Pickleball is exploding in popularity, and for good reason. It is fun, fast, social, and accessible to players of every age and experience level. But with its rise has come a wave of new injuries, especially knee problems that can take players away from the court just when they are starting to improve.
As a physical therapist and racquet sports specialist, I see the same patterns again and again: players who love the game, want to keep progressing, but find knee pain slowing them down or forcing them to modify how they move. The truth is this: pickleball and racquet sports are incredibly rewarding, but they place unique demands on the knees. Understanding those demands—and how to meet them with the right strength, mobility, and technique – can mean the difference between injury and long-term enjoyment.
In this guide, we will break down why knee pain is so common, the movements that cause the most strain, and the practical, evidence-based steps you can take to keep your knees strong and your game improving.
Why Knee Pain Is So Common In Pickleball and Racquet Sports
Even though pickleball is often seen as “low impact,” it requires a combination of movements that can overload the knee joint:
- Sudden stops and starts
- Quick pivots
- Fast directional changes
- Reaching or lunging for wide shots
- Repeated semi-squat positioning near the kitchen
- Playing on hard surfaces for long durations
For players coming from tennis or squash, the game can feel easier on the joints, but pickleball’s smaller court creates more frequent, sharper movements. For new players who haven’t trained laterally in years, the body may not be prepared for this level of agility work.
Knee pain develops when the muscles supporting the joint – particularly the hips, glutes, quads, and hamstrings – can’t keep up with the demands of the game. Over time, this leads to irritation, strain, inflammation, and loss of confidence in movement.
Understanding the Most Common Pickleball Knee Injuries
While everyone’s body is different, these problems appear most often in pickleball and racquet sport players:
1. Patellofemoral Pain (Pain Around the Kneecap)
This develops when the kneecap doesn’t glide smoothly due to muscle imbalance or tight tissues. It shows up during stairs, squatting, and long games.
2. Meniscus Irritation
Twisting on a planted foot, especially during quick change-of-direction movements, can cause irritation or small tears.
3. Tendon Pain (Patellar or Quadriceps Tendinopathy)
Frequent jumping, lunging, or quick stops can overload the tendons, causing stiffness and pain.
4. Early Arthritis Symptoms
Many older athletes return to sport after years away, discovering that their knees are less forgiving than they used to be.
The promising news is that all these issues can be improved or prevented with the right strengthening and technique adjustments.
The Key to Prevention: Stronger Hips and Better Control
One of the biggest misconceptions is that knee pain is a “knee problem.” In most players, knee pain actually begins with poor hip control.
When the glutes are weak or slow to activate, the knee collapses inward during cutting, lunging, or pushing off. This places far more pressure on the knee joint and connective tissues, increasing injury risk.
A strong pickleball athlete needs:
- Hip stability
- Lateral strength
- Core control
- Good balance
- Ability to decelerate safely
These qualities are far more protective than simply stretching or wearing a knee brace.
The Essential Movements Every Pickleball Player Should Train
Below are highly effective exercises used in clinical and sports settings to reduce injury risk in racquet sports. They are simple, targeted, and extremely beneficial when done consistently.
1. Lateral Band Walks
Strengthens the gluteus medius and improves knee alignment.
This directly protects against knee collapse during quick changes of direction.
2. Single-Leg Squats or Step-Downs
Helps you control your knee through the same angles used in lunges and low volleys.
3. Reverse Lunges with Rotation
Trains stability while integrating upper-body movement – similar to reaching for a shot.
4. Hamstring Strengthening (RDLs or Bridges)
Your hamstrings act as a natural “seatbelt” for the knee during deceleration.
5. Balance and Proprioception Drills
Pickleball requires rapid reactions. Balance work helps your knee withstand unexpected changes in movement.
6. Deceleration Training
Learning to stop safely may be the single most important factor in injury prevention.
Without the ability to slow down and control momentum, the knee absorbs excessive force. Controlled drills such as slow-to-fast accelerations and soft-landing hops are protective and performance-building.
How Technique Impacts Knee Health
While strength is essential, technique matters just as much.
Many pickleball players unknowingly adopt movement habits that increase their injury risk.
1. Turning the Body Instead of Twisting the Knee
Pivot around your hips by turning your entire body toward the ball.
Avoid twisting your knee on a planted foot.
2. Keeping the Feet Active
Flat-footed movement increases the load on your knees.
Quick, small steps are easier on the joints and improve shot precision.
3. Staying Too Low for Too Long
Extended crouched positions near the kitchen can irritate the kneecap.
Reset your stance between points to avoid prolonged compression.
4. Overreaching Instead of Moving the Feet
Trying to reach a wide shot with the upper body rather than repositioning the feet places torque on the knee.
Technique improvements not only reduce discomfort but also dramatically elevate playing ability.
Why Warm-Ups Matter More Than You Think
Most knee injuries happen during the first 20 minutes of a match—before the body is fully prepared.
A proper warm-up should include:
- Light cardio for circulation
- Dynamic stretches (not static)
- Glute activation
- Balance work
- Short lateral shuffles
- Small hops for landing prep
This routine takes five minutes but can prevent months of injury downtime.
How Physical Therapy Helps Racquet Sport Athletes Stay In The Game
At BodyWorks Physical Therapy, our approach is simple:
We don’t just treat knee pain. We retrain the movements that caused it.
A thorough assessment looks at:
- Hip strength
- Balance
- Movement control
- Cutting mechanics
- Landing technique
- Flexibility
- Footwear and playing surface
- Sport-specific demands
- Previous injuries
From there, we create a personalised programme that:
- Reduces pain
- Builds strength
- Improves control
- Restores confidence
- Enhances performance
Most importantly, we help you return to the court feeling stronger, safer, and ready to progress.
The Bottom Line: Your Knees Can Be Stronger Than You Think
The Bottom Line: Your Knees Can Be Stronger Than You Think
Pickleball and racquet sports are fantastic lifelong activities. They challenge the mind, help keep you active, and build community in a way few sports can. With the right preparation, your knees can handle the demands of the game and allow you to keep improving year after year.
Whether you’re returning after an injury, playing through discomfort, or trying to prevent problems before they start, the best time to address your knee health is now, not after something goes wrong.
If knee discomfort has been holding you back on the court or you simply want to prevent problems before they start, now is the perfect time to take action. At BodyWorks Physical Therapy, we offer a Free Discovery Visit where you can talk with a specialist, get your questions answered, and understand what is really happening inside your knee.
You’ll learn what is causing your symptoms, which movements may be contributing, and the exact steps you can take to feel stronger, more confident, and ready to enjoy your game again.
Click here to book your Free Discovery Visit and get back to playing the way you love.
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