Foot and Ankle Injuries in Pickleball

The origin: In 1965, Joel Pritchard, a Congressman from Washington State, returned to his home after playing golf with Bill Bell, a business associate, and found their families doing nothing. The two decided to fix that! The converted an old badminton court into the first Pickleball court. They used what they could find at hand – ping-pong paddles for racquets and a perforated plastic ball. They lowered the net to 36 inches and decided to allow the ball to bounce on the asphalt surface after a volley over the net. The next weekend, Barney McCallum joined the other two men to create the rules. The original purpose of the game was to create a game the whole family could play together.

There are differing reports on how the sport developed its Pickleball name. Some say Joel Pritchard’s wife started calling the game Pickleball because, “The combination of different sports reminded me of the pickle boat in crew where oarsmen were chosen from the leftovers of other boats.” Other accounts say the game was named after the Pritchard’s dog, Pickles. Pickles would chase down the ball and run off with it.

The statistics: According to the Sports & Fitness Industry Association’s (SFIA) 2021 Topline Participation Report, there are currently 3.46 million Pickleball players in the US.

• 61% of participants are men and 39% are women
• The average age for all players is 38.1 years old
• The average age for Core players is 47.5 and Casual players 33.6 years old
• 60% of Core players are 55 or older
• 79% of Casual players are 54 or younger

Common Foot and ankle injuries in Pickleball:
1. Ankle strain/sprain – Pickleball involves sudden movements of the feet and ankles forward, backward, and side-to-side. These movements place stress on the ligaments surrounding the ankle joint. Moving side to side can cause the most common ankle injury in Pickleball – the inversion ankle injury. This is an injury where the foot rolls under the ankle and turns under. It produces a strain/sprain to the outside ankle ligaments. The ligaments can become stretched or torn. Repetitive ankle strain/sprains can weaken the normal stability of the outside of the ankle making you prone to repetitive ankle injury. The use of a functional ankle brace that allows full natural ankle range of motion while providing support and stability to the ankle joint is helpful to use for players experiencing ankle strain/sprain. Also, it is extremely important to warm up before every game or practice. Schedule time at least 5 to 10 minutes for warm-up. Start with some easy cardio (i.e., a fast walk, jog, or bike ride) to get your core temperature up. Then, do some light stretching. After play, be sure to cool down by taking a slow walk and doing a bit of stretching too.

2. Achilles tendonitis – Achilles tendinitis occurs from repetitive stress to the Achilles tendon. Pain can appear anywhere along the tendon, from the calf muscle to tendon’s attachment at the back of the heel bone. Risk factors associated with Achilles tendonitis are tight calf muscles and suddenly doing activities that put extra stress on the Achilles tendon. With the physical maneuverings of pickleball, this certainly stresses the Achilles tendon. Symptoms include pain and stiffness along the Achilles tendon in the morning or after periods of sitting or rest. The pain at the back of the heel worsens with activity and swelling can occur. Treatment of Achilles tendon strains includes rest, focused stretching of the tendon before/after activities, and eccentric loading exercises.

3. Achilles tendon tear – Achilles tendon rupture can be a complete or partial tear. This happens when the tendon is stretched beyond its ability. This can occur with a forceful and abrupt downward (plantarflexion) movement of the ankle. The Achilles tendon can also be torn when there is sudden forceful pivoting or sudden acceleration in running. This may occur during falling or tripping which, is quite common in “weekend warrior” pickleball players. Many patients describe a snapping sensation with a sudden pain in the back of the ankle or calf. Pain is severe in the back of the ankle and usually there is difficulty to bear weight on the affected foot/ankle. With a complete rupture of the tendon, most cannot flex their foot downward from the ankle. This type of injury will often require surgical repair. Prompt evaluation is imperative for optimal long-term outcome.

4. Plantar fasciitis/heel bruise – Plantar fasciitis and heel bruising will result from overuse or repetitive pounding on the hard playing surface. Pain can be in the arch area or bottom of the heel. Often, it is in both areas. Pain is sharp in nature to the bottom of the heel and often more painful after inactivity or rest. This is often treated with activity modification, rest, stretching, intrinsic foot exercises, and potentially shoe orthotics or heel cups.

5. Blisters – Blistering of the foot is usually associated with prolonged use of improper footwear and socks. Wear anti-friction socks. Make sure your shoes fit properly. You should NOT be using regular walking or running shoes on a pickleball court. These types of shoes only provide traction when you are moving in a straight line. Pickleball involves fast and frequent side to side movements. Wearing these types of shoes can cause the foot to “stick” and an injury will likely occur. Court shoes are made with a smoother and rounder sole. They do not have deep treads on their sole. The treads are also smaller and closer together than other types of shoes. These court shoe modifications allow you to move and glide on the court.

Disclaimer: This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition.

Lori DeBlasi, DPM
Dr. Lori DeBlasi is a board-certified podiatrist at Family
Foot & Leg Center at the
Colonial Blvd. office.
She is accepting new patients.
To make an appointment, call 239-430-3668 or visit www.NaplesPodiatrist.com.

1645 Colonial Blvd,
Fort Myers, FL 33907

(239) 430 – 3668 (FOOT)
www.NaplesPodiatrist.com