What Muscles Do You Need to Build for Pickleball and Prevent Injuries? The 5 That Matter Most
You’ve probably seen it happen at your courts. Someone lunges for a short ball, grabs the back of their leg, and disappears for months. Or a friend takes a quick step backward, loses their balance, and puts a hand down to catch the fall.
It’s enough to make anyone wonder what they should be doing about it. Stretching? Walking? Lifting weights? Advice is everywhere, and very little of it tells you where your limited time will actually pay off.
Pickleball injuries aren’t random. They keep showing up in the same few places, and that tells you where to focus.
A 10-year national study of emergency room records estimated more than 66,000 pickleball injuries between 2013 and 2022. Falls caused about two-thirds of them, and broken bones were the most common diagnosis. The everyday picture is just as striking. In a 2025 survey of nearly 1,800 regular U.S. players, more than two in three reported an injury in the past year, and about 4 in 10 missed playing time because of it.
This research comes mainly from ER records, clinics, and player surveys, so it shows where injuries happen more than exactly how to stop them. Still, it points clearly at five muscle groups worth your time. Each one supports a part of the body that turns up again and again in the injury data.
You don’t need a gym membership or an hour a day. You need to spend the time you have in the right places.
1. The Calf Complex: The Achilles’ Bodyguard
At one orthopedic center, Achilles tendon rupture accounted for nearly 40% of pickleball-related foot and ankle injuries, followed by calf muscle injuries at 16% and Achilles tendinopathy at about 12%. These injuries hit men and players over 50 more often, usually while running or lunging, and 60% of the ruptures went to surgery.
The calf is really two muscles. The gastrocnemius works hardest with the knee straight. The soleus, deeper underneath, takes over when the knee is bent, which is exactly the posture of a good ready position.
If you only ever do straight-leg calf raises, you’re skipping the muscle that carries you through every split step.
Build it: Single-leg calf raises with a straight knee, then the same with a soft bend. Add slow heel drops off a stair edge, taking three seconds to lower. Work up gradually to sets of 15 to 20 smooth reps on each leg before adding weight.
2. The Glute Medius: The Muscle That Keeps You Level
This is the injury that sends people to the ER. In a large fracture study, falls caused more than 92% of pickleball fractures, and two-thirds of breaks hit the arm and wrist. Falls themselves are common: in one survey, 42% of players reported a pickleball-related fall and 30% had fallen more than once.
Lunging and moving backward were the leading reasons players gave for going down. Both moves ask the glute medius, the muscle on the side of your hip, to keep your pelvis from tipping while you’re on one leg.
The research here has a wrinkle worth knowing. In a study of recreational players tested on court, hip abduction strength wasn’t tied to who had fallen. Stronger hips did go with faster change-of-direction times.
Hip strength helped players change direction faster, so pair it with balance and footwork practice to get the most out of it.
Build it: Side-lying leg raises, banded side steps, and single-leg balance with a slow reach. Then practice the dangerous direction on purpose: controlled backpedaling and drop-steps, slowly at first.
3. The Quadriceps: The Knee’s Brakes
The knee is the most injured spot in recent survey data, topping the list at about 29% in that 2025 national survey of U.S. players. Every time you stop, lunge, or plant to change direction, the quads are lengthening under load to control how fast the knee bends.
When the quads lack strength or tire late in a session, that control gets sloppier. Hip weakness can add to it, because the knee may drift inward when the glute medius can’t hold the thigh in line. If your knees complain, look at your hips and thighs too. They control how much load reaches the knee every time you stop.
Build it: Split squats, step-downs from a low stair with the knee tracking over the second toe, and sit-to-stands from a chair with a slow three-second descent. The lowering phase matters more than the standing up.
4. The Rotator Cuff and Shoulder Blade Muscles
Shoulders surprise people. In a six-year review at one sports medicine center, the rotator cuff was the most commonly injured area, ahead of the back and calf, and women over 60 carried the highest overall injury risk.
Overheads get blamed, but physical therapists point elsewhere. Clinicians see cuff strain coming more from the reaching demands of dinks and volleys than from powerful serves. Holding a paddle out in front for an entire kitchen exchange is sustained work for small muscles.
Age adds context. Degenerative cuff tears show up in an estimated 30% to 50% of people over 50, many without symptoms. A shoulder can feel fine right up until a lunging reach asks too much.
Build it: Banded external rotation with your elbow pinned to your side, rows with a one-second squeeze of the shoulder blades, and prone “Y” raises with light or no weight.
5. The Forearm Extensors: The End of the Line
The upper-body chain finishes at the elbow. In a survey of tournament and rec players, lateral epicondylalgia (pickleball elbow) was the most common overuse injury, and elbow and forearm problems made up 18% of injuries among Korean tournament players, second only to the knee.
One likely contributor sits upstream. When the shoulder and trunk contribute less to the swing, the wrist and forearm do more of the work. Add a tight grip and thousands of repetitions, and the tendon on the outside of the elbow can take the bill.
When the elbow hurts, the fix may start well above it, at the shoulder, the grip, and the swing itself.
Build it: Eccentric wrist extensions: hold a light dumbbell palm-down, use your other hand to lift it, then lower slowly with the working wrist. Pair that with reverse wrist curls and a looser grip on court, around a 4 on a scale of 10.
How the Five Connect
Think of two chains. The lower chain runs calf, quad, hip. A weak link anywhere along it raises the odds of Achilles trouble, knee pain, and falls. The upper chain runs shoulder blade, rotator cuff, forearm. Weakness near the top pushes work toward the elbow.
Falls tie the two together. A balance loss that starts in the legs tends to end with a hand reaching for the court, which is why arm and wrist breaks lead the fracture data.
How to Use This
You don’t need a gym. Treat the exercises above as a menu. Pick one from each of the five sections and do 2 to 3 sets of 10 to 15 controlled reps, two or three times a week. That runs about 20 minutes. When the last few reps of a set feel easy, move to a harder variation or add light weight.
Tendons adapt slower than muscles, so give it eight to twelve weeks before judging results.
If you already have Achilles pain at rest, a diagnosed cuff tear, or a recent fall, start with a physical therapist who can set the load for you.