Medically reviewed by Dr. Tom Biernacki, DPM — Board-Certified Podiatric Surgeon — Balance Foot & Ankle, Howell & Bloomfield Hills, MI. Last updated April 2026.

Quick Answer

Pickleball is now America’s fastest-growing sport, and with that growth comes a surge in foot and ankle injuries. The rapid lateral movements, sudden stops, and repetitive pivoting on hard court surfaces cause ankle sprains, plantar fasciitis, Achilles tendinopathy, and stress fractures. Dr. Tom Biernacki at Balance Foot & Ankle treats pickleball injuries and helps players stay on the court safely.

Why Pickleball Is Hard on Your Feet

Pickleball combines elements of tennis, badminton, and table tennis on a smaller court, creating a sport that demands rapid multidirectional movement, quick reactions, and explosive lateral shuffling. These biomechanical demands place tremendous stress on the feet and ankles, particularly in players over 50 who make up the majority of the pickleball community.

The hard court surface—whether concrete, asphalt, or indoor gym floor—provides no shock absorption, transmitting full impact forces directly through the feet with every step. Unlike running where forces are primarily linear, pickleball involves constant direction changes that load the foot laterally, stressing the ankle ligaments and peroneal tendons.

Many pickleball players come from relatively sedentary backgrounds or other sports that did not prepare their feet and ankles for the specific demands of court sports. This mismatch between tissue readiness and activity demands explains why foot and ankle injuries are so common in recreational pickleball players.

Ankle Sprains: The Most Common Pickleball Foot Injury

Lateral ankle sprains account for approximately 20-25% of all pickleball injuries, occurring when the foot rolls inward during rapid lateral movement or when stepping on a ball during play. The anterior talofibular ligament is most commonly injured, ranging from mild stretching to complete rupture.

Preventing ankle sprains requires a combination of proper footwear with lateral support, pre-game ankle warm-up and strengthening, and awareness of court surface conditions. Players with a history of ankle sprains should consider prophylactic ankle bracing, which reduces re-sprain risk by approximately 50%.

If an ankle sprain occurs, follow the PEACE and LOVE protocol: Protect, Elevate, Avoid anti-inflammatories initially, Compress, Educate for the first 48-72 hours; then Load optimally, Optimism, Vascularization through gentle movement, and Exercise to restore strength and balance. See a podiatrist if swelling persists beyond 1 week or if you cannot bear weight.

Plantar Fasciitis in Pickleball Players

Plantar fasciitis develops in pickleball players from the repetitive impact of running and jumping on hard surfaces combined with the toe-off forces during lateral movements. Players who increase their playing frequency rapidly—a common pattern in the addictive sport—overwhelm the plantar fascia’s ability to adapt to the new loading demands.

Prevention strategies include gradual increase in playing frequency and duration, wearing court shoes with adequate arch support and heel cushioning, performing daily calf and plantar fascia stretches, and using supportive insoles. Avoid playing in running shoes, cross-trainers, or casual sneakers that lack lateral stability.

Treatment for pickleball-related plantar fasciitis follows the same principles as general plantar fasciitis: supportive footwear, stretching, ice after playing, over-the-counter arch supports or custom orthotics, and activity modification. Most players can continue playing at reduced frequency while managing symptoms, rather than stopping entirely.

Achilles Tendon Problems in Pickleball

Achilles tendinopathy and acute Achilles tendon rupture are serious concerns in pickleball, particularly in male players over 40. The explosive push-off during serves and overhead shots, combined with the repetitive loading of court movement, stresses the Achilles tendon beyond its capacity, especially in tendons that have begun age-related degeneration.

Achilles tendon rupture in pickleball typically occurs during a sudden explosive movement—lunging for a drop shot, sprinting to the net, or pushing off for an overhead. Players describe a sensation of being kicked or hit in the back of the ankle, followed by inability to push off the affected foot. This is a medical emergency requiring same-day evaluation.

Prevention includes regular calf stretching and eccentric strengthening exercises, adequate warm-up before play, avoiding playing when the Achilles tendon is sore, and wearing shoes with a slight heel elevation that reduces tendon strain. Players who notice progressive Achilles stiffness or pain should see a podiatrist before the tendon reaches the breaking point.

Choosing the Right Court Shoes for Pickleball

Proper court shoes are the single most important equipment investment for pickleball foot health. Court shoes differ from running shoes in critical ways: they provide lateral stability for side-to-side movement, have non-marking outsoles with herringbone or modified herringbone tread patterns for court traction, and feature reinforced toe caps for toe drag during serves.

Key features to look for include a firm heel counter that prevents excessive rearfoot motion, a slightly wider base for lateral stability, adequate forefoot cushioning for impact absorption, and a toe box wide enough to accommodate natural toe spread during pushing off. Avoid shoes that feel excessively cushioned—too much cushion reduces court feel and stability.

Replace pickleball shoes every 60-80 hours of court time or when the outsole tread pattern shows significant wear. Worn shoes lose both traction and lateral stability, dramatically increasing injury risk. If you play 3-4 times per week, plan to replace shoes every 4-6 months.

Pre-Game Warm-Up and Conditioning for Foot Health

A 10-minute pre-game warm-up reduces pickleball foot and ankle injury risk by 40-60%. Start with 3-5 minutes of light jogging or brisk walking to increase blood flow, followed by dynamic stretches: ankle circles, calf raises, lateral shuffles, and gentle lunges that prepare the feet and ankles for multidirectional movement.

Foot and ankle conditioning exercises performed 2-3 times per week build the strength and stability needed for safe pickleball play. Key exercises include single-leg balance holds progressing to balance on unstable surfaces, lateral band walks, calf raises both straight-leg and bent-knee, and towel scrunches for intrinsic foot strength.

Cool-down stretching after play is equally important. Perform static calf stretches, plantar fascia stretches, and gentle ankle range of motion exercises for 5-7 minutes after every session. This reduces post-play stiffness and helps prevent the gradual tightening that leads to overuse injuries over weeks of regular play.

⚠️ Red Flags: When to See a Podiatrist Immediately

• Ankle that swells significantly or cannot bear weight after a court injury
• Progressive heel or arch pain that worsens with each pickleball session
• Sudden sharp pain in the back of the ankle with a popping sensation
• Foot pain that persists for more than 2 weeks despite rest from playing

The Most Common Mistake

The most common mistake pickleball players make is wearing running shoes on the court. Running shoes are designed for forward motion with cushioned, curved soles that are inherently unstable for lateral movement. Playing pickleball in running shoes dramatically increases ankle sprain risk and reduces court performance. Invest in proper court shoes—your feet and ankles will thank you.

Products We Recommend

As part of the Foundation Wellness family, Balance Foot & Ankle recommends these evidence-based products:

PowerStep Pinnacle Insoles

Best for: Provide arch support and heel cushioning inside court shoes to prevent plantar fasciitis during pickleball play

Not ideal for: Not a substitute for proper court shoes—insoles enhance good shoes but cannot fix bad ones

CURREX SupportSTP Insoles

Best for: Dynamic sport-specific arch support designed for multidirectional court sports including pickleball

Not ideal for: May alter the fit of already-tight court shoes; ensure adequate shoe volume

Doctor Hoy’s Natural Pain Relief Gel

Best for: Post-game topical relief for heel pain, Achilles soreness, and ankle discomfort after pickleball

Not ideal for: Not a treatment for acute ankle sprains—see a podiatrist for proper evaluation

Your Next Step: Expert Treatment

If you are experiencing symptoms discussed in this guide, the specialists at Balance Foot & Ankle can help. View our full range of treatments or book your appointment today.

Frequently Asked Questions

What are the best shoes for pickleball?

Dedicated court shoes from brands like ASICS, New Balance, or K-Swiss provide the lateral stability, court traction, and toe protection needed for pickleball. Look for shoes specifically labeled as court shoes or tennis shoes rather than running or cross-training shoes.

Should I wear an ankle brace for pickleball?

If you have a history of ankle sprains, a lace-up ankle brace reduces re-injury risk by approximately 50% and is recommended during play. Players without prior sprains benefit more from ankle strengthening exercises than prophylactic bracing.

How do I prevent blisters from pickleball?

Moisture-wicking socks, properly fitted court shoes, and blister-prevention products like moleskin or body glide on friction areas prevent most blisters. Break in new shoes gradually rather than wearing them for a full match immediately.

Is pickleball safe for people with arthritis in their feet?

Many patients with mild to moderate foot arthritis enjoy pickleball with proper footwear, custom orthotics, and activity modification. Avoid playing through pain, warm up thoroughly, and discuss your specific limitations with your podiatrist.

The Bottom Line

Pickleball is an excellent sport for fitness and social connection, but protecting your feet and ankles requires proper court shoes, conditioning, warm-up, and attention to early warning signs. A small investment in foot health keeps you on the court for years to come.

Sources

1. Greiner N. Pickleball-related injuries treated in US emergency departments. Inj Epidemiol. 2024;11(1):18.
2. Forrester MB. Pickleball-related injuries in the United States. J Emerg Med. 2024;66(5):e523-e530.
3. Caswell SV, et al. Epidemiology of pickleball injuries. Am J Sports Med. 2024;52(11):2876-2884.
4. Menz HB, et al. Court sport footwear and injury prevention. Br J Sports Med. 2025;59(2):134-142.

Play Pickleball Without Foot Pain

Call Balance Foot & Ankle at (810) 206-1402 or schedule online to see Dr. Tom Biernacki and our team of podiatric specialists. Serving Howell, Bloomfield Hills, Brighton, Hartland, Milford, Highland, Fenton, and communities across Southeast Michigan.

Pickleball Injury Prevention & Treatment

Pickleball’s explosive lateral moves put feet and ankles at risk. Our sports podiatrists at Balance Foot & Ankle help pickleball players stay on the court with injury prevention and treatment in Howell and Bloomfield Hills.

Learn About Our Sports Injury Treatment | Book Your Appointment | Call (810) 206-1402

Clinical References

1. Forrester MB. “Pickleball-related injuries treated in emergency departments.” J Emerg Med. 2020;58(2):275-279.
2. Hsu WK, et al. “The rising incidence of pickleball injuries in the United States.” Injury. 2022;53(10):3437-3441.
3. Greiner N. “Pickleball: injury considerations in an increasingly popular sport.” Mo Med. 2019;116(6):488-491.

Your Board-Certified Podiatrists

Dr. Tom Biernacki, DPM

Board-Certified · FACFAS

Dr. Carl Jay, DPM

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Dr. Daria Gutkin, DPM

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Dr. Tom Biernacki, DPM

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Dr. Tom Biernacki, DPM is a double board-certified podiatrist and foot & ankle surgeon at Balance Foot & Ankle Specialists in Southeast Michigan. With over a decade of clinical experience, he specializes in heel pain, bunions, diabetic foot care, sports injuries, and minimally invasive surgery. Dr. Biernacki is a member of the APMA and ACFAS, and his patient education content on MichiganFootDoctors.com and YouTube has reached over one million views.