The #1 Pickleball Injury, and Why It Keeps Coming Back

Ankle sprains are one of the most common injuries in pickleball. The sport is full of quick side-to-side movement, and all it takes is one awkward step, a slippery spot, or a foot landing on the line to roll the ankle.

Most sprains recover well. The problem is that many players return too early or never fully rehab, and end up with an ankle that keeps giving out. Understanding what to do in the first days, and what to do in the weeks that follow, is what separates a one-time sprain from a recurring one.

Why pickleball ankles roll

The court demands a lot of lateral movement, and that is exactly where the ankle is most vulnerable:

• Fast side steps and shuffles near the net
• Sudden changes of direction to chase a shot
• Stepping on a ball, a line, or an uneven surface
• Reaching wide and landing on the edge of the foot
• Fatigue late in a session, when control slips

The most common type is a lateral ankle sprain, where the ligaments on the outside of the ankle get overstretched or torn as the foot rolls inward.

How bad is it?

Sprains range from mild to significant:

• Mild: some stretching of the ligament, minor swelling, still able to walk
• Moderate: partial tearing, more swelling and bruising, painful to weight bear
• Severe: a full ligament tear, major swelling, and real difficulty putting weight on it

Signs that deserve a prompt assessment include severe swelling, inability to walk more than a few steps, numbness, bony tenderness, or an ankle that looks out of shape. These can point to a more serious ligament injury or a fracture.

The first 48 hours

Early care sets up a smoother recovery:

• Stop playing straight away
• Rest, ice, and elevate the ankle
• Use gentle compression to manage swelling
• Keep some pain-free movement rather than fully immobilizing it
• Avoid heat, alcohol, and hard massage in the early stage

Gentle, protected movement early on tends to recover better than complete rest. Getting the ankle moving within comfortable limits helps reduce stiffness and swelling.

Why rehab matters more than you think

Here is the part many players miss. Once the pain settles, the ankle can feel fine walking in a straight line but still be unstable during quick pivots. That leftover weakness is why sprains so often turn into repeat sprains.

After a sprain, the ankle loses some of its balance and position sense, the feedback system that tells your body where the joint is and reacts when it starts to roll. Without retraining, that gap stays, and the next awkward step is more likely to become another sprain.

How physiotherapy helps

A physiotherapist can guide the full recovery, not just the sore first week:

• Assess the severity and rule out a fracture where needed
• Settle pain and swelling
• Restore full ankle movement and strength
• Rebuild balance and control with targeted exercises
• Retrain cutting, pivoting, and quick side steps for the court
• Guide a safe, staged return to play

The balance and control work is what protects you against the next sprain, and it is usually the piece people skip when they rehab on their own.

Returning to the court safely

Before going back to full play, you generally want to be able to walk and jog without pain, hop and land on the ankle with control, and change direction confidently. Coming back before that point is the classic setup for a repeat roll.

Avoiding chronic ankle instability

If sprains keep happening, you may be dealing with chronic ankle instability, where the ankle repeatedly gives way. To lower your risk:

• Fully rehab every sprain, even the mild ones
• Keep your ankles and calves strong
• Add simple balance work to your week
• Wear supportive court shoes in good condition
• Consider bracing or taping if you have sprained it before

A rolled ankle is common in pickleball, but a properly rehabbed one is far less likely to become a recurring problem.

Should you brace or tape?

Bracing or taping can be useful, especially if you have sprained the same ankle before. It adds support and can give you confidence while the ankle rebuilds its strength and control. It works best as part of a plan rather than a permanent crutch. The long-term goal is an ankle strong and well controlled enough that it does not rely on a brace, though many players choose to keep taping for higher-intensity sessions.

Myths worth clearing up

• "If I can walk on it, it is not sprained." Many moderate sprains still let you walk. Walking is not proof it is minor.
• "Rest is all it needs." Rest settles the pain, but it does not rebuild the balance and strength that prevent the next sprain.
• "Once it stops hurting, it is healed." Pain settles well before full stability returns, which is exactly why re-sprains are so common.

Clearing up these misunderstandings is often the difference between one sprain and a pattern of them.

Our team at Vaughan Physiotherapy Clinic helps pickleball players across Vaughan and Thornhill recover from ankle sprains and build the stability to stay on court.