Pickleball is fun, fast to learn, and supposedly easy on the body. But a brand-new study out of Stanford Healthcare is telling a more complicated story. Researchers spent five years tracking pickleball-related injuries treated at a major academic medical center — and what they found should change how players of all ages warm up, train, and think about risk on the court.
The Big Picture: Injuries Are Climbing Fast
Between 2019 and 2023, the number of pickleball injuries seen at Stanford's orthopedic clinics increased nearly sixfold — from just 10 cases in 2019 to 59 in 2023. That spike mirrors the sport's explosive growth, which saw U.S. player numbers jump from 4.8 million to 13.6 million in just two years. More players means more injuries, sure — but the type and pattern of those injuries tells a deeper story about who's getting hurt and why.
Out of 913 cases screened, 164 confirmed pickleball-related musculoskeletal injuries made it into the final analysis. These weren't minor aches. These were injuries serious enough to land players in an orthopedic specialist's office at one of the country's leading academic medical centers.
Where Players Are Getting Hurt Most
The two body parts showing the steepest injury climbs were the wrist and hand — jumping from zero recorded injuries in 2019 to 15 in 2023 — and the knee, which went from 6 injuries to 20 over the same period. Shoulder injuries were also a significant finding, with 23 acute shoulder cases in the study cohort and a mean patient age of 67 at the time of injury.
That number — 67 — matters a lot. The research reinforces what earlier national-level data has suggested: older players are bearing the brunt of this injury wave. Americans over 55 make up 40% of all pickleball players and 52% of "core" players (those playing 8 or more times per year). And while the sport is marketed as low-impact and beginner-friendly, the non-volley zone (the "kitchen") can only do so much to protect a body that may not be conditioned for the quick lateral cuts, overhead swings, and sudden direction changes the game actually demands.
Why This Happens: It's Not Just Age
Researchers pointed to a combination of factors driving injuries — including players returning to activity after long periods of being sedentary, the physical vulnerability that comes with aging joints and bones (including osteoporosis), and the biomechanics of specific shots like overhead smashes and low digs at the kitchen line. The study was specifically designed to capture biomechanical factors documented in clinical notes, meaning this wasn't just a headcount of injuries — it was an attempt to understand how and why they happen.
The wrist and hand findings are particularly worth noting. These injuries are often linked to falls — a player reaching out to brace themselves — or to the repetitive stress of paddle mechanics. With composite paddles and a lightweight wiffle ball, it's easy to underestimate how much torque and repetition the forearm and wrist absorb during a typical session.
What This Means for Your Training
- Treat pickleball like a real sport — because it is one. The kitchen slows the game down, but it doesn't eliminate the physical demands. Add knee-strengthening exercises (like squats, lunges, and step-downs) and wrist stability work to your routine before injuries force you to. This is especially important if you're over 55 or returning to activity after a break.
- Don't skip the warm-up. Given that shoulder injuries had a mean patient age of 67, older players in particular need to prioritize dynamic warm-ups that include shoulder circles, rotator cuff activation, and light cardio before play. Cold muscles and stiff joints are a recipe for the exact injuries this study documented.
- Build up gradually if you're new or returning. The research specifically flags sudden increases in activity among previously sedentary players as a major risk factor. If you've just discovered pickleball (welcome to the club), resist the urge to play every day right out of the gate. Give your body time to adapt to the lateral movement, quick stops, and overhead mechanics the game demands.
The Bottom Line
This Stanford study is one of the most detailed looks yet at who is getting hurt in pickleball, where on the body, and how it's happening. With injuries at a single academic center jumping nearly 600% in five years, the sport's medical community is sounding an early alarm. The good news? Most of these injuries are preventable with smarter training habits, proper conditioning, and a realistic understanding of what pickleball actually asks of your body. The sport is for everyone — but staying healthy enough to keep playing requires treating it with the same respect you'd give any other athletic pursuit.
Have you dealt with a pickleball injury this season? Drop your story in the comments — we want to hear from you.