Pickleball has exploded across Spokane. Courts that sat empty five years ago now have waiting lists. Rec centers, parks, and dedicated facilities are packed with players ranging from their 30s to their 80s, drawn by the sport's addictive combination of accessibility, social connection, and competitive intensity. But pickleball's accessibility is also its risk factor — the sport is easy enough to play immediately but demanding enough to create serious overuse injuries, especially in players who jump from relatively sedentary lifestyles into multiple games per week without adequate physical preparation or recovery.
The elbow takes the most common hit. Pickleball's backhand stroke, dinking motion, and the vibration transmitted through the paddle on contact create repetitive loading of the forearm extensor muscles that originate at the lateral epicondyle — the bony bump on the outside of the elbow. This is the same mechanism that creates tennis elbow, and pickleball players develop it at rates that rival tennis players despite the sport's lighter paddle and smaller court. The grip demands compound the problem — sustaining a firm grip on the paddle during rapid exchanges creates forearm fatigue that accumulates across games, sets, and weeks of play.
The shoulder faces demands that many recreational players aren't prepared for. Overhead serves, smashes, and the reaching volleys that fast exchanges require place the shoulder in loaded positions that the rotator cuff must stabilize. Many pickleball players have desk-job shoulders — rounded, tight anteriorly, weak posteriorly — and the overhead demands of pickleball load these compromised shoulders with forces they can't safely absorb. The result is rotator cuff irritation, biceps tendon strain, and the progressive shoulder impingement that makes overhead shots painful and eventually limits the ability to play.
The lower body absorbs the court's punishment. Pickleball involves constant lateral shuffling, sudden direction changes, quick starts and stops, and the explosive lunging that reaching for shots at the net requires — all on hard court surfaces that provide minimal shock absorption. The knees absorb cumulative impact loading that stresses the menisci and patellar tendon. The Achilles tendon sustains the stretch-and-recoil loading of quick movements. The hips tighten from the sustained low, ready position that competitive play demands. Many players over 50 are asking their joints to perform at levels they haven't demanded since their 20s — and the gap between enthusiasm and physical preparation creates the injury patterns that fill orthopedic offices.
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