If you have walked past a tennis court or community center anywhere in Ottawa recently, you already know. The unmistakable thwack of a plastic ball hitting a composite paddle is everywhere. Pickleball has officially taken over the capital. From the outdoor courts at Walter Baker Park in Kanata to indoor gymnasiums running winter leagues, the sport’s popularity has exploded.
It is easy to see why. Pickleball is incredibly social, easy to pick up, and genuinely fun. It is marketed as a low-impact alternative to tennis, making it highly appealing to older adults and former athletes looking to stay active. But there is a hidden catch to this rapid growth. Here at Kinoveo, our schedule has seen a dramatic influx of a very specific type of patient: the sidelined pickleball player.
Despite its reputation as a gentle game, pickleball demands intense, explosive movements that place a massive amount of stress on your joints, tendons, and ligaments. If you are hitting the courts three or four times a week, ignoring the nagging aches and pains is a surefire way to end your season early.
The Illusion of “Low Impact”
The biggest misconception about pickleball is that because the court is small, roughly one-third the size of a tennis court, you don’t have to move as much. Biomechanically, the exact opposite is true.
A smaller court means less running, but it requires significantly more starting, stopping, twisting, and lunging. The game is built on rapid, lateral movements and quick changes of direction. You are constantly dropping into a low squat to return a dink at the kitchen line, then immediately backpedaling to handle a lob, followed by an explosive overhead smash.
When you combine these fast-twitch, multi-directional movements with the unforgiving surface of a hard asphalt or gymnasium floor, your lower body absorbs a tremendous amount of shock. If your tissues haven’t been conditioned for this specific type of load, they will eventually break down.
Common Pickleball Injuries We Treat in Kanata
When a player limps into our Kanata clinic or walks in clutching their arm, the injury almost always falls into one of these four categories
1. “Pickleball Elbow” (Lateral Epicondylitis) Tennis elbow tendinitis has a new name. This is a repetitive strain injury affecting the tendons that attach your forearm muscles to the bony bump on the outside of your elbow. While a pickleball paddle is lighter than a tennis racquet, the mechanics of the game involve a lot of aggressive wrist flicking, especially on backhand shots and quick volleys. Over time, these repetitive micro-tears lead to inflammation, weakness, and a sharp pain that makes it difficult to even hold a coffee mug, let alone a paddle.
2. The Achilles and Calf “Pop” Pickleball requires a constant “split step”—a slight hop that players do right before their opponent hits the ball, allowing them to explode in any direction. This explosive push-off places extreme tension on the calf muscles and the Achilles tendon. If your calves are tight, or if you haven’t properly warmed up, this sudden demand can cause an acute calf strain or, in severe cases, an Achilles tendon tear. Patients often describe the sensation as feeling like they were struck in the back of the leg with a stick.
3. Knee Tweaks: Meniscus Tears and Patellar Tendinitis The “kitchen” (the non-volley zone) is where the most delicate, low-to-the-ground shots happen. Players are constantly lunging forward and bending deeply to dig out low balls. This deep knee flexion, often combined with a sudden twisting motion, creates a perfect storm for meniscus irritation. Additionally, the constant hard stops on a solid surface can inflame the patellar tendon (the thick band connecting your kneecap to your shin), causing a sharp, localized pain right below the knee.
4. Rotator Cuff Strain Reaching backward to return a lob overhead forces the shoulder into a vulnerable position of maximum external rotation and extension. If your rotator cuff muscles, the small stabilizing muscles of the shoulder, are weak or fatigued, the larger muscles overpower them, leading to pinching, inflammation, and eventual tearing in the shoulder joint.
How to Stay Healthy and Avoid the Treatment Table
The good news is that the vast majority of pickleball injuries are preventable. You do not need to give up the sport, but you do need to prepare your body for it. Here is what we tell our patients:
Stop Wearing Running Shoes on the Court If there is only one piece of advice you take from this article, let it be this. Running shoes are engineered for forward, straight-line motion. They have thick, cushioned heels and zero lateral support. When you wear running shoes to play a sport that requires side-to-side shuffling, your foot can easily slide over the edge of the sole, resulting in a severe ankle sprain. Invest in proper court shoes. They sit lower to the ground, have a wider base, and feature reinforced sides to lock your foot in place during lateral shifts.
Respect the Warm-Up Walking from the parking lot to the court does not count as a warm-up. Before you start aggressive rallies, your muscles need blood flow and your joints need lubrication. Spend five minutes doing dynamic stretches: leg swings, torso twists, high knees, and arm circles. Start your hitting session with gentle dinks down the middle before you start ripping baseline drives.
Manage Your Playing Time (Load Management) Many players go from being relatively sedentary to playing pickleball for two hours a day, five days a week. Your cardiovascular system might be able to handle that jump, but your tendons cannot. Tendons adapt very slowly to new loads. If you ramp up your playing time too aggressively, tendonitis is almost guaranteed. Increase your court time gradually.
Strength Train for the Sport Playing pickleball will not make you strong enough to play pickleball. You need external resistance training to build the tissue capacity required for the sport. Focus on eccentric calf raises to bulletproof your Achilles, lateral band walks to strengthen your hip stabilizers, and rotational core exercises to protect your lower back during swings.
How Physiotherapy Gets You Back in the Game
If you are already experiencing pain that lasts longer than a day or two after playing, resting for a week and hoping it goes away is a flawed strategy. Tendons respond to load, not just rest. As soon as you step back on the court, the pain will likely return.
At Kinoveo Physio, our goal isn’t just to reduce your current pain; it is to figure out exactly why the tissue failed in the first place. We conduct a full biomechanical assessment to find the weak links in your kinetic chain. We use hands-on manual therapy to restore joint mobility, and we build customized, progressive loading programs to strengthen your tendons so they can handle the explosive demands of the game.
Don’t let a preventable injury ruin your season. If a nagging ache is slowing down your game, reach out to us today. Let’s get your body mechanics sorted out so you can get back to the kitchen line.