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What to do Following an Acute Injury

The secret is out—pickleball is too much fun not to play! However, it’s not just a game; it’s a sport—and injuries happen, resulting in players being sidelined and unable to participate in their favorite activity. So what should you do when you injure yourself on the courts? It depends!

Every injury is different and will require a different approach to address it. I will give you general guidelines that may improve your decision-making should an unfortunate injury occur. Remember, when in doubt, always consult a healthcare professional, or go to the hospital in an emergency situation!

The main types of acute injuries seen in pickleball are strains, sprains, tears, contusions, fractures, disc herniations and spinal joint dysfunctions. It’s important to be mindful of how your injury occurred so if you need to consult a healthcare professional, he or she will be able to diagnose you more accurately. The main thing following an acute injury is to protect the injured area, and make sure you’re in a safe environment.

For lower extremity injuries (ankle, knee, hip, calf, thigh, hamstring and quads), a “wait and see” approach may work IF you are able to bear weight on the affected limb after the injury. Avoid icing the injury as this may delay the healing process. Only use ice as a pain control method in order to numb the area! If the pain is tolerable, do not use ice. Instead, perform gentle motion, elevate the injury, compress, and avoid painful positions. Keep track of how the injury progresses: is it swollen, warm to the touch, discolored, etc.? If the injury improves daily, it’s a good sign! If it does not, consult a physical therapist!

If you’re unable to bear weight following the injury, or the area feels unstable, you need to go to the hospital and get checked out.

For injuries involving the spine (neck, mid-back, or lower back), consulting a Physical Therapist within a few days following the injury can make a huge difference. Your therapist may be able to correct the dysfunction and improve your recovery time tremendously. Research has shown that physical therapy is very effective when addressing back pain, and results in decreased pain and limitations with activity. Here are a few common acute injuries and the best actions to be taken after the injury:

Ankle sprains
Ninety percent of ankle sprains involve the lateral (outside) aspect of the ankle. Initially there is often swelling, pain and possible discoloration. Most ankle sprains will resolve on their own, but the best thing to do in order to accelerate the healing is to compress the area (using compression sleeves or ACE bandage if nothing else is available) and elevate the ankle while performing movement in all directions of the ankle.

In addition, start doing some resistance band exercises, standing on one leg, calf stretching, and then progress to higher level balance activities and hip strengthening.

Hamstring strain/pull/tear
This is usually an overstretching injury. Therefore, do not stretch following this injury! Let it heal and put some heat on the area. As it starts to heal, slowly add some gentle walking. Once the pain is significantly decreased, you can introduce gentle stretches, then progress to running and higher level activities. Performing gluteal strengthening is important in order to take pressure off of the hamstrings.

Lower back injuries
There are multiple types of acute lower back injuries: disc bulges/herniations, lumbar spine muscle strains, facet joint dysfunctions, etc. It can sometimes be difficult to self-identify exactly the type of injury sustained. However here are some things you can do after an acute lower back injury.

Be mindful of movement direction and different positions—does it hurt more if you bend forward or bend backward, does it hurt more sitting, standing, or lying down? Does any position cause numbness or tingling in your legs? Is the pain on the left side or right side of your back?

All of the findings above will be important in order to determine the best course of action for you. Generally speaking, with lower back injuries, it’s best to perform movements that do not aggravate your pain. For example, if bending forward seems to feel good, then do a lot of stretches bending forward, and avoid bending backward as much as possible. If standing feels good, then perform a lot of walking, and avoid sitting too long. As mentioned earlier, physical therapy is very effective for low-back pain when addressed early in the process, so if you don’t feel much improvement within few days of your injury, be sure to consult a healthcare professional, preferably a qualified, licensed physical therapist.

Fall on Outstretched Hand (FOOSH) injury
Falls are still very prominent within the pickleball community. Oftentimes when people fall, they brace themselves with their hands, and end up falling on an outstretched hand, causing a FOOSH injury. Most FOOSH injuries lead to injuries within the hand and wrist, but can also (less often) cause injury to your elbow and shoulder. The most common injuries caused by a FOOSH are fractures, often of the Scaphoid (bone at the base of your thumb), distal radius, radial head fractures, scapholunate tears, etc. If you happen to experience a fall on an outstretched hand, and notice pain in the hand, wrist, or elbow following the fall, do your best to immobilize the area, and be sure to get it checked out if the pain and discomfort does not resolve within a couple of days.

As always, consult a healthcare professional if you’re unsure of the best way to handle your acute injury. Every injury is different, and the above information does not apply to everyone or all injuries.

If you have any questions, contact the Pickleball Doctor at

Noe Sariban is a Doctor of Physical Therapy, Certified Pickleball Teaching Professional through the IPTPA, and an Engage sponsored athlete. 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. Please like his Facebook page,, for updates and new information.

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