Pickleball is the fastest-growing sport in the United States, with over 48 million adults picking up a paddle in recent years. It is fun, social, and low-impact enough that many people play well into their 60s, 70s, and beyond. But there is a catch that doctors are now tracking closely: lower back injuries are rising just as fast as the sport itself.
A 2025 study published in the Journal of the American Academy of Orthopaedic Surgeons found that pickleball-related spine injuries increased 56-fold between 2013 and 2023. The lumbar spine (the lower back) was the most frequently injured region, accounting for 84% of all cases. Most players who got hurt were women, and the average age was 62.
Key Finding: Pickleball-related spine injuries increased 56-fold in a single decade. The lumbar spine accounted for 84% of all cases. (Dansby et al., J Am Acad Orthop Surg, 2025)
If you have felt that familiar ache after a few sets on the court, you are not imagining it. Here is what the research says about why pickleball stresses the back, what warning signs to take seriously, and how to protect yourself.
Why Does Pickleball Hurt My Lower Back?
Pickleball looks gentle. There is no sprinting, no contact, and the court is smaller than a tennis court. But the movement patterns are demanding in a specific way.
Every shot involves a twist. You rotate your torso to return a shot, bend to reach a low ball, then spring back to ready position. Over the course of a two-hour session, that sequence happens hundreds of times. The lumbar spine absorbs much of that load. When the muscles around the spine are fatigued or weak, the discs and joints between the vertebrae take the strain instead.
The most common complaint among injured players in the 2025 study was lumbar radiculopathy, the sharp, shooting pain that travels down one leg. You may know it as sciatica. It happens when a disc presses on a nerve root, often because repetitive twisting and bending have shifted the disc out of its normal position.
Is It Normal to Have Back Pain After Pickleball?
Some muscle soreness after a new sport is normal. Feeling sore in your lower back the day after you start playing is common, especially if you are not used to rotational movement.
What is not normal is pain that:
- Shoots down one leg
- Lasts more than a few days
- Gets worse when you sit or stand for long periods
- Comes with numbness or tingling in your foot
Those symptoms suggest something beyond muscle soreness and are worth having evaluated. A physical therapist, orthopedic specialist, or chiropractor can assess whether the problem is muscular, disc-related, or something else.
How Serious Are Pickleball Spine Injuries?
Most are manageable without surgery. In the 2025 JAAOS study, 98% of injured players were treated as outpatients, and the majority improved with conservative care. That said, 10% did require surgical intervention, typically a spinal decompression procedure to relieve nerve compression.
A 2024 review published in Cureus found that pickleball injuries are overwhelmingly musculoskeletal. Sprains and strains respond well to rest, physical therapy, and gradual return to play. But older players face higher risk of more serious injuries, including fractures. A separate 2024 analysis in the Orthopaedic Journal of Sports Medicine found that pickleball-related fractures increased 90-fold over two decades, with players aged 60 to 69 most affected.
The risk is real but manageable with the right preparation.
Simple Exercises to Protect Your Back Before You Play
Strong core muscles are the single best protection for your spine on the pickleball court. A 2024 randomized trial published in the Journal of Clinical Medicine found that six weeks of core strengthening exercises significantly reduced chronic low back pain scores and improved functional endurance compared to a no-exercise control group.
These three exercises take about ten minutes and can be done at home:
Dead bug. Lie on your back with arms pointing to the ceiling and knees bent at 90 degrees. Slowly lower your right arm overhead while straightening your left leg. Return to start. Repeat on the other side. Do 10 reps per side.
Bird dog. Start on hands and knees. Extend your right arm and left leg at the same time, keeping your back flat. Hold three seconds. Repeat 10 times per side.
Glute bridge. Lie on your back with knees bent. Drive your hips toward the ceiling by squeezing your glutes. Hold two seconds at the top. Do 15 reps.
How to Prevent Lower Back Pain from Pickleball
Beyond core exercises, a few habits make a real difference on the court:
Warm up before you play. Five minutes of light movement, hip circles, and torso rotations prepares the spine for the demands ahead. Cold muscles tear more easily.
Use your legs, not your back. On low shots, bend at the knees and keep your spine long. Rounding the back while reaching down is how most disc injuries happen.
Take rest days seriously. Pickleball courts are busy because people love the game. Playing every day without recovery time is a setup for overuse injury. Two or three days a week is plenty to improve and stay healthy.
Work on hip flexibility. Tight hips shift the rotational load onto the lumbar spine. Stretching the hip flexors and piriformis regularly reduces that transfer.
If pain starts during a session, stop. Playing through back pain usually makes it worse, not better.
The Bottom Line
Pickleball is a genuinely good sport for older adults. It builds cardiovascular fitness, keeps people socially connected, and is accessible to a wide range of physical abilities. The back injury risk is real and rising, but it is not a reason to avoid the sport.
Knowing what causes the pain, what warning signs to take seriously, and how to prepare your body changes the equation. With consistent core work and smart habits on the court, most players can keep playing well into their later years. For persistent or severe symptoms, early evaluation by a spine specialist or musculoskeletal clinician can prevent a minor problem from becoming a major one.
Sources & Further Reading
- Dansby J, Nilssen P, Ocampo A, et al. Introduction to Spine Injuries in the Pickleball Athlete. J Am Acad Orthop Surg. 2025;33(22):1271–1276. PMID: 40048727. https://pubmed.ncbi.nlm.nih.gov/40048727/
- Knapik DM, et al. Pickleball Injuries in the Aging Athlete: A Critical Analysis Review. Cureus. 2024;16(9):e69950. PMID: 39445252. https://pmc.ncbi.nlm.nih.gov/articles/PMC11496387/
- Ghattas YS, Zeblisky P, Cassinat J, et al. Pickleball-related fractures in the United States from 2002 to 2022: An analysis using the NEISS database. Orthop J Sports Med. 2024;12:23259671241255674. https://pubmed.ncbi.nlm.nih.gov/39010888/
- Ejaz A, et al. Efficacy of Core-Strengthening and Intensive Dynamic Back Exercises on Pain, Core Muscle Endurance, and Functional Disability in Patients with Chronic Non-Specific Low Back Pain: A Randomized Comparative Study. J Clin Med. 2024;13(2):475. PMID: 38256609. https://pubmed.ncbi.nlm.nih.gov/38256609/
