Pickleball has taken Southwest Florida by storm, and it’s easy to see why. It’s social, low-impact on the legs, and easy to learn. But ask any orthopedic surgery practice in Naples and they’ll tell you the same thing: pickleball shoulder injuries are showing up in clinics at an unprecedented rate. Whether you’re a weekend warrior or a daily court regular, your shoulder takes a serious beating every time you step up to that non-volley zone.
Why Pickleball Is Hard on Your Shoulders
Pickleball may look gentler than tennis, but the shoulder mechanics involved are surprisingly demanding. The overhead serves, quick dinks, and reactive volleys require rapid, repetitive rotation of the shoulder joint, often with poor form or an untrained body. This combination puts enormous strain on the rotator cuff, the labrum, and the surrounding tendons and bursa.
The sport’s popularity among older adults compounds the risk. As we age, the tendons and cartilage in the shoulder become more vulnerable to wear and degeneration. Many players already have underlying conditions; they just don’t know it yet. Pickleball is often what finally pushes an already-stressed shoulder over the edge.
The Most Common Pickleball Shoulder Injuries
Patients experiencing shoulder pain after pickleball most often present with one of the following conditions:
Common Injuries We See
- Rotator cuff tears — partial or full tears from overhead play and overuse
- Labrum tears — damage to the cartilage ring that stabilizes the ball-and-socket joint
- Shoulder impingement — tendons become pinched during arm elevation
- Shoulder instability — the joint slips or feels loose, sometimes leading to dislocation
- Bursitis — inflammation of the fluid-filled sacs cushioning the shoulder
- Arthritis flare-ups — aggravating pre-existing joint degeneration
Prevention Tips: Keep Playing Without the Pain
The good news is that most pickleball shoulder injuries are preventable with a few proactive habits. Before you grab your paddle, consider these strategies:
How to Protect Your Shoulder on the Court
- Warm up thoroughly (dynamic shoulder circles, arm swings, and band exercises before every game)
- Strengthen your rotator cuff and scapular stabilizers off the court with targeted resistance training
- Work with a coach or pro to refine your serve and overhead mechanics
- Use a paddle grip size and weight appropriate for your hand and strength level
- Rest between sessions and avoid playing through sharp or worsening pain
- Stay hydrated and maintain good posture (fatigue accelerates injury risk)
For most seniors playing pickleball on a recreational basis, it is recommended to play pickleball no more than every other day, instead of consecutive days, to avoid overuse injuries.
When to Stop Playing and See a Doctor
Not all shoulder pain is a reason to hang up the paddle permanently, but some warning signs demand prompt attention. If you’re experiencing persistent aching at rest, sharp pain during or after play, weakness when lifting your arm, clicking or popping sensations, or night pain that disrupts your sleep, it’s time to get evaluated.
Untreated injuries tend to worsen. A small rotator cuff tear that might have been addressed with shoulder arthroscopy or conservative care can progress into a full tear requiring more extensive rotator cuff surgery. A labrum injury left unaddressed can escalate into chronic instability, potentially requiring labrum repair surgery. Early intervention almost always means faster recovery and a quicker return to the court. Most of our patients are successfully treated with rest and physical therapy and, fortunately, do not require any surgery.
When Conservative Treatment Isn’t Enough
For patients with significant joint degeneration or advanced damage, non-surgical approaches like physical therapy, injections, and rest may no longer provide lasting relief. In those cases, surgical options are available to restore function and eliminate chronic shoulder pain. Depending on the severity and the patient’s anatomy, these may include shoulder resurfacing, partial shoulder replacement, total shoulder replacement surgery, or for patients with complex rotator cuff insufficiency, reverse shoulder replacement. The right treatment is always tailored to the individual patient’s needs and goals.
Shoulder Pain Slowing You Down?
Don’t let an injury keep you off the court. Dr. Steven S. Goldberg is a board-certified orthopedic surgeon in Naples, FL specializing in shoulder conditions, from sports injuries to complex reconstructive procedures. Schedule a consultation today and get back to the game you love.
