Pickleball Knee Injuries: Prevention & Recovery Tips

Whether you are an experienced player or new to the game, knee injuries are common among pickleball players. Today, we’re diving deep into the why, how, and what to do to prevent those nagging knee problems from sidelining you.

Why Are Knee Injuries So Common in Pickleball?

First off, let’s talk demographics. Pickleball has exploded in popularity among active adults and older athletes. But with maturity comes wear and tear—especially on the knees. Hard courts, sudden movements, and repetitive impact add stress to already aging joints.

From my experience as a movement specialist and physical therapist, I’ve seen that female players are particularly prone to knee injuries. This largely comes down to anatomy. Women typically have wider hips, which creates a greater “Q angle”—the angle at which the femur meets the knee. This angle increases stress on the inner (medial) compartment of the knee, setting the stage for injuries like:

• Medial meniscus tears

• ACL and PCL sprains

• MCL strain because of valgus (inward) collapse.

If you're locking your knees during play, you could be putting yourself at serious risk.

The Problem With Locked Knees and Poor Movement Mechanics

Pickleball is full of rotation—hips, shoulders, trunk—all twisting and turning as you chase and return shots. When your feet are planted and your knees are locked, your body cannot spread those rotational forces well.

Instead of moving smoothly, your joints absorb torque they weren’t designed to handle. When the knees are locked, they cannot rotate or absorb shock. All that pressure goes straight into the knee joint, especially the meniscus and ligaments. This is a recipe for injury.

I've watched hundreds of players move with poor mechanics—lunging with straight knees, twisting awkwardly at the hips or back instead of taking small, efficient steps. And yes, I’ve even fallen victim to it myself, suffering a painful meniscus injury that sidelined me for weeks.

The Key to Injury Prevention: The 30-Degree Flexion Sweet Spot

The good news? There’s a biomechanical “sweet spot” that can dramatically reduce your injury risk: keeping the knees slightly bent—around 30 degrees of flexion.

Why 30 degrees? At this angle, your body can engage all the stabilizing muscles that support knee movement:

• Quads and hamstrings for joint control

• Calves and dorsiflexors for ankle and foot stability

• Glutes for pelvic control and power

This position allows for smoother directional changes, better shock absorption, and far less stress on your ligaments and meniscus.

One of the best ways to train this position is to master the split step, a technique used in both pickleball and tennis. With a slight knee bend and weight on the balls of your feet (not your heels!), you’re primed to move in any direction with stability and control.

Real Talk: Rehab From a Knee Injury

When I injured my own meniscus, I couldn’t squat, bend, or even get into a child’s pose. I used the RICE method, which stands for rest, ice, compression, and elevation. However, I knew recovery would take more than just waiting.

The game-changer? Pool therapy. The water allowed me to perform movements like squats and lunges without the full impact of my body weight. I practiced forehand and backhand motions in waist-deep water while keeping my knees in that ideal 30–40 degrees of flexion.

Once I rebuilt strength and mobility in the pool, I took it to the gym. My go-to exercises included:

• Backward treadmill walking on an incline (hello, quad activation!)

• Side steps on the treadmill to mimic court movement

• Leg presses and modified squats to build glute, quad, and hamstring strength

• Dorsiflexor activation to stabilize the ankle and foot during play

  
  

Ditch the Brace: Train Your Body’s Natural Stability System

Many players rely on knee braces or compression sleeves to feel “secure.” While they might offer short-term support, they don't solve the real problem: damaged proprioception.

Proprioceptors are your body’s internal GPS—they tell your brain where your joints are in space. An injury to the knee also affects these proprioceptors, dulling your ability to sense and control joint movement. Relying on external support like a brace can interfere with retraining this crucial feedback loop.

Instead of depending on a sleeve, focus on rebuilding neuromuscular control. Train the muscles around the knee to co-activate and respond to quick changes in movement. When your body can trust itself again, you’ll feel the confidence to move freely—without that crutch.

For me, it was a huge win to finally ditch the brace and feel unchained on the court.

Practical Tips for Knee Injury Prevention in Pickleball

Let’s wrap it up with some key takeaways that’ll help you protect your knees and extend your time on the court:

1. Stay slightly bent – Maintain 30 degrees of knee flexion whenever possible, especially during ready stance and transitions.

2. Avoid heel planting – Stay on the balls of your feet for faster reaction times and better shock absorption.

3. Use video analysis – Record yourself playing to identify compensations or poor movement patterns.

4. Strength train regularly – Focus on quads, hamstrings, glutes, calves, and dorsiflexors to build resilience and stability.

5. Incorporate pool training – Low-impact aquatic exercises can rebuild motion and strength without joint stress.

6. Ditch the brace (eventually) – Rebuild proprioception and neuromuscular control to play confidently without external support.

Final Thoughts

Pickleball is an incredible sport, and the last thing you want is to be benched due to an avoidable knee injury. By understanding your anatomy, improving your mechanics, and strengthening key muscle groups, you’ll not only reduce your risk but play better, smoother, and longer.

So keep those knees slightly bent, stay mobile, and train smart. Your future self (and your pickleball doubles partner) will thank you.

See you on the court—and stay tuned for the next post where we dive into more injury prevention tips!

At Aguila Pickleball Physio, I’m here to help you stay on the court longer and play stronger. Are you interested in learning more about how we can work together? Schedule a free consultation here.