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September 16, 2022

Pickleball After a Joint Replacement

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

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Pickleball has continued to grow in the past year. While younger players are coming into the game, according to USA Pickleball, most recreational players are still over 50, and joint replacement surgeries are very common among this active older population.


There are more than 1 million joint replacement surgeries (called total joint arthroplasties) in the United States every year, with that number expected to increase to nearly 4 million by 2030. This makes total joint replacements one of the most common types of orthopedic surgeries today. The most common type of total joint arthroplasty is a total knee replacement, followed by a total hip replacement. We will discuss the reason most people get a knee replacement, as well as expectations for returning to playing.


The biggest risk factor for undergoing a total joint replacement is osteoarthritis. It is estimated that 1 in 4 Americans will experience some form of arthritis in their life, with osteoarthritis being the overwhelming leader of all types of arthritis in the active population. A joint is where two bones connect. For example, the knee joint is where the femur (thigh bone) and tibia (shin bone) meet. At the end of bones that form a joint, there is a lining that covers the surface of the bones called cartilage, which helps promote smooth motion of the bones on one another. Over time, this cartilage lining can degrade, and the surface of the bones becomes rougher. This process is called osteoarthritis.


When people describe their knee as being “bone on bone,” that means the lining has degraded so much that the bones are now contacting each other, which can lead to pain and difficulty moving. This is when people start thinking about joint replacements.


People are often confused or misguided regarding the expectations following a total joint replacement and returning to playing pickleball. While some people may have a speedy recovery and be back on the courts playing within a few weeks, this does not apply to most people. A good timeline to keep in mind when having a total joint replacement is as follows (all timing is postoperative):


Phase 1 – Painful phase: 0-4 weeks

The goal is to manage the pain, increase range of motion, regain basic muscle function, and restore a normal gait pattern. No on-court playing.


Phase 2 – Development phase: 1-3 months

Continue to modulate pain as needed, restore full range of motion, normal gait pattern, and restore balance and muscle strength. No on-court playing.


Phase 3 – Dynamic phase: 3-6 months

Continued strength and balance training, gentle agility training, gentle plyometrics. Gentle on-court activity can take place: dinking, drop shots, gentle side-to-side work.


Phase 4 – Return to sport: 6-12 months

Higher-level strength, balance, and power development, agility and plyometric training, sport-specific strengthening and conditioning. Return to full pickleball.


If you’d like to learn more about this, you can contact “The Pickleball Doctor” at The Pickleball Doctor is the owner of Move It Physical Therapy in Chapel Hill, NC. 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. Movement screens can be performed virtually, and Noe can provide you with the appropriate guidance to make sure you are ready to play this sport we all love!  

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 world #1 Ben Johns. Visit for more information on injury prevention and rehabilitation tips. You can also like his Facebook page,, for updates and new information.

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