Pickleball has become one of the fastest-growing sports in the United States — and for good reason. It’s social, enjoyable, easy to learn, and an excellent way for adults over 50 to stay active.¹

However, as participation has increased, so have injuries. One of the most common complaints among recreational pickleball players is low back pain.²

If your back hurts during or after playing, it doesn’t necessarily mean you have to give up the sport. In many cases, back pain develops because of a combination of movement patterns, muscle endurance, mobility limitations, and training habits that can often be improved.³

Understanding these contributing factors is the first step toward enjoying pickleball with greater comfort and confidence.

Why Does Pickleball Cause Back Pain?

Although pickleball is considered a low-impact activity compared with sports such as basketball or tennis, it still places significant demands on the body.

During a typical match, players repeatedly:

• Bend forward to reach low shots
• Rotate quickly to return the ball
• Accelerate and decelerate
• Lunge in multiple directions
• Reach overhead for lobs
• React rapidly to unpredictable movements

These repetitive motions require coordination between the feet, hips, core, spine, and shoulders. If one area lacks strength or mobility, another area — often the lower back — may compensate.³

Common Causes of Back Pain in Pickleball Players

1. Limited Hip Mobility

Your hips are designed to rotate, absorb force, and generate power.

When hip mobility becomes limited, your lower back frequently compensates by rotating more than it was designed to.⁴

Over time, repeated compensation may increase stress on the muscles, joints, and soft tissues of the lumbar spine.

What may help

• Hip mobility exercises
• Dynamic stretching before play
• Rotational movement drills
• Glute strengthening

2. Reduced Core Endurance

The core functions as the body’s natural stabilizing system.

It includes the abdominal muscles, spinal stabilizers, diaphragm, pelvic floor, and muscles surrounding the pelvis.⁵

During pickleball, these muscles work continuously to help transfer force between the upper and lower body.

If they fatigue quickly, additional stress may be placed on the spine.

Helpful exercises may include:

• Bird dogs
• Side planks
• Modified planks
• Pallof presses
• Farmer carries

3. Playing Without a Warm-Up

Many players walk directly onto the court and begin playing.

A dynamic warm-up helps prepare muscles and joints for the demands of quick movement, rotation, and balance.⁶

A five- to ten-minute warm-up may include:

• Walking
• Leg swings
• Hip circles
• Bodyweight squats
• Arm circles
• Gentle trunk rotations

Preparing your body before play may improve movement quality and reduce stiffness.

4. Poor Balance

Pickleball requires frequent changes of direction and rapid reactions.

Reduced balance may lead players to compensate with awkward body positions that increase stress on the lower back.⁷

Balance also becomes increasingly important as we age because it supports efficient movement and may reduce fall risk.

Improving balance often benefits both performance and confidence on the court.

5. Playing Too Much, Too Soon

One of the most common mistakes among enthusiastic players is increasing playing time too quickly. For example:

• Playing four days in a row after months away from the sport
• Participating in multiple tournaments over a weekend
• Suddenly increasing match intensity

Like any athletic activity, pickleball requires gradual adaptation. Allowing adequate recovery helps tissues adapt to increasing workloads.⁸

6. Ignoring Early Warning Signs

Many active adults continue playing despite mild discomfort.

While occasional muscle soreness may be expected after activity, persistent or worsening pain should not be ignored.

Addressing symptoms early may help prevent small problems from becoming larger ones.³

7. Forgetting That Pickleball Is an Athletic Activity

Although pickleball is enjoyable and social, it is still a sport.

Successful players often benefit from preparing their bodies through:

• Strength training
• Mobility exercises
• Balance training
• Cardiovascular conditioning
• Recovery strategies

Maintaining overall fitness may improve both performance and long-term participation.

Does Back Pain Mean I Should Stop Playing?

Not necessarily.

For many people, continuing to move — while modifying activity when appropriate — is preferable to complete rest.⁵

Temporary adjustments may include:

• Reducing playing time
• Taking more frequent breaks
• Avoiding multiple consecutive days initially
• Improving conditioning between matches

Remaining active is generally recommended for many forms of mechanical low back pain.⁹

When Should You Seek Medical Attention?

Although most pickleball-related back pain improves with conservative care, seek prompt medical evaluation if you experience:

• Progressive leg weakness
• Loss of bowel or bladder control
• Numbness around the groin or saddle area
• Fever
• Significant trauma
• Unexplained weight loss
• A history of cancer with new back pain⁹

These symptoms require immediate medical assessment.

How Can Physical Therapy Help?

A comprehensive evaluation can identify movement patterns that may be contributing to your symptoms. Depending on your individual needs, treatment may include:

• Therapeutic exercise
• Functional movement retraining
• Manual therapy
• Balance training
• Hip mobility exercises
• Progressive strengthening
• Education about activity modification

The goal is not simply to reduce pain but to help you continue participating in the activities you enjoy.

How We Help at Kriz Mobility and Vitality

At Kriz Mobility and Vitality, we enjoy helping active adults continue playing the sports they love.

Whether your goal is to compete in local pickleball leagues, enjoy recreational games with friends, or simply stay active throughout retirement, our approach begins with understanding why your symptoms developed.

Your individualized evaluation may include an assessment of:

• Hip mobility
• Core endurance
• Balance
• Functional movement
• Walking mechanics
• Strength and flexibility

Depending on your examination findings and goals, your rehabilitation program may incorporate:

• Therapeutic exercise
• Manual therapy
• Functional movement retraining
• Balance and gait training
• Neuromodulation when clinically appropriate
• Radial shockwave therapy when indicated
• Photobiomodulation (light therapy) as part of a comprehensive rehabilitation program

Our mission is to help you return to pickleball — and all the activities you enjoy — with greater confidence and comfort.

Frequently Asked Questions

Is pickleball bad for your back?

Not necessarily. For many adults, pickleball is an excellent form of physical activity. Improving strength, mobility, balance, and conditioning may help reduce unnecessary stress on the spine.³

Why does my back hurt after pickleball but not during the game?

Symptoms sometimes appear after activity as muscles fatigue or irritated tissues become more sensitive following repeated movement.³

Should I stretch before playing?

Current evidence generally supports dynamic warm-ups before activity, while longer static stretching is often more appropriate after exercise or during separate flexibility sessions.⁶

Can physical therapy help me continue playing?

Many individuals with mechanical back pain benefit from individualized exercise programs that address mobility, strength, balance, and movement quality.⁹

Download Our Free Back Pain Guide

Want to better understand back pain after age 50? Download our Free Back Pain Guide to learn about common causes of back pain, evidence-based treatment options, and practical strategies that may help you continue enjoying an active lifestyle.

Schedule a Complimentary Telephone Consultation

If back pain is keeping you off the pickleball court, our team at Kriz Mobility and Vitality is here to help. Schedule a complimentary telephone consultation to discuss your symptoms, ask questions, and learn more about your options.

References

1. Sports & Fitness Industry Association (SFIA). Topline Participation Report. Latest edition.

2. Weiss H, Dougherty J, DiMaggio C. Non-Fatal Senior Pickleball and Tennis-Related Injuries Treated in United States Emergency Departments, 2010–2019. Injury Epidemiology. 2021;8:34.

3. Hartvigsen J, Hancock MJ, Kongsted A, et al. What Low Back Pain Is and Why We Need to Pay Attention. The Lancet. 2018;391(10137):2356-2367.

4. Vad VB, Bhat AL, Basrai D, et al. Low Back Pain in Professional Golfers: The Role of Associated Hip and Low Back Range-of-Motion Deficits. American Journal of Sports Medicine. 2004;32(2):494-497. (Supports the relationship between hip mobility and lumbar stress, a principle applicable to rotational sports.)

5. George SZ, Fritz JM, Silfies SP, et al. Interventions for the Management of Acute and Chronic Low Back Pain: Revision 2021. Journal of Orthopaedic & Sports Physical Therapy. 2021;51(11):CPG1-CPG60.

6. Behm DG, Blazevich AJ, Kay AD, McHugh M. Acute Effects of Muscle Stretching on Physical Performance, Range of Motion, and Injury Incidence in Healthy Active Individuals: A Systematic Review. Applied Physiology, Nutrition, and Metabolism. 2016;41(1):1-11.

7. Sherrington C, Fairhall NJ, Wallbank GK, et al. Exercise for Preventing Falls in Older People Living in the Community. Cochrane Database of Systematic Reviews. 2019;1:CD012424.

8. Gabbett TJ. The Training-Injury Prevention Paradox: Should Athletes Be Training Smarter and Harder? British Journal of Sports Medicine. 2016;50(5):273-280.

9. Qaseem A, Wilt TJ, McLean RM, Forciea MA; Clinical Guidelines Committee of the American College of Physicians. Noninvasive Treatments for Acute, Subacute, and Chronic Low Back Pain: A Clinical Practice Guideline From the American College of Physicians. Annals of Internal Medicine. 2017;166(7):514-530.

This material is educational in nature and is not a substitute for individualized medical advice, diagnosis, or treatment. Consult a qualified health care provider with any questions regarding a medical condition.