Also called: Pickleball injuries; tennis injuries in older adults
Exercise strongly helps
Strength
Stretch
Balance
Explosive lateral movement and overhead serving in bodies that have not trained for either. Pickleball and tennis have brought huge numbers of older adults into a sport that demands sudden acceleration - and Achilles ruptures and wrist fractures from falls dominate the injury list.
How common: Pickleball is the fastest-growing injury category in over-50s; injury rates rose sharply from 2020
What it is
Racquet sports, and pickleball in particular, have grown enormously among older adults. The health benefits are real and substantial - racquet sports have among the strongest associations with reduced mortality of any activity - and the injury profile is specific.
The demands are exactly the ones that decline with age and are rarely trained: explosive lateral movement, rapid deceleration, backward stepping and overhead serving. Achilles tendon ruptures from a sudden push-off and wrist fractures from falling onto an outstretched hand are the characteristic injuries, and both are largely preventable.
What it feels like
- Calf and Achilles tightness after playing
- Reduced confidence moving backward and sideways
- Shoulder soreness after serving
- Falls or near-falls when moving quickly for a ball
- General soreness disproportionate to the effort, particularly the day after
What causes it
Most people have more than one of these at once, and they feed each other. Read the
list looking for the two or three that sound like your week rather than for the one
true answer — the ones that describe you are the ones worth acting on.
- Explosive lateral movement without preparation
- Racquet sports demand rapid acceleration and deceleration sideways. Almost nothing in ordinary life or in walking-based exercise prepares the body for it.
- Sudden push-off and Achilles rupture
- The classic injury: a sudden push-off to reach a ball, in a middle-aged tendon that has degenerated with age. Rupture rates in racquet sports rise steeply after fifty.
- Backward stepping and falls
- Moving backward for a lob is a high-risk movement for falls. A fall onto an outstretched hand produces the wrist fractures that dominate pickleball injury statistics.
- Declining balance and reaction time
- Both fall with age and both are what prevent a stumble becoming a fall. Neither improves without deliberate training.
- Overhead serving on an untrained shoulder
- The serve is an overhead throwing motion. A shoulder that has not been prepared for it, in a body over fifty, is a common source of cuff problems.
- No warm-up
- Social play frequently starts at full pace. Cold tendons and unprepared muscles are far less tolerant of sudden loading.
- Playing multiple days without recovery
- The social nature of these sports means people play frequently, and recovery capacity is lower at sixty than at thirty.
- Court surface and footwear
- Running shoes are designed for forward motion and provide poor lateral support. Court shoes matter, and they are frequently not worn by new players.
- Age-related tendon change
- Achilles and rotator cuff tendons degenerate from the forties. The tissue tolerates a sudden high load far less well than it did.
- Coming to it from nothing
- Many new players have not done explosive exercise in decades. The fitness benefits arrive quickly and the tissue tolerance does not.
Who tends to get it
- Anyone over fifty starting or returning to racquet sports
- Players with no strength or balance training background
- Anyone playing several days a week without recovery
- Players in running shoes rather than court shoes
- Anyone with previous Achilles or calf problems
What makes it worse, and what settles it
Makes it worse
- Starting play at full pace with no warm-up
- Backing up quickly for a lob, which is the classic fall mechanism
- Playing several consecutive days without recovery
- Wearing running shoes on court
- Ignoring calf tightness, which precedes many Achilles problems
Settles it
- Calf strengthening - heel raises progressed to single leg and loaded - which is the best protection against the Achilles injury
- Balance and lateral movement training off court
- A real warm-up including progressive lateral movement before playing
- Court shoes with lateral support
- Turning and running rather than backpedalling for a lob, which is a coachable change
What actually helps
The short version: Explosive lateral movement and overhead serving in bodies that have not trained for either; Achilles and wrist fractures from falls dominate
Strength work: Legs: Calves: Gastrocnemius and Soleus; Glutes: Med; Legs: Quads; Shoulders: Rotator Cuff; Arms: Forearms: Wrist Extensors
Stretching: Legs: Calves; Shoulders; Hips: Flexors; Legs: Hamstrings
Massage: Legs: Calves; Shoulders area; Arms: Forearms
Also worth doing: Balance and lateral agility work; proper warm-up; court shoes not running shoes
What the evidence says: Achilles rupture and distal radius fracture are the signature injuries. Calf strengthening and balance training address both.
The names above are the Targets qFIT tracks —
the Muscle Guide explains what each one does, and
Quick Add switches on the Exercises you
already have.
The qFIT routine for this
Ready-made routineRotation Sports (Golf, Racquet & Throwing)
qFIT already has this one built. It runs massage first, then stretching, then
strength — the order that works on a body that is already sore — and every
activity in it carries the reason it is there.
The button below opens your Checklist with this routine already selected, so instead
of your whole list you land on just its Categories, Targets
and Exercises, each with its checkbox, ready to tick as you work through
them.
Have more than one problem? Tick yours under My Problems on
My Profile and your Checklist's Routine list gains
Recommended for my problems — every routine for the problems you picked, merged
into one. Your picks stay private; that filter is the only thing they feed.
Get it checked if…
Sudden calf pop while lunging back - suspect Achilles rupture, urgent
And whatever the body part: chest pain or unusual breathlessness on
exertion; a fever alongside the pain; unexplained weight loss; pain that is constant and
unrelated to how you move; new numbness, weakness or loss of bladder or bowel control; or
one calf that is swollen, warm and painful. Any of those, stop and get assessed.
How it usually goes
The health benefits of racquet sports at this age are substantial and worth having - the mortality data is among the strongest for any activity. The injury profile is specific and largely preventable with calf strengthening, balance work and a proper warm-up. A sudden pop in the calf with an inability to push off is an Achilles rupture and needs same-day assessment; a fall onto an outstretched hand with wrist pain and deformity needs an x-ray.
Prevalence basis: Emergency department injury data
Others the same routine covers
These share the Rotation Sports (Golf, Racquet & Throwing) routine, so the work is the same. If one of them also
sounds like you, that is a reason to expect more from it, not less.
This is general information, not a diagnosis, and it cannot examine you.
If it matches you, use it to ask better questions of a clinician rather than to replace one.