Have you or your friends recently jumped on the pickleball bandwagon? If so, you’re not alone. Invented right here on Bainbridge Island by former U.S Representative Joel Prichard, pickleball has taken the U.S. by storm.
There are two different accounts about how the sport was named. One story says Joel's wife started to call it pickleball because the elements from a variety of sports reminded her of the pickle boat in crew. Another story says it was named after their dog, Pickles.
According to the Sports and Fitness Industry Association it’s our fastest growing sport, growing an average of 11.5% per year in the past 5 years with over 4.8 million players nationwide.
While pickleball’s largest numbers of players fall into the 18-34 age range, there is also a large contingent among older players as well. One reason for its popularity with older players is the perception that it’s slower and easier than tennis (smaller courts) and not as hard on the body.
Although pickleball may require less running after balls because it requires smaller courts, it can still take a toll on a player’s feet and ankles. According to one study in 2018, the annual number of senior pickleball injuries reached the same level as senior tennis injuries in that year.
It’s not surprising. Just like tennis there is repetitive pounding on a hard court which can cause problems such as Achilles tendonitis and heel pain. Then there’s the rapid side-to-side movements and quick changes in direction which can lead to ankle sprains and other lower extremity injuries.
Today I’m going to discuss the major pickleball foot and ankle injuries you may encounter, how they’re treated, and how to prevent them.
Acute injuries are those that occur suddenly. You twist and sprain your ankle, or you fall after a sudden turn or pivot.
One of the more common injuries in pickleball are ankle sprains. They occur due to the movements needed to play the sport. Symptoms of an ankle sprain are sudden pain with difficulty bearing weight. Signs can include swelling, pain, and bruising.
Ankle sprains need to be treated so a small problem doesn’t become worse later. Chronic ankle pain can result from insufficiently treated sprains.
Initially, injured players should apply the principles of RICE which stands for rest, ice, compression, and elevation. This can help reduce swelling, inflammation, and pain. It’s important to see a podiatrist to get an X-ray or MRI to find out if there is more extensive damage. Other treatments can include wearing a walking boot, crutches if non-weightbearing, and physical therapy to build strength and increase range of motion.
Ankle fractures can also occur in this sport. Treatment is similar to that for an ankle sprain. Imaging will determine the severity of the fracture and whether any ligaments are torn.
Achilles tendon rupture
An Achilles tendon rupture can occur when the tendon is stretched beyond its capacity. This can occur with the twisting and rapid movements found in pickleball. Older players who only play on occasion are most at risk as well as certain medications such as steroids and some antibiotics can weaken the tendon making it more likely to rupture.
Chronic injuries typically build up over time and occur due to overuse, poor shoes, hard surfaces, problems with foot mechanics and other body structures. One day you might feel fine, the next day a painful twinge, and the following day a sharp pain. This is typical for conditions like plantar fasciitis and Achilles tendonitis.
Plantar fasciitis or heel pain is one of the most common conditions found in people who play sports with high levels of foot impact, like pickleball. Many other factors also come into play in developing this condition including poor foot mechanics, tight calf muscles, overweight, and non-supportive or inappropriate shoes. Older players are also at greater risk.
In plantar fasciitis the affected foot structure is the plantar fascia. It runs from the heel across the bottom of the foot and inserts at the base of the toes. When the plantar fascia becomes too stretched and stressed it becomes inflamed causing pain at the bottom of the heel and sometimes across the arch. One of the hallmarks of this condition is pain upon first steps out of bed in the morning with gradual reduction as the day goes on.
Because so many factors are involved in its development, treatment needs to be comprehensive to work. First, pickleball players who experience heel pain, should refrain from playing. A trip to the podiatrist’s office will reveal what else needs to be treated. In addition to rest, most people will need help with reduction of inflammation, get fitted for custom orthotics, stretching exercises, assessment of their shoes, and sometimes physical therapy.
Achilles tendonitis is a chronic condition that develops as a result of repetitive stress to the Achilles tendon. In addition, many of the factors involved in development of plantar fasciitis can also bring on Achilles tendonitis. In addition, athletes who take certain antibiotics or have high blood pressure are also at greater risk.
Achilles tendonitis can begin with mild pain on the back of the heel to just below the calf muscle but can gradually worsen over time.
Treatment for this condition is virtually the same as that for plantar fasciitis. Without adequate treatment this condition can progress to Achilles tendonosis, a degenerative disorder which can require surgery or injections to heal.
Stress fractures are small cracks in the bone caused by engaging in repetitive sports like pickleball. All the risk factors named above can also influence whether a player develops a stress fracture. In addition, women who are post-menopausal or women who are underweight are also at greater risk for this condition. Also, building up pickleball play too quickly without giving the body a chance to recover can also lead to a stress fracture.
Symptoms can include:
- Pain that comes on quickly in the foot or ankle that’s relieved by rest
- Pain, swelling, redness, or bruising at the top of the foot or ankle
Rest and immobilization of the foot for six weeks is the usual treatment.
Prevention of Foot and Ankle Injuries in Pickleball
It’s always best to prevent a condition from developing in the first place. There are several key steps to take to prevent foot and ankle injuries in pickleball.
Purchase the Right Shoes
Don’t just pull any old gym shoes out of the closet to play pickleball. While there are a lot of shoes that look like they may qualify for a pickleball court, many do not. Also, it’s important to consider whether you plan to play the sport indoors or outdoors. The surface you’re playing on will dictate the type of shoe to purchase.
For those who play indoors your best shoe will be a badminton, racquetball, or squash shoes. If you play outdoors, tennis shoes will be your best bet. The key to a good shoe is one that will keep your foot and ankle stable while you’re moving side-to-side or twisting. You can also check out Pickle Ball Central for shoes designed specifically for pickleball for both men and women.
Make sure you measure your feet before making your purchase. Our feet can get larger as we age. Shoes that are too loose will lead to blistering and shoes that are too tight can cause ingrown and black toenails.
If you have orthotics, be sure to bring them with you when you purchase shoes.
Buy The Right Socks
Pickleball socks like all athletic socks should wick away moisture from your feet to prevent blistering. Try Fila Drymax socks for their wicking ability, but any non-cotton wicking sock should work well.
Build Up Your Play Slowly
It’s important to start slow when learning any new game, pickleball included. This will give your body a chance to recover and build the muscles needed to play the game. Increase your play time by no more than 10% a week. A half an hour of play at the start would be a good rule of thumb. But listen to your body. If you’re feeling tired after 15 minutes or experiencing any pain, you should stop and rest. This will be particularly important for older players who aren’t already active and have bodies that are less forgiving.
Players with Flat Feet or Plantar Fasciitis
If you have flat feet or you’ve had plantar fasciitis or Achilles tendonitis in the past, it’s important to visit your podiatrist to determine whether you should be fit for custom orthotics. Wearing orthotics will go a long way in preventing a recurrence or an initial incident of foot pain.
It’s critical to stretch your calf muscles before and after play to prevent a flare up of heel pain or Achilles tendonitis. Please review the video below.
You can also try using Dynamic Warm-Ups for Runners.
Getting Ready to Play Pickleball
As with any sports it’s best to condition your body to play pickleball. Here are some great exercises anyone can do to get ready. Also, check with your doctor before starting to play pickleball particularly if you have a chronic condition (i.e. osteoarthritis) or have been inactive for awhile.
Need Relief From Pickleball Foot or Ankle Injuries in Seattle, Washington? Request an Appointment Now
Don't let a foot or ankle injury prevent you from playing pickleball. Complete the contact form on this page or call our office at 206-368-7000 to schedule an appointment with Dr. Berg.
Most new patients are seen within 1-2 week's time. During your initial visit, Dr. Berg will spend up to 30 minutes getting to know you, your podiatry complaints, and your goals so that he can recommend the treatment best meets your needs. Don’t wait—contact us today.
North Seattle Foot & Ankle Specialist Dr. Rion Berg offers compassionate podiatry care for all foot and ankle problems to those living in Seattle Washington and the surrounding areas. Call us today at 206-368-7000 for an immediate appointment or request an appointment online.