Pickleball is an exciting, fast-moving sport, but it can take a toll on your body—especially your tendons. If you’ve ever felt heel pain after sprinting, knee discomfort when lunging, or elbow soreness from repeated swings, you may be dealing with tendon overload.
Tendons connect muscles to bones and help absorb force every time you move. But when they get overworked, strained, or weakened, they can become irritated, inflamed, and painful.
So, if you’re feeling tendon pain, it’s a signal from your body that something needs to change.
The good news? You don’t have to live with chronic pain, and you don’t have to stop playing. The key is taking action early before a small issue becomes a long-term injury.
In this article, we’ll break down the three most common tendon injuries in pickleball, why they happen, and what you can do to heal, strengthen, and keep playing pain-free.
Achilles Tendonitis – Heel Pain from Sprinting & Stopping
The Achilles tendon runs down the back of your lower leg, connecting your calf muscles to your heel. It absorbs impact every time you sprint, push off, or stop suddenly. In pickleball, quick lateral movements and explosive starts can overload the tendon, leading to stiffness, soreness, and even sharp pain.
Why It Happens:
- Tight or weak calf muscles put extra strain on the tendon
- Repeated jumping or sudden direction changes overload the tissue
- Poor ankle mobility forces the Achilles to work harder than it should
How to Prevent & Fix It:
- Strengthen Your Calves & Feet – Add slow, controlled calf raises and single-leg hops to build tendon resilience.
- Improve Ankle Mobility – Stretch your calves and work on ankle dorsiflexion (knee-over-toes movements).
- Don’t Skip Tissue Work – Tight calves can pull on the Achilles, increasing strain. Foam rolling and tissue work help release tension.
Patellar Tendonitis – Knee Pain from Lunging & Jumping
The patellar tendon connects your kneecap to your shinbone and helps absorb force when you lunge, squat, or jump. If your quads are weak or tight, this tendon takes too much stress—leading to pain just below the kneecap.
Why It Happens:
- Overuse from repeated lunging or squatting
- Weak quads and glutes force the tendon to absorb too much load
- Tight hip flexors limit movement, creating extra knee stress
How to Prevent & Fix It:
- Strengthen Your Quads & Glutes – Add goblet squats, Bulgarian split squats, and step-ups to build knee stability.
- Work on Landing Mechanics – When lunging, keep your knee in line with your foot to reduce stress.
- Do Soft Tissue Work – Tight quads and hip flexors can pull on the patellar tendon, so foam rolling and tissue work help release pressure.
UCL Strain – Elbow Pain from Repeated Swings
The ulnar collateral ligament (UCL) runs along the inner side of your elbow and stabilizes your arm during swings. Its the site of a common tendon injuries in pickleball (and tennis.)
In pickleball, repeated overhead shots and backhands put stress on this ligament, leading to inner elbow pain, stiffness, and sometimes weakness in grip strength.
Why It Happens:
- Overuse from repeated swinging motions
- Weak shoulder and forearm muscles put more strain on the elbow
- Poor mechanics (too much wrist flick) overload the ligament
How to Prevent & Fix It:
- Strengthen Your Shoulder & Forearm – Add 1-arm rows, shoulder presses, and wrist curls to reinforce your arm’s stabilizers.
- Improve Grip Strength – Squeezing a stress ball or using grip trainers helps reduce elbow strain.
- Don’t Ignore Tightness – Forearm and triceps tissue work can release tension that builds up around the elbow.
- LEARN MORE: Rebuild, Remodel, and Restore Elbow Injuries
From Tendonitis to Tendinosis: Why Ignoring Pain Can Lead to Bigger Problems
One of the common tendon injuries in pickleball is actually a longer-term, chronic injury; tendonosis.
When tendon pain first appears, it’s usually tendonitis—an early-stage injury caused by inflammation from overuse or excessive strain. At this stage, the tendon is irritated, swollen, and painful, but the tissue itself is still intact.
If left untreated, tendonitis can progress to tendinosis, a more serious condition where the tendon degenerates due to ongoing stress without proper healing.
Unlike tendonitis, tendinosis is not just inflammation—it’s structural breakdown. The collagen fibers in the tendon become disorganized, weaker, and less capable of handling load.
How Tendonitis Becomes Tendinosis:
- Overuse Without Recovery – Repeated stress on the tendon without allowing time for repair.
- Chronic Inflammation – Ongoing irritation causes small microtears, weakening the tendon over time.
- Poor Blood Flow – Tendons have limited blood supply, making healing slower compared to muscles.
- Ignoring Early Pain – Continuing activity without addressing the underlying issue leads to further degeneration.
To learn more about fixing tendon injuries check out Vive’s: Tendon Recovery Checklist
Keys to Reversing Tendinosis & Restoring Tendon Health
Tendinosis can be reversed, but it requires a different approach than treating simple inflammation. The goal is to stimulate healing, rebuild tendon strength, and improve mobility.
Eccentric Strength Training (Slow, Controlled Movements)
- Tendons respond well to slow, lengthening exercises (eccentric loading). For example:
- Heel drops for Achilles tendinosis
- Slow squats or step-downs for patellar tendinosis
- Wrist curls with slow lowering for UCL injuries
- These exercises remodel tendon fibers and improve resilience.
Blood Flow Stimulation & Tissue Work
- Since tendons have limited blood supply, increasing circulation helps healing.
- Techniques like massage, pneumatic compression, and blood flow restriction therapy can improve oxygen and nutrient delivery to the tendon.
Progressive Load Increase (Avoid Complete Rest)
- Rest alone does not fix tendinosis. Tendons need gradual, controlled loading to rebuild strength.
- The key is finding the right balance between reducing aggravating movements while still strengthening the tendon.
Mobility & Soft Tissue Release
- Tight surrounding muscles (calves, quads, forearms) pull on the tendon, increasing strain.
- Soft tissue work helps release tension and improves joint mechanics to offload stress from the tendon.
Consistency Over Time
- Tendon healing is slower than muscle healing and can take weeks to months.
- Sticking to a progressive strengthening program and getting regular recovery work is key for long-term health.
Get Rid of Common Tendon Injuries in Pickleball and Play Pain-Free
Tendon pain can be frustrating, but it doesn’t have to keep you off the court. The key to staying pain-free isn’t just resting—it’s building strength, improving mobility, and getting the right recovery work.
If you’re feeling aches in your heel, knee, or elbow, take it as a sign that your body needs support. Ignoring it won’t make it go away—taking action will.
- Strength training builds resilience so your tendons can handle the demands of pickleball.
- Mobility work keeps your joints moving freely, reducing strain on your tendons.
- Tissue work & recovery help relieve tightness and improve circulation for faster healing.
If you’re already dealing with tendon pain or want to prevent long-term issues, you might need to see someone for guidance. Getting it evaluated by a physical therapist or other sports medicine professional is recommended.
If you already know what you’re dealing with, a Pickleball Injury Risk & Mobility Assessment can help identify weak links in your movement and create a plan to keep you playing strong and pain-free.
🎯 [Book Your Assessment Today]
Tendon pain doesn’t have to stop you from playing the game you love. Take action now, strengthen your body, and stay pain-free on the court.
