Accessible, social, and fun for all ages, Pickleball offers a fresh and engaging way to stay active, connect with others, and enjoy friendly competition with friends, family, and acquaintances alike. 

​​Originally ​invented in the US in 1965, Pickleball remained a niche sport for decades, and was mostly played by those over 60 years of age. However, this is changing fast. The sport is continuing to gain traction across the UK, particularly since the COVID-19 pandemic, where people turned to socially distanced activities to stay healthy and connected to their loved ones. 

Now, participation is booming across all age groups, with growing interest among younger generations, largely due to the efforts of the UK Pickleball Association and the surge in numbers of both indoor and outdoor courts. From coaching sessions and leagues to community events in London and throughout the UK, Pickleball is here to stay. 

However, while learning the basics is simple, staying fit enough to improve your game, prevent injuries, and play consistently takes more than just a paddle and a pair of trainers. 

At Pure Sports Medicine, we see a growing number of recreational athletes who have taken up the sport without preparing their bodies properly, and as a result, they’re more vulnerable to injury and fatigue. Whether you’re a total beginner wondering how to play Pickleball, or a regular player hoping to stay pain-free, this guide is your essential companion for playing stronger, safer, and smarter, so you can enjoy the game for many years to come. 

Pickleball is a fast-paced, easy-to-learn racket sport that combines the best elements of tennis, badminton, and table tennis, making it both familiar and refreshingly different. The Pickleball court size is roughly one-third that of a tennis court and with a lower net, with solid, lightweight paddles and a perforated plastic ball – while rallies are quick, it remains manageable for all skill levels. 

Reasons for Pickleball’s Popularity:

• Accessibility: Suitable for all ages and fitness levels, it’s a favourite among older adults, but is increasingly embraced by younger generations.
• Social Appeal: Join a game, meet new people, and take part in local events, leagues, or casual rallies.
• Low Barrier to Entry: The equipment is affordable, the rules are simple, and beginners can start having fun almost immediately.
• Fitness Benefits: Pickleball still delivers a solid cardiovascular workout, improves agility and coordination, and helps build balance and endurance.

Pickleball can be played indoors or outdoors in a singles or doubles format and can be highly competitive. The game is played on a 20×44 ft court (similar in size to a badminton court), and is split into right and left service areas, with a 7ft “no-volley zone” (also known as “the kitchen”) on either side of the net. 

The game starts with an underhand serve that must be made diagonally cross-court and land in the opponent’s ‘service area’. Your serve must clear the net and cannot land in the no volley zone. 

After the serve, each team must let the ball bounce on their side once before hitting it. This means both serve and return should bounce before volleys are allowed. Once the ball has bounced on each side, players can then hit the ball before it bounces, but not while standing inside the kitchen. Players can only enter the kitchen to play a ball that has bounced. 

When it comes to point scoring, only your serving team can score points. Games are typically played to 11 points, and a team must win by at least two points. However, in tournament play, games can go to 15 or 21. 

Key tip – for those in doubles, when the serving team wins a point, the server switches sides and continues serving. After both players have served and lost a point, service goes to the opposing ​team​.

While often compared to Padel, there are some major distinctions between the two sports. Padel is typically played in an enclosed glass court with a tennis-like ball and a rebound-focused strategy. Pickleball, in contrast, features shorter rallies, lighter equipment, and a different rhythm, one that’s easier on the body, but still demands agility, power, and quick reflexes. 

One of the great things about Pickleball is how little you need to get started!  

Here’s the basic kit: 

• Paddle: Made from lightweight materials like graphite, carbon fibre, or composite, they’re easy to handle and come in a variety of shapes and grip sizes. 
• Pickleball Ball: Indoor and outdoor balls differ slightly in weight, so keep this in mind. 
• Sports Shoes: A good pair of non-marking court or Pickleball shoes is key. Look for shoes that offer lateral support, grip, and cushioning to protect your joints and keep you moving confidently on court. 
• Breathable, comfortable sportswear. 
• Water bottle and towel: Games can get competitive, so stay hydrated! 
• Hat or visor (for outdoor play). 
• Paddle bag: Store your paddle, balls, and gear.

You can find everything you need to play, without breaking the bank. 

Despite its friendly reputation, Pickleball isn’t always as low impact as it seems, particularly for adults returning to sport after years away or those juggling busy work and family lives. While it offers excellent social and health benefits, the game’s quick pace and sharp, lateral movements can be physically demanding and potentially result in injury if players aren’t properly prepared. 

From quick starts and abrupt stops to lunges, overhead swings, and sudden directional changes, Pickleball can put significant strain on the knees, ankles, shoulders, and lower back. Many players underestimate the physicality of the sport until they start experiencing stiffness, soreness, or more serious injuries like ankle sprains, rotator cuff irritation, or tendon overuse. 

“As a Physio working with racket sport injuries, I often find weaknesses and imbalances when assessing lower body strength and capacity. It’s important to build a baseline level of strength to stay robust and meet the demands of your sport,” explains Henry Clarke, Physiotherapist at Pure Sports Medicine.  

“If you’re experiencing repeated aches or pains in the same area, that’s usually a sign the tissue isn’t coping. I’d recommend getting this checked by a professional so they can identify what’s driving it and put the right plan in place. Not only can this help prevent injury, but it can also improve your performance on court, allowing for more powerful movements, reaching more shots, recovering faster, and getting into position earlier for the next rally.” 

A study published in the Journal of Physical Activity and Health highlights that older adults may be particularly vulnerable, with injuries occurring both during matches and through aggravation of pre-existing conditions. And as Pickleball continues to attract former tennis players who are drawn in by its smaller courts and lower impact on joints, injury prevention becomes even more important. 

While proper footwear with strong lateral support and grip is essential, conditioning the body for Pickleball’s specific physical demands is equally critical. Without adequate strength, mobility, and balance training, the risk of injury rises sharply, particularly for those over 50. 

That said, it’s not all risk: research shows that regular Pickleball participation can significantly improve quality of life, with improved mental health and life satisfaction, an enhanced sense of community, alongside a combination of cognitive and physical stimulation. 

So, while Pickleball is both physically rewarding and physically demanding, with the right preparation, you can stay on court, stay healthy, and enjoy all the social and mental perks the sport has to offer. 

To ensure you are ready for the game it’s important to train, not just for strength, but for mobility, stability, endurance, and resilience. Dynamic flexibility is especially important, as reduced joint mobility in the hips, shoulders, and ankles can contribute to poor court movement and injury risk. At Pure Sports Medicine, we regularly perform mobility screenings to help players identify problem areas and resolve them before they cause breakdowns in performance. 

“Strength and mobility provide the basis for all athletic performance, and especially in Pickleball. It requires sufficient movement, competency and a solid foundation of robustness. Even as little as one strength session per week can have huge benefits to performance and injury risk,” affirms Tom Williams, Strength & Conditioning Coach at Pure Sports Medicine. 

Strength is a key pillar of longevity. The ability to produce adequate levels of force is crucial to successfully performing any task. In Pickleball, the short, powerful movements needed to return a shot or sprint to the net relies not only on strength, but also the ability to express force quickly and explosively. Integrating resistance-based training into your routine, with exercises such as squats and lungs, and explosive exercises like jumps, hops and bounds help build a solid athletic foundation that supports both performance and injury prevention.  

Equally vital is the ability to rapidly accelerate, decelerate, and change direction, all underpinned by high levels of balance and agility. Pickleball requires fast lateral shifts, forward darts, and frequent adjustments of the whole body. Exercises that target coordination and reaction speed, such as cone drills or side shuffles, can also help to build court confidence and reduce your risk of falls. At Pure Sports Medicine, our Strength & Conditioning coaches can create a bespoke plan to suit your needs, helping players stay fast on their feet while protecting their joints. 

Finally, stamina shouldn’t be overlooked. Even casual games can be long, especially in tournament settings or league play. Low-impact cardiovascular training like swimming, rowing, or cycling is great for building endurance.  A combination of shorter, higher intensity intervals as well as longer, slower cardiovascular exercise will increase your ability to play and reduce your likelihood of both fatigue and injury. 

Many overuse injuries stem not from the intensity of play, but from subtle issues in form and positioning throughout your game. Poor footwork, excessive gripping of the paddle, or reaching too far can gradually lead to joint stress or tendon pain. 

At Pure Sports Medicine, we often complete biomechanical assessments and Physiotherapy to analyse each player’s technique and body mechanics. A small adjustment in posture or stroke technique can significantly reduce strain on the shoulders or back. The earlier these patterns are identified, the easier it is to correct them and keep you playing well on the court. 

“By identifying areas of weakness through a biomechanical assessment, we can create tailored exercises to target those specific needs. Adjusting technique can also help to reduce pain while building muscle capacity to better cope with the overall demands of the sport”, adds Henry. 

Recovery often takes a back seat, especially for players who treat Pickleball as a weekend activity rather than a serious sport. From hydration, sleep, active stretching, and perhaps most importantly, knowing when to rest, recovery remains essential to your long-term health. 

If something feels wrong, listen to your body. The earlier you seek professional help, the faster we can intervene and prevent further complications. 

Our multidisciplinary team offers Soft Tissue Therapy, ​​Shockwave Therapy, and Pilates to help support tissue recovery, improve mobility, and promote long-term joint health. We also offer access to Consultant Sports & Exercise Medicine specialists and diagnostic imaging if pain or stiffness persists after matches. 

Pickleball is here to stay, and whether you’re playing socially or competitively, your body deserves the highest levels of care. Investing in strength, mobility, technique, and recovery will not only improve your performance but also allow you to enjoy the sport for longer, without pain. 

With more courts opening across the UK, there’s never been a better time to take your game seriously. At Pure Sports Medicine, our multidisciplinary team is ready to help you improve, prevent injury, and recover faster. 

If you’re ready to level up your performance, book a consultation with one of our specialists. Whether it’s a tailored rehabilitation plan, a strength program, or support for a nagging injury, we’re here to help provide elite care for all individuals who walk through our doors.