Spine Stability to Prevent Injury
According to the Mayo Clinic, lower back pain is among the top 10 reasons for doctor visits in the United States. It’s estimated about two-thirds of Americans will experience lower back pain at some point in their lives. Of these two thirds, 37 percent do not seek professional treatment, which may delay healing and put them at risk for further injury. Participation in sports increases an individual’s risk of developing lower back pain due to impact and extra forces placed on the spine from athletic movements. Pickleball is no exception!
Pickleball requires players to perform movements in multiple planes of motion, which demands high levels of stability around the lumbar spine (lower back). Side-to-side movements, spinal rotation, bending, jumping and running put players at an increased risk of developing lower back pain if spinal stability is impaired.
Of all movements in pickleball, repetitive dinking is probably the most taxing on the lower back. Dinking requires players to stay low while moving side to side and often combines bending and twisting in order to hit a soft shot over the net that will land in the No-Volley Zone. Many players get low by bending through the spine rather than through the knees, which further increases their risk for injury while dinking.
Repetition of biomechanically disadvantaged movements in the lumbar spine can lead to injuries such as muscle strains, ligaments sprains, facet joint dysfunctions, disc bulges, herniated disc and compression fractures. Each injury requires a different approach to rehabilitation. If you’re injured, you should consult a Licensed Health Care Professional such as a Sports Physical Therapist in order to be evaluated and effectively treated.
Developing a stable spine by performing dynamic core stabilization exercises, that are specific to the demands of Pickleball, is the only way to try and prevent lower back pain. There are multiple ways to train the core, and these days everyone has “the best” recipe for success. In my opinion, training in different planes of motions— combining stable and unstable surfaces, while progressing the level of difficulty to achieve stability, strength endurance and power development—is the only way to properly prepare your spine for the demands of sports. These stages are described next.
The core can loosely be defined by the structures that make up the lumbo-pelvic-hip-complex. This grouping of muscles, ligaments and fascia work in a coordinated and intricate manner to produce force concentrically, decelerate force eccentrically and stabilize against compressive, torsional, and shear forces isometrically. When designing a program to train your core, it’s important to build stability first, followed by strength and then power.
The stabilization stage emphasizes improving dynamic joint stability, postural equilibrium and neuromuscular control. Its purpose is to prepare the body for more demanding activities by establishing a solid foundation and developing optimal communication between the body’s nervous and muscular systems. This includes correcting existing muscle imbalances and training in proprioceptive environments. It’s imperative that stabilization training be performed first because research has shown that inefficient stabilization often results in altered force production in muscles, excessive stress at joints, tissue overload and eventual injury.
The strength stage focuses on enhancing stabilization strength while also increasing prime mover strength. Strength endurance is typically improved by performing two similar exercises back-to-back where one is completed in a stable environment (e.g. barbell squats) while the other is performed in an unstable environment (e.g. squats on BOSU ball). This type of training is called a “superset.” The strength stage also includes hypertrophy training and maximal strength training, if the athlete’s goals include gaining muscle mass. Research has shown that while strength adaptations can happen quite rapidly, muscle hypertrophy does not occur for at least 4 to 8 weeks of training. Those initial strength gains can be attributed to improved motor unit recruitment by the neuromuscular system. The best way to achieve muscle hypertrophy is to follow a resistance-training program consisting of moderate to low repetitions with progressively higher loads.
After acquiring optimal levels of stabilization and strength, the power stage focuses on applying those gains by training with speeds and forces that are more “game-speed.” This development of speed and power is essential to athletic performance in nearly all sports. Power is defined as force multiplied by velocity (P = F x V). Therefore, an increase in either of those factors will result in an increase in power. Typically this is done by training with both heavy loads at low speeds (force) and light loads at high speeds (velocity). Another effective method is to superset a traditional strengthening exercise (e.g. barbell squats) with a similar plyometric exercise (e.g. jump knee tucks). By doing so, you can effectively improve the muscle’s rate of force production, thereby becoming more explosive.
If you’re interested in developing a program that fits your needs, consulting a Sports Physical Therapist can be incredibly beneficial. Physical Therapists have a Doctorate level education, and their expertise surpasses that of a personal trainer at a gym by a long shot! You can always visit or my Facebook page ( for more information, videos, updates or to contact me.
Noe Sariban is a Doctor of Physical Therapy, Certified Pickleball Teaching Professional through the IPTPA, and a USAPA Rated 5.0 player sponsored by Engage Pickleball. Please visit for more information on injury prevention and rehabilitation tips. Noe started his website to provide pickleball players around the world with a reliable and free source of information.