How Pickleball Supports Safe ACL Recovery and a Joyful Return to Sport

Pickleball and ACL Recovery: A Gentle Route Back to Sport for Injured Knees

After months of rehabilitation, Lucy Barnes was ready to move again. The 38-year-old teacher from Sheffield had undergone anterior cruciate ligament (ACL) reconstruction following a netball injury. Running was still uncomfortable. Squats were tiring. But she missed the rhythm of sport. Her physiotherapist suggested something she had never considered: pickleball.

Two sessions later at her local leisure centre, Lucy felt a shift — not just in her knee but in her mindset. She wasn’t just rehabbing anymore. She was playing again.

ACL injuries are notoriously difficult to recover from, both physically and mentally. The ligament plays a crucial role in stabilising the knee during pivoting, landing and lateral movement. Recovery typically involves surgery followed by six to twelve months of progressive physiotherapy. For many, returning to sport feels like climbing a mountain with no summit in sight.

In England, growing numbers of patients and practitioners are exploring a fresh path back — one marked not by intense contact or sprint drills, but by careful footwork, short bursts of motion, and the satisfying pop of a perforated ball. Pickleball, with its slower pace and joint-friendly court design, is emerging as a valuable recovery tool for those returning from ACL surgery.

A Long Road to Recovery
Every year in England, thousands of ACL injuries are reported, particularly among amateur footballers, netball players, skiers, and gymgoers. The NHS offers surgical repair followed by structured physiotherapy. While recovery times vary, many patients experience loss of strength, confidence, and functional stability well into the later stages of rehabilitation.

“Physically, you can rebuild muscle,” says James Douglas, a chartered physiotherapist in Manchester specialising in post-operative knee rehab. “But mentally, returning to movement — trusting your knee again — that’s the final hurdle.”

Traditional return-to-play pathways in England involve progressive loading, balance work, and sport-specific drills. Yet patients often face a gap between formal rehab and full return to dynamic sports. That’s where activities like pickleball can offer a bridge.

Why Pickleball Fits the Gap
Pickleball is played on a compact court, roughly a third the size of a tennis court. The game is typically played in doubles, reducing the distance players need to cover. Movement is strategic rather than explosive. Points are built through dinks, lobs, and controlled volleys, rather than sprints or abrupt stops.

These features make pickleball particularly suited to ACL recovery. The game encourages joint stability, proprioceptive control, and lateral movement — all vital components of knee rehabilitation.

“In late-stage rehab, we’re looking for ways to reintroduce reactive movement under control,” explains Douglas. “Pickleball does exactly that. The court encourages lateral steps, weight transfer, and quick pivots, but without the speed or chaos of football or squash.”

Players can also adjust intensity. Beginners often play at 50–60% effort. The light paddle and plastic ball further reduce impact on joints, especially during deceleration or lunges. Unlike basketball or rugby, there are no tackles, jumps, or heavy landings.

A Growing Trend in English Clinics and Clubs
Physiotherapists and sports rehab specialists across England are beginning to recognise the potential of pickleball in their programmes. At a clinic in Bristol, the team at PhysioPoint has partnered with a local leisure centre to offer supervised sessions for recovering patients.

“We saw a need for a stepping stone activity,” says clinic director Nisha Kapoor. “Something fun, social, low-risk — but still functional. Pickleball ticked every box.”

Patients are first cleared for lateral movement and multidirectional stepping before entering supervised play. Early sessions include modified games, focusing on controlled serves, short-court play, and progressive drills. Over time, participants recondition movement patterns used in cutting, reaching, and deceleration — without excessive stress on the joint.

Kapoor says the response has been overwhelmingly positive. “People don’t feel like patients anymore. They feel like players again.”

Clubs are noticing the shift too. At Eastbourne Pickleball Club, a handful of new members over the past year have joined while recovering from knee surgeries, including ACL reconstruction. Club chairperson Martin Wells recalls one member who began playing just three months after completing formal physiotherapy.

“She couldn’t quite get back into tennis,” he says. “The court was too big, and the surface too hard. But with pickleball, she found a rhythm. She started slowly, stuck to dinking drills — and now she’s playing three times a week.”

Physical Gains and Psychological Boosts
The benefits go beyond biomechanics. For many recovering from injury, sport is about identity as much as mobility. Returning to an environment that fosters progress, encouragement and camaraderie can speed recovery in ways the clinic cannot.

“Social sport supports mental wellbeing,” says Dr Ellie Goodwin, a consultant in sports medicine working in Leeds. “Isolation and frustration are common after ACL surgery. Pickleball offers community. That matters.”

Players regain confidence not just in their knees, but in themselves. Structured, low-pressure games give them room to relearn body cues, adapt to discomfort, and develop new movement habits that support long-term joint health.

Dr Goodwin is careful to note that pickleball is not a substitute for structured rehabilitation. “But as part of a wider plan — especially in the return-to-function phase — it has real value.”

Proceeding with Care
Like any sport, pickleball must be introduced with caution during recovery. Patients should first be cleared by their physio or orthopaedic consultant. Early integration should prioritise stability, balance, and controlled movement — not competition.

Douglas recommends starting with basic paddle drills, mini-court rallies, and shadow footwork before progressing to live points. Doubles is preferred over singles to reduce physical demands. Supportive footwear, knee bracing (if recommended), and warm-up routines are essential.

Above all, communication with a physiotherapist remains key. “Pickleball is a tool, not a shortcut,” says Kapoor. “When used thoughtfully, it can do wonders.”

A Return to Movement, and to Joy
For patients like Lucy Barnes, pickleball wasn’t the end of her rehab journey — but it marked a turning point. She found flow again. She laughed during rallies. Her knee still twinged occasionally, but her fear was fading.

“Physio got me moving,” she says. “Pickleball reminded me how to enjoy it.”

Across England, more recovering patients are discovering the same. With the support of physios, clubs, and careful reconditioning, pickleball is proving itself more than a pastime. It is becoming part of the recovery pathway — not just to movement, but to confidence, connection, and joy.