How to Avoid Shoulder Injuries in Pickleball and Tennis
That sharp ache in your shoulder after a weekend of pickleball matches isn't just "part of the game"—it's your body asking for help. While both tennis and pickleball offer incredible cardiovascular and agility benefits and social connection, the repetitive overhead motions can put serious strain on your shoulders if you're not prepared.
Here in Happy Valley, where active adults embrace everything from tennis at Happy Valley Park to the growing pickleball courts across Clackamas County, understanding how to protect your shoulders means the difference between playing for years to come and sitting on the sidelines. Let's explore how to keep your shoulders healthy, powerful, and ready for whatever the court throws your way.
Understanding Shoulder Vulnerability in Racquet Sports
Your shoulder is an incredible feat of engineering—but with great mobility comes great responsibility. Research presented at the American Academy of Orthopaedic Surgeons meeting this year found a 90-fold increase in pickleball-related injuries between 2002 and 2022, especially among people aged 60-69, while the overall prevalence of shoulder injuries among tennis players of all levels ranges from 4 to 17%.
The good news? Most shoulder injuries in racquet sports are preventable when you understand the patterns.
The Primary Culprits
Rotator Cuff Strain: The rotator cuff—four small but mighty muscles that stabilize your shoulder—bears the brunt of overhead motions. The serve is the most energy-demanding motion in the sport, and it accounts for 45 to 60% of all strokes performed in a tennis match, putting the shoulder at increased risk of overuse injury and rotator cuff tears. In pickleball, aggressive overhead shots create similar stress patterns.
Weak Shoulder Muscles: This happens when the supporting muscles don’t have enough strength or balance to keep the shoulder steady during swings and overhead shots. The shoulder may feel weak, unstable, or fatigue quickly, making it harder to hit with power and consistency.”
Overuse Injuries: Common injuries include rotator cuff tears. We also see rotator cuff tendinopathy and lateral epicondylalgia – often called "pickleball elbow," which results from repetitive motions.
Why These Injuries Happen
Understanding why shoulder injuries occur helps us develop a resilient approach to prevention. Many active adults I work with share common patterns:
The Competitive Drive: Pickleball can bring out the fierce competitors in us. It's fun and addictive, so we often want to keep playing, which predisposes us to strains and overuse injuries. This competitive spirit is fantastic, but it needs balance with body awareness.
Weekend Warrior Syndrome: Jumping into multiple-hour sessions without adequate conditioning puts tremendous stress on unprepared shoulders.
Poor Movement Foundations: Perfect form means nothing without the strength and mobility to support it consistently throughout an entire match.
Building Shoulder Resilience: Your Action Plan
The most empowering approach isn't just avoiding injury—it's building shoulders that get stronger under appropriate stress.
Pre-Game Preparation
Your warm-up should prepare your entire movement system. Warm Up Before Every Game – Do arm circles, band work, and light cardio just minutes before starting to play to prepare your body for the movements and stresses that will be placed on it while playing.
Dynamic Movement Flow (5-10 minutes):
Arm circles: Start small, gradually increase range
Shoulder rolls: Forward and backward
Cross-body arm swings
Light paddle swings with no ball
This preparation is both physical and psychological—you're communicating to your nervous system that it's time to perform with clarity and focus.
Essential Strength Training
Your rotator cuff is the foundation of shoulder health. Strengthening these small but mighty muscles reduces injury risk and improves control on the court. Remember: movement is medicine, uniquely applied to each person's needs.
Key Exercises (2-3x per week):
External Rotations: Using a resistance band, keep your elbow at your side and rotate your arm away from your body. This strengthens posterior rotator cuff muscles often overwhelmed by forward activities.
Scapular Wall Slides: Stand against a wall with arms in "goal post" position. Slide arms up and down while maintaining wall contact. This builds shoulder stability foundations.
Core Integration: Your shoulder is only as strong as your foundation. Planks and rotational core work create the stable base your shoulders need for optimal performance.
Smart Mobility Work
A stiff shoulder is a weak shoulder. If your range of motion is limited, your body will compensate, leading to pain, impingement, and reduced power on the court.
Daily Stretches:
Thoracic spine stretch: 30 seconds each side
Doorway chest stretch: Address forward shoulder posture
Lat stretch: Improve your overhead position
Our normal daily lives do not regularly require us to use our full range of motion everyday and that is why mobility work is particularly crucial.
Smart Playing Strategies
Equipment and Technique
Choose the Right Paddle – Lighter paddles (7.5-8.3 oz) reduce strain. Use a Looser Grip – Avoid squeezing too tightly, which can fatigue the shoulder. Focus on generating power from your legs and core rather than just your shoulder.
Engage Your Core – A strong core reduces strain on the shoulder. Use Your Whole Arm – Avoid excessive wrist flicks that overwork the rotator cuff.
Recovery and Load Management
Aim for 150 minutes a week of regular exercise outside of pickleball to limit fatigue when playing. This baseline fitness creates resilience against sport-specific demands.
Smart Progression:
Build playing time gradually
Take rest days between intense sessions
Listen to your body—fatigue increases injury risk exponentially
When to Seek Professional Help
Your body's feedback system is sophisticated. If you have pain that gets progressively worse in the shoulder, or pain that persists for a long time after your activity, these may be warning signs of a torn rotator cuff tendon.
Red Flags:
Pain worsening rather than improving with rest
Weakness lifting your arm overhead
Night pain disrupting sleep
Sudden, sharp pain during play
At Timber and Iron Physical Therapy, we consistently see better outcomes when people seek help early rather than pushing through pain.
Your Path Forward
Remember: optimal performance isn't about playing through pain—it's about building a body that can handle the demands you place on it while maintaining excellent movement quality.
Whether you're hitting the courts at RECS or joining the growing pickleball community across the Portland metro area, your shoulders can be your greatest asset. With proper preparation, intelligent training, and respect for your body's signals, there's no reason your favorite racquet sport can't be a lifelong pursuit.