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  • Writer's pictureSerendipityPTW

Pickleball and Knee Health - Part 1

Next time you’re out playing a pickleball game, take a quick peek at your partner’s and opponent’s legs. There’s a pretty high chance that at least one person in your group of four is utilizing some kind of knee sleeve. In fact, knee pain is one of the most common physical issues that pickleball players have problems with.

Even though pickleball is less intense than many other sports, the knees still deal with quite a bit of stress during a game as a result of all of the quick side to side motions and lunging movements that the game demands.

While there is no way to create a situation in which pickleball puts zero strain on your knees, there are methods you can use to keep your knees as healthy as possible during your play.

My goal today is to provide you with some tips to minimize the likelihood of knee problems holding back your game, and dispel a couple of myths that people have regarding knee issues.

Pay Attention to How You Bend

If you’re moving as you should out on the courts, you’ll know that pickleball entails a lot of forward and side to side lunging motions. When I work with pickleball players who have knee issues, one of the first things I like to look at is how they perform these movements.

Ideally, players should be primarily utilizing their butt muscles to lunge for the ball. However, what I often find is that players kneel forward, such that their knees go over their toes when they try to lunge. Aesthetically, it’s a small difference, but it makes a big difference for your knees! By lunging in this manner, a player is putting more stress on the quadriceps (big group of muscles in the front of the upper leg), ACL, patellar tendon, and the kneecap itself. Though our bodies are typically tough enough to deal with this strain on occasion, moving in this way repetitively over time can often lead to pain and poor knee function.

Keep it Limber

In many cases, knee pain and tightness go hand in hand. Because of how much the knee relies on the hip for control and positioning, keeping a limber hip is also quite important. Essentially, if you’re tight in a direction that is needed for good pickleball play, you’re going to be moving abnormally and placing more stress on surrounding joints and muscles.

Though all movements in the hip and knee are important in some manner for good knee health, I find that pickleball players most often run into knee trouble in two key movement areas. The first is if the knee lacks the ability to fully straighten. The second is a limitation in the hip’s ability to extend (go backwards). Pickleball players need to be able to use these movements so frequently that tightness is going to eventually result in a noticeable issue.

It’s important to mention that a lack of movement can be caused by a number of different things. The joint itself could be tight, or perhaps the muscle. It’s possible that a person may not have enough muscle strength to utilize the movement that they could have. If you know you have tightness but aren’t sure why, working with a specialist such as myself is helpful for ensuring that you’re working on the right things to improve the issue.

The Big Myth: Arthritis Pain is Just Something You Deal With

One of the things that I often hear from retiree pickleball players is that they’ve been diagnosed with arthritis in their knees and just have to deal with the pain. Whether or not an arthritic player will be able to play with no pain depends on a lot of different factors, but a diagnosis of arthritis doesn’t mean that you should just give up on ever feeling better or playing more skillfully. In fact, knee arthritis is one of the most common things that people utilize physical therapy or wellness services to improve.

Just as a quick explanation, arthritis involves a number of different changes in the body, and osteoarthritis (the kind of arthritis that most people develop) is considered to be a typical part of the aging process. In essence, as we get older the structures that provide good cushioning to the knee begin to get worn down. When too much stress is placed upon the knee joint, this means that there is bone-on-bone friction which can lead to painful irritation and swelling around the joint. Arthritis also often involves the development of bone spurs, which can worsen the above scenario.

It doesn’t sound all that great, but honestly there are a lot of studies out there that show that people can substantially improve their pain and function with proper interventions and a good exercise program. Even though the anatomical changes to the knee aren’t going to be altered, by building proper strength and restoring more normal motion through the knee, people can reduce how much stress and friction they place upon the knee joint as they move around.

How much better can it get? Most people that I’ve worked with are able to resume play either pain free, or with large improvements in pain and the ability to play for longer periods of time. It’s actually pretty uncommon for people to experience no improvement, in which case it may be worth considering communicating with an orthopedic surgeon - in such instances, the arthritis may be widespread enough or in a sensitive enough location that surgery is worth considering. That said, due to risks such as infection, lengthy recovery times, and the likelihood that the knee can improve without it, surgery should never be the first option.


As the owner of Serendipity Physical Therapy and Wellness, I’m an avid pickleball addict with a goal of keeping pickleball players moving at their best and injury free. I work with players for anything ranging from reducing shoulder pain or tightness, to helping with injury prevention and good technique.

If you’re new, you can check out more of my advice and content here:

If there is anything I can help you with or you have questions, please give me a call at (239) 232-8155, or send me an email at I would love to see how I can help get you moving at your best!

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