The Foundation of Better Pickleball: How Proper Footwork and Balance Keep You in the Game

Picture this: You’re at the kitchen line, locked in an intense dinking rally. Your opponent sends a sharp angle to your left. You lunge for it, make contact, but your ankle rolls as you land awkwardly. The sharp pain tells you immediately: Your pickleball session is over, and possibly your next few weeks on the court too.

Sound familiar? This is a common story for many players.

The reality is that pickleball-related emergency department visits jumped from around 1,300 in 2014 to more than 24,000 in 2023 (Forrester, 2024). Ninety percent of these injuries affect people aged 50 and older, with about half being sprains or fractures (Forrester, 2024).

Most players don’t realize that the biggest factor in these injuries isn’t bad luck or aggressive play. It’s weak footwork and poor balance. While everyone focuses on perfecting their serve or mastering the dink, they’re ignoring the foundation that keeps them safe and competitive on the court.

And the good news is you can dramatically reduce your injury risk and play better pickleball at the same time. This article will show you exactly how proper footwork and balance training protect your body, improve your performance, and keep you playing the sport you love for years to come. By the end, you’ll know the warning signs to watch for and when it’s time to get professional help.

Why Pickleball Players Keep Getting Hurt

Pickleball might look easy, but your body disagrees.

The sport demands quick stops, sharp turns, and explosive movements all while you’re focused on a small ball flying at your face. Your brain is thinking about shot placement, but your feet? They’re scrambling to keep up.

The Most Common Pickleball Injuries (And Why They Happen)

The most common injury among pickleball players is a sprained ankle (Forrester, 2024), usually happening during those quick side-to-side movements. Right behind that? Fractures, knee problems, and falls.

But here’s what’s really happening beneath these injuries:

Your feet aren’t in the right place. When you lunge for a ball instead of moving your feet, you’re putting your joints in vulnerable positions. Your ankle rolls. Your knee twists. Your back compensates.

You’re off-balance when you make contact. Ever feel yourself tipping forward during a shot? That instability means you’re not generating power efficiently AND you’re one stumble away from hitting the ground.

You get tired and your form falls apart. Maybe your footwork is decent in the first game. But by game three, you’re flat-footed and reaching because your legs are tired. That’s when injuries happen.

Who’s at Greatest Risk?

The numbers tell a clear story. Eighty-seven percent of all pickleball-related injury incidents that required an emergency room visit happened to participants older than 50 (Casper et al., 2024).

If you’re over 50, you’re not alone and you’re not imagining things. Your balance naturally declines with age. Your reaction time slows down. Your muscles don’t fire as quickly as they used to.

But here’s what matters: these aren’t reasons to stop playing. They’re reasons to train smarter.

You’re also at higher risk if you:

• Played other racquet sports (tennis players especially struggle with pickleball’s different movement patterns)
• Jump into games without warming up
• Play multiple times a week without any conditioning
• Have had previous ankle, knee, or hip injuries

How Balance and Footwork Actually Make You Better at Pickleball

Let’s flip the script. Forget injuries for a minute. Want to know the real secret to beating players who have better shots than you?

Better footwork and balance.

You’ll Cover More Court (Without Getting Exhausted)

Good footwork means you’re moving efficiently. You’re not taking three small steps when two bigger ones would do. You’re not lunging and recovering, you’re positioned and ready.

Players with solid footwork reach balls that others can’t. And they do it while using less energy, which means they’re still fresh in the third game when everyone else is dragging.

Your Shots Get More Consistent

Shot quality starts with your feet.

When you’re balanced and positioned correctly, your paddle naturally finds the sweet spot. Your dinks land softer. Your drives have more power. Your volleys feel automatic.

When you’re off-balance? Every shot becomes a struggle. You’re fighting your body position instead of focusing on the ball.

You Can Play More Aggressively (Safely)

Good balance gives you confidence. You can charge the net knowing your feet will get you there. You can take bigger swings because you trust your foundation.

A patient of mine (we’ll call her Nancy) experienced this firsthand. After a doctor told her to “never play pickleball again,” she worked with me. Here’s what she said after a few sessions:

“He had me bring my paddle to our sessions, fed me cloth stuffed balls, having me stand on a foam pad, varying my movements from side to side and having me hit the balls into a bucket. Wow! That certainly lifted my spirits. I’m taking my pickleball return to the courts slowly, but I WILL get there, thanks to Dustin’s encouragement.”

Nancy’s story shows what proper balance training can do. Not just for injury recovery, but for building the foundation to play with confidence.

The Science Behind Balance and Footwork (Made Simple)

You don’t need a degree in exercise science to understand this, but knowing the basics helps you train smarter.

Your Body Works Like a Chain

When you hit a pickleball, the power doesn’t start in your arm. It starts in your feet. The force travels up through your legs, into your core, through your shoulder, and finally to your paddle.

This is called the kinetic chain (Kibler et al., 2006). When one link is weak or out of position, the whole chain breaks down. That’s why players with poor footwork often develop shoulder problems; they’re compensating with their arm for what their feet should be doing.

Balance Changes as You Age

After age 40, your balance naturally declines. Your inner ear (which helps you stay upright) doesn’t work as well. Your muscles don’t react as quickly. Your joints become less flexible (Maki & McIlroy, 1996).

This isn’t a death sentence for your pickleball game. It just means you need to actively work on balance instead of taking it for granted.

The good news? Balance exercises work. Studies show that targeted training can improve balance at any age (Sherrington et al., 2019), which directly translates to better performance and fewer injuries in pickleball training for seniors.

Pickleball Demands Specific Movement Skills

Unlike jogging or biking, pickleball requires:

• Multi-directional movement (forward, backward, side-to-side)
• Quick starts and stops (accelerating to the ball, then recovering)
• Balance during contact (staying stable while you swing)

If you’re only walking or going to the gym, you’re not training these specific skills. That’s why dedicated pickleball footwork training and balance exercises for pickleball matter.

Essential Footwork Patterns You Need to Master

Let’s get practical. These are the movement patterns you use in every single rally. Master them, and you’ll see immediate improvement in your game.

The Split Step (Your Most Important Move)

The split step is a small hop you do right before your opponent hits the ball. It loads your legs like springs and gets you ready to move in any direction.

How to do it: As your opponent’s paddle approaches the ball, do a small hop where both feet leave the ground slightly. Land on the balls of your feet with your knees bent and weight forward.

Common mistakes: Hopping too late (after they’ve hit), landing flat-footed, or standing up tall instead of staying low.

Most injuries happen when players are caught flat-footed and have to lunge awkwardly. The split step prevents this.

Lateral Shuffle (Moving Side-to-Side)

When the ball goes to your left or right, you should shuffle—not run or cross your feet.

How to do it: Push off with your outside foot and slide the inside foot to meet it. Keep your knees bent and your weight on the balls of your feet. Your feet should never touch or cross.

Why it matters: Shuffling keeps you balanced and ready to react. Crossing your feet puts you off-balance and vulnerable to ankle rolls.

Forward and Backward Movement

Moving to and from the kitchen line is where a lot of players struggle.

Forward: Push off your back foot and take controlled steps. Don’t lean forward—your weight should stay centered over your feet.

Backward: This is the tricky one. You need to backpedal while watching the ball. Take small, quick steps and keep your knees bent. Never turn your back to the ball.

Pivot and Recovery

After each shot, you need to return to a ready position quickly.

How to do it: After hitting, pivot on your inside foot to face the center of the court. Use small, quick steps to recover instead of one big lunge.

This is where conditioning matters. In the first game, everyone recovers. By the third game, tired players stay out of position… and that’s when injuries happen.

Why Balance Training Prevents Injuries

Balance isn’t just about not falling over. It’s about your body knowing where it is in space and reacting automatically to keep you stable.

What Weakens Your Balance

Several factors chip away at your balance:

Sitting all day. If you work at a desk, your core muscles and stabilizers aren’t getting used. Then you show up to pickleball and expect them to work perfectly.

Previous injuries. Ever sprain your ankle? Even after it heals, your balance on that side is often permanently affected… unless you specifically retrain it (McKeon & Hertel, 2008).

Age-related decline. Your inner ear, vision, and muscle reaction time all naturally decline. This isn’t your fault, but it is up to you to put in the necessary training to correct it.

Warning Signs Your Balance Needs Work

Pay attention to these red flags:

• Feeling wobbly or unstable during play or when managing uneven surfaces or steps/curbs
• Favoring one leg over the other
• Difficulty with quick stops
• Near-falls or actual falls on court or off
• Ankle soreness after playing
• Knee pain during turns and pivots

If any of these sound familiar, you have a balance issue that’s affecting your play—and putting you at risk for pickleball ankle injuries.

The Three Types of Balance for Pickleball

Static balance: Can you stand on one leg for 30 seconds? If not, you have work to do.

Dynamic balance: Can you maintain stability while moving? This is what you use during every rally.

Reactive balance: Can you right yourself when you’re off-balance, without having to grab onto something? This determines whether an awkward step becomes an injury or just a stumble.

All three types of balance matter for pickleball injury prevention (Horak, 2006).

Test Your Own Footwork and Balance

Before you can improve, you need to know where you stand (pun intended). Try these simple tests at home.

Balance Tests You Can Do Right Now

Single-leg stance: Stand on one leg with your eyes open. Can you hold it for 30 seconds without wobbling or putting your other foot down? Now try with your eyes closed. Most people find this much harder.

If you can’t do 30 seconds with your eyes open, your balance needs serious work. If you can’t do 10 seconds with eyes closed, you’re at high risk for falls (Springer et al., 2007).

Tandem stance: Stand with one foot directly in front of the other (heel to toe) like you’re on a tightrope. Hold for 30 seconds. This tests your side-to-side balance.

On-Court Warning Signs

When you’re playing, watch for:

• Landing off-balance after shots (you stumble or have to take extra steps to recover)
• Reaching with your paddle instead of moving your feet
• Feet stuck to the ground during your opponent’s shot (no split step)
• Crossing your feet when you should shuffle
• Getting slower and sloppier as the game goes on

If you’re noticing these patterns, your footwork and balance are limiting your game and likely setting you up for injury.

Pain Patterns That Signal Problems

Certain types of pain are red flags:

Ankle instability: Does your ankle feel weak or give out occasionally? This means the ligaments are stretched and your balance system isn’t working right.

Knee pain during pivots: This suggests weak hip muscles that aren’t stabilizing your knee properly.

Lower back tightness after playing: Often caused by poor core stability and compensating with your back.

Hip soreness from overreaching: You’re lunging instead of moving your feet, putting excessive strain on your hip flexors.

Don’t ignore these. They won’t get better on their own.

When Self-Training Isn’t Enough (And Why Physical Therapy Makes the Difference)

Here’s the truth: watching YouTube videos and doing some balance exercises at home is better than nothing. But it has serious limitations.

Signs You Need Expert Help

You should consider working with a physical therapist for pickleball players if:

• You have persistent pain during or after playing (anything that lasts more than a few days)
• You’ve had recurring injuries (same ankle keeps rolling, same knee keeps hurting)
• You failed the balance tests significantly
• You’re over 50 and new to pickleball
• You’re returning after an injury or surgery
• You want to prevent problems before they start (smart players do this)

What Physical Therapy Actually Offers

A good physical therapist doesn’t just give you exercises. Here’s what you get:

Movement assessment: They watch how you actually move. Most people have no idea their left foot turns in or their right hip drops… but these patterns directly cause injuries.

Your specific weaknesses: Generic exercises help everyone a little. Targeted exercises fix YOUR problems. Maybe your hip strength is fine but your ankle stability is terrible. A PT identifies this.

Sport-specific training: Regular physical therapy is good. Physical therapy from someone who understands pickleball is better. They can analyze your footwork, watch you hit, and design exercises that directly improve your game.

Progression and adjustment: Exercises that help at week one might be too easy by week four. A PT adjusts your program as you improve.

Accountability: Most people don’t consistently do home exercises without guidance. Regular PT appointments keep you on track.

The MovementX Approach to Pickleball Performance

At MovementX, physical therapists (like me) specialize in helping pickleball players not just recover from injuries, but improve their game through better movement. The mobile, concierge-style service provided by MovementX Physical Therapists means you’re not limited to training in a PT clinic. Your training can meet you where you need it: on the court, at a fitness center, or in your home.

Remember Nancy’s story? She was told her pickleball days were done, but with the guidance of a Doctor of Physical Therapy, pickleball-specific training focused on the exact movements and balance training she’d need on court.

That’s the difference between generic physical therapy and sport-specific treatment.

What to Expect in Your First Appointment

When you see a physical therapist for pickleball issues, here’s what typically happens:

1. Detailed assessment: They’ll ask about your pain, your playing habits, and your goals. They’ll watch you move, test your balance, and identify specific weaknesses.
2. Video analysis (if needed): Some PTs will have you demonstrate your footwork or even review video of you playing to spot problems you can’t feel.
3. Customized plan: Based on what they find, they’ll create a program specifically for you. Not generic exercises—YOUR exercises.
4. Hands-on treatment: If you have tight muscles or joint restrictions, they’ll address these with manual therapy.
5. Home program: You’ll get exercises to do between sessions to maximize your improvement.

Benefits Beyond Injury Prevention

Working with a physical therapist improves pickleball performance in ways you might not expect:

• Faster improvement: When your movement foundation is solid, you learn new skills more quickly
• More confident play: When you trust your body, you play more aggressively (in a good way)
• Longer playing career: The goal isn’t just to play now—it’s to keep playing for decades
• Better recovery between sessions: Good movement patterns reduce overall body stress
• Understanding your body: You’ll learn what your body needs to perform well

Take Control of Your Pickleball Future

You’ve got a choice to make.

You can keep playing the way you are, hoping you don’t become another injury statistic. You can watch YouTube videos and try some exercises when you remember.

Or you can invest in your movement foundation and actually do something about it.

Your Next Steps

Right now:

• Try the balance tests from earlier in this article
• Pay attention to your footwork patterns next time you play
• Notice any of the warning signs we discussed

This week:

• Film yourself playing (even just on your phone) and watch your footwork
• Start incorporating basic balance work into your routine
• Be honest about whether you’re experiencing any of the pain patterns mentioned

Soon: Schedule an evaluation with a physical therapist who understands pickleball. Not next month. Not “when it gets worse.” Now—before a preventable injury takes you off the court for weeks or months.

Don’t Wait for an Injury to Force Your Hand

Pickleball injuries generated more than $350 million in medical costs in 2023 (UBS, 2024). Those aren’t just numbers. They represent thousands of players who had to stop doing something they love because they didn’t take prevention seriously.

Nancy Brown’s doctor told her to never play again. But she didn’t accept that. She found the right help and did the work. Now she’s getting back on the court.

You don’t have to wait until you’re injured to get help. In fact, the smartest players work on their footwork and balance before problems develop.

Ready to Build Your Foundation?

I specialize in helping pickleball players move better, play better, and stay injury-free. Whether you’re dealing with an existing injury or want to prevent one, he can help.

Schedule your evaluation with me (Dr. Dustin Burns, DPT) today

Don’t let poor footwork and weak balance keep you from playing the pickleball you’re capable of. Your future self (still playing pain-free years from now) will thank you.

References

1. Casper, M., Pierpoint, L., Sheffield, J., Comstock, R. D., & Currie, D. W. (2024). Epidemiology of pickleball-related injuries presenting to emergency departments in the United States, 2007-2022. Injury Epidemiology, 11(1), Article 17. https://doi.org/10.1186/s40621-024-00494-4
2. Forrester, J. D. (2024). The rise of pickleball-related injuries in the United States. Surgery, 175(3), 777-778. https://doi.org/10.1016/j.surg.2023.10.025
3. Horak, F. B. (2006). Postural orientation and equilibrium: What do we need to know about neural control of balance to prevent falls? Age and Ageing, 35(Suppl. 2), ii7-ii11. https://doi.org/10.1093/ageing/afl077
4. Kibler, W. B., Press, J., & Sciascia, A. (2006). The role of core stability in athletic function. Sports Medicine, 36(3), 189-198. https://doi.org/10.2165/00007256-200636030-00001
5. Maki, B. E., & McIlroy, W. E. (1996). Postural control in the older adult. Clinics in Geriatric Medicine, 12(4), 635-658. https://doi.org/10.1016/S0749-0690(18)30193-9
6. McKeon, P. O., & Hertel, J. (2008). Systematic review of postural control and lateral ankle instability, part I: Can deficits be detected with instrumented testing? Journal of Athletic Training, 43(3), 293-304. https://doi.org/10.4085/1062-6050-43.3.293
7. Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., Clemson, L., Hopewell, S., & Lamb, S. E. (2019). Exercise for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 1(1), Article CD012424. https://doi.org/10.1002/14651858.CD012424.pub2
8. Springer, B. A., Marin, R., Cyhan, T., Roberts, H., & Gill, N. W. (2007). Normative values for the unipedal stance test with eyes open and closed. Journal of Geriatric Physical Therapy, 30(1), 8-15. https://doi.org/10.1519/00139143-200704000-00003
9. UBS. (2024). Pickleball: America’s fastest growing sport. UBS Financial Services Inc.