaging, surgery, or injections. We focus on your whole body because we know from science that your body works as a whole and needs to be treated as such. We are skilled and experienced in movement-based philosophies that help you not only have less pain, but retrain your brain to help you move more effectively going forward. 

FAQs for the Future Pros of Pickleball:

1. What are the most common knee injuries in pickleball players?  

Some of the most common knee injuries include:  

• Patellar tendinitis (“jumper’s knee”) – inflammation of the tendon below the kneecap from repetitive jumping and stopping.  
• Meniscus tears – caused by twisting motions while pivoting.
• Ligament strains or sprains – especially the MCL (medial collateral ligament) due to lateral movements.  
• Arthritis flare-ups – for players with pre-existing knee osteoarthritis, pickleball can aggravate joint pain.  Check out this blog to help you determine if you have arthritis or maybe bursitis.

2. How can I tell if my knee pain is just soreness or a serious injury?  

If your knee pain is mild, goes away with rest, and isn’t affecting your movement, it’s likely just soreness. However, if you experience swelling, persistent pain, instability (feeling like your knee might “give out”), or pain that worsens over time, you could have a more serious injury that needs medical attention. Call us if it’s the latter.

3. Should I wear a knee brace while playing pickleball?

It depends on your knee health. If you have a history of knee injuries or instability, wearing a brace can provide extra support and help prevent excessive movement. However, it’s not a substitute for strengthening exercises and proper mechanics. If you’re unsure, consult a specialist for guidance on the best type of brace for your needs.  

4. How can I improve my balance and stability to prevent knee injuries? 

Good balance reduces unnecessary stress on the knees by improving your ability to move efficiently. Try:  

• Single-leg balance drills – standing on one foot for 30+ seconds.
• Bosu ball exercises – adding instability to engage stabilizing muscles.
• Lateral band walks – strengthening hip muscles to support the knees.
• Core exercises – a strong core helps with body control and movement efficiency.  

5. How do I modify my playing style to reduce stress on my knees?  

A few small changes can make a big difference:  

• Bend your knees instead of locking them when reaching for the ball.
• Engage your core and hips by staying in an athletic stance to take pressure off your knees.
• Shorten your stride to reduce impact when stopping.  
• Use good footwork – shuffle rather than lunging too aggressively.  

Pro tip: Check out our 8-part series on how we utilize the GOATA method to help you rewire your brain to optimize your movement in a way that is most effective for your own body.

6. Is stretching before and after pickleball really that important?  

Yes! Dynamic stretching before playing warms up your muscles and increases blood flow, reducing the risk of strains. After playing, static stretching helps prevent stiffness and improves flexibility.  

7. When should I come into your office for knee pain or an injury?  

You should seek professional treatment if you experience:  

• Persistent knee pain that lasts more than a few days.
• Swelling, stiffness, or redness around the joint.
• A popping sound or sensation at the time of injury.
• Difficulty bearing weight or instability in the knee.
• Pain that interferes with daily activities or worsens over time.  

Early intervention can prevent minor issues from turning into major injuries. If you’re unsure whether your knee pain requires treatment, it’s always better to get it checked out before it leads to a more serious problem.