Does this sound familiar?

One day you’re out playing pickleball, and don’t notice any injury while you’re playing. You wake up the next morning and feel some soreness in your shoulder, knee, Achilles, elbow, etc. It’s not debilitating, and certainly nothing to stop you from playing, so you return to the courts. But now you feel a little soreness during play, with some lingering soreness after play. It finally gets bad enough that you decide to rest and take two weeks off. It now feels better, and you return to the courts happy to be back. However, after a few sessions, the pain starts creeping back.

You decide to go see a doctor, who takes some imaging and determines you don’t need surgery at this time, prescribes some anti-inflammatories and recommends some physical therapy. You show up at physical therapy only to find out your PT has never heard of pickleball, but is confident he or she can help your injured body part. You do six weeks of PT and your pain level is now minimal. You haven’t played pickleball in weeks, and can’t wait to be back on the courts. You decide to return to the courts, and it feels good for a few weeks, maybe even months.

But, eventually, the pain returns. You’re feeling frustrated, and don’t know how to proceed.

Unfortunately this is a situation I encounter regularly, and it can be very discouraging if you’re the affected person. Lingering injuries are sometimes difficult to get rid of and require proper care in order to resolve. Oftentimes, there’s more going on than the injury site itself, and addressing all aspects of the equation is vital to recovery. For example, if your Achilles tendon is hurting, it may not be enough to just stretch and strengthen your calf. There’s an entire kinetic chain above the injury site, starting from your core to your buttocks, back, hip and knees that will affect your movements on the court. If there are any mobility issues or muscle imbalances placing you at a biomechanical disadvantage over time, your injury will not get better. This applies to all injuries!

When injuries linger, it’s important to evaluate the entire chain and how someone performs the motions and movements that cause pain in order to determine the best course of action to promote healing and recovery. There are various scenarios that will require a certain type of intervention in order to be successful. The four main categories under which a person may require treatment or correction related to injuries are as follows: mobility and flexibility, muscle imbalances and stabilizations, movement patterns and motor control, and compensations for old injuries.

1. Mobility and flexibility are the foundation to most movements and requirements in order to perform in any sport. Mobility is the ability of your joints to move through their intended range of motion without pain or limitations. Flexibility refers to the total amount of motion through a kinetic chain, involving joints, muscles, tendons and ligaments. When they are compromised, it creates a “crack” in the foundation, and addressing any other issues prior to this will be like placing a band-aid on the problem instead of addressing the source.

2. Muscle imbalances need to be corrected and stabilization needs to be achieved in order to promote adequate strength to perform athletic movements. This should be achieved after mobility and flexibility have been restored in order to promote healthy movement and avoid loading faulty movements on top of poor mobility. Correcting muscle imbalances can be crucial in addressing lingering injuries, as it will help correct the next category—faulty movement patterns and motor control.

3. Oftentimes when an injury won’t go away, there may be some faulty movement patterns present that could be the underlying cause of the lingering pain. Human Biomechanics is the study of the mechanical laws that relate to the movement or structure of human beings. It’s basically physics applied to human movement. Biomechanical analysis of one’s movement patterns can reveal improper motor control and biomechanical faults leading to compromising positioning of joints during dynamic activities such as pickleball. Being able to identify those faulty movement patterns and correct them can lead to decreased repetitive injury and stress on painful areas, therefore promoting healing by avoiding poor biomechanical positions that would cause injuries to linger.

4. Finally, one of the biggest predictors of future injury is the presence of past injuries. Once a person has injured him- or herself, and hasn’t corrected the injury through the previous steps listed, this puts a person at greater risk for being injured in future activities. Having an injury that hasn’t been properly addressed leads to compromised mobility and flexibility, muscle imbalances, and faulty movement patterns, which over time will create compensations that increase your risk for injury, and also lead to lingering pain that won’t go away.

So what can you do? The best thing to do is consult a Sports Physical Therapist who can address your muscle imbalances and other impairments in order to implement a long-term solution. If the Physical Therapist is familiar with the demands and needs of pickleball, he or she will be even better suited to address your injury and correct any deficits in order to get you back on the courts. Physical Therapists are independent practitioners and, in most states, and for most people’s insurance, don’t require a prescription from a physician (always check with your insurance first to be sure). Physical Therapists are educated at the Doctoral level, and their knowledge base on orthopedic injuries is better than general physicians, by far! Don’t be afraid to utilize this resource as it can help with many lingering injuries.

If you have any questions, contact the Pickleball Doctor at thepickleballdoctor@gmail.com.