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July 21, 2023

Fall Prevention in Pickleball

By Noe Sariban, PT, DPT, Cert. DN, TPI MII, CPTP

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As pickleball continues to grow across the country (and world), it’s only natural to see the number of injuries related to the sport increase as well. While muscle strains, ligament sprains, and other non-contact injuries certainly can occur while playing, the most common mechanism of injury is a fall. Falls while playing pickleball can lead to bruises, scrapes, sprains, fractures, and even head injuries. There are certain factors that increase your risk of falling, and players should take preventive steps to avoid being the next person to visit the emergency department.


Among pickleball players, beginners (or novice players) are the most likely to experience a fall for various reasons: not knowing the game as well as experienced players, leading to improper movement on the court; indecision about how to get to a ball; reactive play as opposed to anticipation; and faulty equipment and preparation to play the sport. Even so, intermediate and advanced players are not immune to falls either, and minimizing risk factors would benefit everyone.


Footwear is one of the leading causes of falls in pickleball. I have seen countless players all around the country (even some who have participated in three-day camps with me) show up on the courts wearing regular sneakers. Usually it’s because they don’t know any better, but I have also talked to people who report they prefer to wear a traditional sneaker because of the comfort level (or possibly because of a medical condition in their feet). However, in order to reduce your falls risk, wearing proper shoes made for hard court surfaces is extremely important.


Pickleball (and tennis) court surfaces are usually made up of an acrylic paint coating that contains sand to prevent skidding and slipping. This makes for a rough surface (almost like sandpaper). The rubber on regular sneakers (or running shoes) is much too soft to be able to interact with the court surface, which leads to much higher friction during deceleration or changes of direction. This in turn can lead to the court “carving into” the shoe and therefore placing the player at great risk of toppling over their feet and falling. In addition, sneakers (running shoes) are made with a forward motion in mind (running), not lateral movement. Therefore, they greatly lack the lateral stability needed to effectively play pickleball, creating yet another hazard.


Final note on footwear: A common complaint I’ve heard is that people don’t like the way tennis shoes feel. However, there are many different brands and models of tennis shoes, so it’s important not to give up. Go to a store and try out at least five pairs until you find the one that fits nicely. Every brand (Wilson, Nike, Adidas, Babolat, K-Swiss, Head, etc.) has different models, widths, and toe boxes, and just because you’ve tried a couple of models that weren’t good for you doesn’t mean you won’t find a great tennis shoe for your feet.


Another risk factor for falling is the lob retrieval. Players often tend to backpedal to retrieve a lob, which is the most dangerous thing you can do on a pickleball court. Generally speaking, backpedaling is fine as long as you are not looking up. Forward and backward motions are normal movements found in pickleball, however once the ball has been lobbed, that’s when backpedaling is extremely dangerous. As soon as the lob is hit and the ball is up in the air, players look up to see and track the ball. Therefore, as they start to backpedal while looking upward, their weight shifts behind their center of mass, which leads to falling backward. Usually, they are still looking up at the ball, and by the time they realize they are falling, it’s very difficult to catch their fall and lessen the blow. This can lead to wrist and hand fractures, as well as serious head injuries. Instead, if you are lobbed, turn and run back to where you think the ball is headed in order to retrieve the ball and extend the point.


Finally, to decrease the risk of falling, players can work on their balance, agility, and proprioception off the court in order to improve their overall movement patterns and control. Research has shown that no matter what level of fitness you are, if you start working on your balance, it will improve. However, as we get older, we start taking less risk as it relates to our daily movement, which in turn leads to decreased balance and body awareness. Training with a doctor of physical therapy to target specific balance deficits can help identify potential weaknesses and prevent faulty movement patterns on the pickleball court in order to reduce your falls risk.


If you’d like to learn more, contact The Pickleball Doctor at The Pickleball Doctor is the owner of Move It Physical Therapy in Chapel Hill, North Carolina. Free 10-minute consults are available to see if it’s a good fit, and virtual sessions are available if you are not in the area.  

Noe Sariban is a doctor of physical therapy and owner of Move It Physical Therapy in Chapel Hill, NC. He is a certified pickleball teaching professional through the IPTPA, and the tournament physical therapist for the world’s #1 men’s player, Ben Johns. Visit for more information on injury prevention and rehabilitation tips, and like his Facebook page,, for updates and new information.

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