Pickleball is one of the fastest-growing sports, especially among adults 35+. It’s easy to see why: the game is social, engaging, and provides a great workout. But as fun as it can be, it also comes with its fair share of shoulder injuries, especially for players who haven’t yet developed the necessary movement control.

The quick overhead motions, fast serves, and frequent pivots place a lot of strain on the shoulder. And here’s the thing: your shoulder isn’t just a single muscle. In fact, 17 muscles attach to your shoulder blade, all working together to allow for efficient movement. This complexity is what makes the shoulder both powerful and vulnerable.

Every time you make a move, these muscles need to work in perfect synchrony, firing in the right sequence at the right time. If one or more of these muscles aren’t doing their part, other muscles have to pick up the slack—and that’s when pain begins to show up.

Understanding the Root Cause of Shoulder Pain

While temporary treatments may offer some relief, understanding the true cause of shoulder pain goes beyond just the muscles involved. The real issue often lies in how your body moves and how the muscles of your trunk, shoulder, and upper body work together. If movement patterns are off or the wrong muscles are firing at the wrong times, your shoulder can become overloaded and painful.

Traditional treatments like icing, stretching, or dry needling may offer temporary relief, but they don’t address the underlying issue—inefficient movement patterns. Without correcting how your muscles are coordinated, the pain is likely to return.

The Most Common Shoulder Injuries in Pickleball (and What They’re Really Telling You)

Shoulder injuries in pickleball aren’t just the result of bad luck—they often point to deeper issues in how your body moves. Let’s take a closer look at some of the most common shoulder injuries in the sport:

1. Rotator Cuff Tendinopathy

This is a classic case of the shoulder doing more work than it should. Often, other muscles aren’t “online” (i.e., properly activated) when they should be, and the rotator cuff takes on the extra load. This constant overuse leads to inflammation, pain, and potentially long-term damage.

2. Shoulder Impingement

If you’ve felt a pinching or catching sensation when raising your arm, this is likely shoulder impingement. While it might seem like a structural issue, impingement is often caused by poor coordination of muscle activation, especially during overhead motions.

3. Labral Issues or Instability

Your shoulder joint depends on proper stability to function effectively. If your brain doesn’t trust the stability of your shoulder (due to poor neuromuscular control), it might restrict movement, creating a cycle of stiffness and vulnerability. This protective response can lead to labral tears or chronic instability.

4. Postural Dysfunction

Posture is more than just “how you sit.” It’s how your body positions itself during all movements, including on the pickleball court. If your movement map is “off” (i.e., faulty movement patterns are ingrained), this can lead to postural dysfunction. Over time, this misalignment stresses the shoulder and leads to injury.

The common thread? These injuries often point to a deeper root issue in your movement software, not just your shoulder hardware. Treating them effectively requires addressing these faulty movement patterns and reprogramming how your body moves.

How to Rebuild Shoulder Function for Long-Term Relief and Performance

Medications and injections will do nothing if we don’t explore why your symptoms came about in the first place.  Here’s an overview of the key elements that contribute to a successful shoulder recovery process:

1. Brain-Based Movement Assessment

Rather than just focusing on the shoulder itself, start with a full movement assessment to understand how your brain and body are working together. A thorough evaluation will uncover patterns of dysfunction, so we can retrain the body to move better.

2. Core and Shoulder Integration

Your shoulder doesn’t move in isolation. It needs to work in unison with your core, so it’s essential to reestablish that connection. When your core and shoulder move together as a unit, the shoulder joint is more stable, reducing risk of injury.

3. Scapular Stabilization and Thoracic Mobility

Proper shoulder function starts with the scapula (shoulder blade) and the thoracic spine (upper back). If these areas aren’t moving correctly, the shoulder joint won’t have a solid foundation, making it more vulnerable. Exercises that focus on scapular stabilization and thoracic mobility are key.

4. Reflexive Motor Control Drills

Training the brain to fire muscles in the right sequence is essential for long-term recovery. Reflexive motor control drills help retrain your nervous system to send the right signals to your shoulder muscles during dynamic movements.

5. Progressive Loading and Coordination

Pickleball requires quick pivots, rapid overhead motions, and a lot of endurance. We use progressive loading and coordination drills to help your system learn how to respond to these demands safely. The more efficient and controlled your body is, the more you can push your limits without pain.

This approach doesn’t just relieve pain—it optimizes performance, helping you stay in the game longer, with fewer injuries along the way.

When to Get Help for Pickleball Shoulder Pain

If shoulder pain is affecting your game, your sleep, or hasn’t improved in a week or two, it’s time to seek help. The longer you wait, the more ingrained those faulty movement patterns become. And that makes recovery more difficult.

At DPT, we believe that the sooner you retrain your movement patterns, the easier it is to break the cycle of pain and compensation. Don’t wait for things to get worse—addressing these issues early leads to better outcomes and a quicker return to full function.

Final Thoughts: You Don’t Have to Choose Between Playing and Healing

Shoulder pain doesn’t mean you have to give up the sport you love. In fact, with the right approach, you can strengthen your shoulder, restore function, and get back on the court stronger than before.

Don’t settle for temporary fixes—learn how to retrain your body and address the root cause of your pain. When your brain and body are in sync, you’ll play with more confidence, more power, and less risk of injury.

Ready to make lasting changes? Give us a call today to schedule your consultation and give your body the chance it deserves.