Physiotherapy
Padel and Pickleball Injuries: When to See a Doctor, When You Need a Scan, and How Physio Gets You Back on Court
Oct
Padel and pickleball have taken off in Singapore, with new courts opening across the island and players of every age picking up a paddle. Both are fast, social and easy to learn, but the quick stops, lunges, overhead shots and repetitive swings can also lead to injuries, especially if you are new to the sport or returning after time off.
At Ashford Medical Centre, the injuries we see most often in padel and pickleball players are knee injuries, ankle sprains, tennis elbow and shoulder strains. This guide explains what causes them, when you should see a doctor, when a scan is actually needed, and how physiotherapy gets you back on court.
- Most padel and pickleball injuries are sprains, strains and tendon problems that get better with the right rehab.
- See a doctor if pain, swelling or weakness is not settling after a few days, or straight away for any red flag below.
- Most injuries do not need a scan. When one is needed, we arrange an X-ray, ultrasound or MRI with our partner imaging centres.
- A physiotherapy assessment finds out why the injury happened, so it is less likely to come back.
Why padel and pickleball cause injuries
- Sudden starts, stops and changes of direction put strain on knees, ankles and calves.
- Repetitive swings and wrist-heavy shots load the forearm tendons at the elbow.
- Overhead smashes and bandejas in padel strain the shoulder.
- Hard courts and lunges at the net in pickleball increase the risk of falls and ankle rolls.
- Doing too much too soon. Many players go from no sport to several sessions a week, faster than tendons and muscles can adapt.
Research backs this up. A 2023 review of padel studies found the elbow was the most commonly injured area, with tennis elbow the most frequent diagnosis, followed by the knee, shoulder and lower back. In pickleball, falls are a leading cause of injury, and older players are more likely to suffer sprains and fractures.
The most common injuries
| Injury | Typical cause | What you may notice |
|---|---|---|
| Knee injuries ligament sprain, meniscus tear, knee tendon pain |
Twisting on a planted foot, sudden direction changes, repeated lunging | Pain, swelling, the knee giving way, clicking or locking |
| Ankle sprain | Rolling the ankle when moving sideways or landing | Pain and swelling on the outside of the ankle, bruising, difficulty walking |
| Tennis elbow lateral elbow tendinopathy |
Repeated backhands, gripping the paddle too tightly, sudden increase in play | Pain on the outside of the elbow, worse with gripping or lifting |
| Shoulder strain rotator cuff irritation or tear |
Overhead smashes and serves, especially without enough shoulder strength | Pain lifting the arm or reaching overhead, pain at night, weakness |
| Calf strain and Achilles injuries | Explosive push-offs and quick sprints to the net | Sudden pain at the back of the lower leg; a “pop” may mean an Achilles tear |
| Wrist injuries | Falling onto an outstretched hand | Wrist pain, swelling, difficulty gripping |
When to see a doctor
- An obvious deformity, or you think a bone may be broken
- You cannot put any weight on your leg, or cannot move the joint
- A “pop” at the back of the ankle with sudden weakness pushing off (possible Achilles tear)
- Numbness, pins and needles or a cold, pale hand or foot
- A head injury with confusion, vomiting, drowsiness or loss of consciousness
Book an appointment with a doctor if:
- Pain or swelling is not improving after 3 to 5 days
- Your knee gives way, locks or catches
- You have ongoing weakness, for example lifting your arm or gripping the paddle
- Pain is waking you at night
- The same injury keeps coming back
What the doctor checks
Our doctor will ask how the injury happened, what you felt at the time, and how it has changed since. They then examine the area, check movement, strength and stability, and use simple clinical tests to work out which structure is injured, for example the ligaments of the knee or ankle, a tendon, or a muscle. From there, the doctor can advise on pain relief, provide a medical certificate if needed, and decide whether you need a scan.
Do I need an X-ray, ultrasound or MRI?
Many people expect a scan after an injury, but most sprains and strains can be diagnosed with a careful examination. A scan is useful when it would change your treatment. When you do need one, we arrange the appointment for you with our partner imaging centres and go through the results with you.
| Scan | Best for | Example |
|---|---|---|
| X-ray | Checking for broken bones | A badly swollen ankle where you could not walk afterwards, or tenderness over specific bony points; a wrist injury after a fall |
| Ultrasound | Tendons, muscles and some ligaments | Suspected Achilles or calf tear, ongoing tennis elbow, shoulder tendon problems |
| MRI | Detailed view of ligaments, cartilage and joints | A knee that gives way or locks (possible ligament or meniscus tear), or an injury not improving after several weeks of rehab |
Doctors use well-established guidelines, such as the Ottawa ankle and knee rules, to decide when an X-ray is needed after a sprain. This avoids unnecessary scans while making sure fractures are not missed.
What the physiotherapy assessment involves
A physiotherapy assessment looks at more than the painful area. Our physiotherapist will:
- Test strength, flexibility, balance and control around the injured joint
- Check how much load the area can take, for example hopping, lunging or gripping
- Look at the factors behind the injury, such as footwork, technique, paddle grip, footwear, and how quickly you increased your court time
- Explain what is injured and set a clear plan with goals
Rehab and getting back on court
Rehab usually moves through stages:
- Settle pain and swelling with relative rest, ice, compression and gentle movement.
- Restore movement and strength with targeted exercises, hands-on therapy and taping if helpful.
- Rebuild sport-specific fitness: footwork, side-to-side movement, landing, and gradually adding swings and overheads.
- Return to play in steps, starting with shorter, lighter sessions before full matches.
Rather than a fixed number of weeks, we use strength and movement tests to decide when you are ready to return. Going back too early is one of the most common reasons injuries come back.
How to prevent padel and pickleball injuries
- Warm up for 5 to 10 minutes with light movement, side steps and gentle swings before you play.
- Build up gradually. Increase how often and how long you play over several weeks.
- Strengthen calves, hips, shoulders and forearms two or three times a week.
- Wear court shoes with good side support, not running shoes.
- Check your grip and paddle. A grip that is too tight or the wrong size can overload the elbow.
- Avoid diving for shots, especially if your balance or bone health is a concern.
- Do not play through sharp pain. Get it checked early.
Frequently asked questions
Should I see a doctor or a physiotherapist first?
Either is fine. See the doctor first if you think you may need a scan, pain medicine or a medical certificate, or if the injury is severe. For most strains and ongoing aches, you can book our physiotherapist directly.
Do I need a referral for a scan?
Our doctor will assess you and, if a scan is needed, arrange the X-ray, ultrasound or MRI with our partner imaging centres and review the results with you.
How long does tennis elbow take to heal?
It varies. Many people improve over several weeks to a few months with the right exercises and changes to their play, but long-standing cases can take longer. Early treatment usually means a quicker recovery.
Can I keep playing with a minor ankle sprain?
It is best to rest from play until you can walk, hop and move side to side without pain. Returning too early increases the risk of spraining it again. Ankle strengthening and balance exercises help prevent repeat sprains.
Is pickleball safe for older adults?
Yes, and it is a great way to stay active. Warming up, building up gradually, wearing proper shoes and avoiding dives for difficult shots reduce the risk of falls and injuries. If you have bone or joint concerns, speak to our doctor before you start.
Injured on court?
See our doctor and physiotherapist under one roof at 79 Serangoon Garden Way, with scans arranged when you need them.
Related: Physiotherapy at Ashford · Elbow and wrist pain · Shoulder pain · Achilles tendon pain
Medically reviewed by Dr Namthep Sachathep, Clinical Director, with input from Valerie Tan, AHPC-registered physiotherapist. This article is general information and is not a substitute for a medical assessment.
