Can You Play Pickleball After Hip and Knee Replacement? What You Need to Know

The question I hear most often from my active patients facing joint replacement isn't about pain relief or walking again—it's "Doc, will I be able to get back on the pickleball court?"

Here's the encouraging answer: Yes, most patients can return to pickleball after hip and knee replacement surgery. Recent research shows that 72% of racket sports players successfully return to their sport after joint replacement, with most achieving their previous skill level within six months.

As an orthopedic surgeon who's helped hundreds of patients return to active lifestyles after joint replacement, I want to share what you need to know about playing pickleball after surgery. This isn't about giving you false hope—it's about setting realistic expectations based on solid evidence.

What the Latest Research Shows About Pickleball After Joint Replacement

A groundbreaking study published in The Journal of Arthroplasty specifically looked at patients returning to pickleball and other racket sports after total joint arthroplasty.¹ The results might surprise you.

The Numbers That Matter

The research followed over 1,200 patients who had undergone hip or knee replacement. Here's what they found:

• 71.9% of recent racket sports players returned to their sport after surgery
• Only 30.2% of patients who hadn't played in years before surgery returned to racket sports
• Most players returned to their same skill level and frequency of play
• The majority were back on the court within six months post-surgery
• Patients who returned to racket sports reported higher physical function scores

Why These Results Are Significant

What makes this study different is that it looked specifically at racket sports like pickleball, tennis, and squash. These activities involve quick directional changes, sudden stops, and lateral movements that place different demands on your new joint compared to walking or swimming.

The key finding? If you were playing pickleball regularly before your joint problems got worse, you have an excellent chance of returning to the court after replacement surgery.

Understanding Your Recovery Timeline for Return to Racket Sports

Recovery isn't just about when your incision heals. Getting back to pickleball safely requires your muscles, tendons, and new joint to work together as a team.

The First Three Months: Building Your Foundation

During the first 6-12 weeks after surgery, your focus should be on basic recovery:

• Following your physical therapy program religiously
• Regaining normal walking patterns
• Building strength in the muscles around your new joint
• Improving your range of motion

I tell my patients this phase is like rebuilding the engine of a car—you can't race until all the parts are working properly together.

Months 3-6: Progressive Activity Return

This is when most patients start thinking about sports again. Your physical therapist will likely introduce:

• Balance and stability exercises
• Light jogging or treadmill work
• Sport-specific movement patterns
• Equipment like the SRS Restore You Therapeutic device for targeted rehabilitation

Month 6 and Beyond: Return to Court

Most research shows that six months is the sweet spot for returning to racket sports. By this time:

• Your bone has grown into the implant (for uncemented joints)
• Muscle strength has returned to near-normal levels
• Your balance and coordination have improved
• You've developed confidence in your new joint

Which Patients Are Good Candidates for Pickleball After Surgery

Not every patient should return to high-level recreational sports after joint replacement. Here's how I evaluate whether pickleball is realistic for my patients.

Your Pre-Surgery Activity Level Matters Most

The strongest predictor of returning to pickleball isn't your age or how bad your arthritis was—it's whether you were playing regularly before surgery. Patients who played within two years of their surgery have the best success rates.

If you haven't touched a paddle in years, that doesn't mean you can't start playing after surgery. But your expectations should be different, and your approach more gradual.

Physical Factors I Consider

Several medical factors influence whether I encourage patients to return to racket sports:

Good candidates typically have:

• Successful healing with no complications
• Good muscle strength and balance
• Normal joint range of motion
• Realistic expectations about performance
• Previous racket sports experience

Patients I counsel more cautiously include those with:

• Multiple previous surgeries on the same joint
• Ongoing balance or coordination issues
• Unrealistic expectations about performance level
• Limited rehabilitation compliance

Age Is Just One Factor

I've had 75-year-old patients return to competitive pickleball and 55-year-old patients who struggle with basic activities. Your biological age matters more than your chronological age.

Essential Preparation Steps Before Getting Back on the Court

Returning to pickleball after joint replacement isn't just about getting medical clearance. You need a strategic approach.

Physical Preparation Beyond Basic PT

Standard physical therapy gets you back to normal daily activities. Getting back to sports requires additional preparation:

• Sport-specific agility training
• Plyometric exercises (jumping and landing)
• Reaction time and hand-eye coordination drills
• Court movement patterns

Many of my patients benefit from working with a trainer who understands post-surgical athletes. The SRS Restore You Therapeutic device can be particularly helpful during this phase for targeted muscle strengthening and movement re-education.

Equipment Considerations

Your equipment choices can make a significant difference in your success and safety:

Paddle selection: Consider a lighter paddle initially to reduce stress on your arm and shoulder while your coordination returns.

Footwear: Invest in high-quality court shoes with good lateral support. Your balance and proprioception may be different initially.

Knee or hip bracing: Some patients benefit from supportive bracing, especially during the early return phase.

Starting Back: The 50% Rule

When I clear patients for pickleball, I recommend starting at about 50% of their previous intensity:

• Play shorter sessions initially
• Focus on doubles rather than singles
• Choose recreational play over competitive matches
• Listen to your body between sessions

Managing Expectations and Long-term Considerations

One conversation I have with every patient considering return to pickleball involves setting realistic expectations about performance and longevity.

Performance Expectations

Most patients return to their previous skill level, but the timeline varies. Some factors that influence your return to peak performance:

• Your age at the time of surgery
• How long you were limited before surgery
• Your commitment to rehabilitation
• Overall fitness level

In my experience, about 80% of patients feel they're playing at or near their previous level within a year of surgery.

Protecting Your Investment

Your joint replacement is designed to last 15-20 years or more with proper care. Playing pickleball doesn't necessarily shorten this lifespan, but smart choices help protect your investment:

• Warm up thoroughly before every session
• Cool down and stretch after playing
• Don't play through significant pain
• Maintain your fitness between pickleball sessions
• Follow up regularly with your orthopedic team

Signs to Take a Break

Even experienced players need to recognize when to step back:

• Persistent joint pain that doesn't resolve with rest
• Swelling that's worse after playing
• Feeling unstable or insecure on the court
• Significant decrease in your playing ability

When to Contact Your Orthopedic Surgeon

While most patients have smooth sailing back to pickleball, certain situations require immediate medical attention.

Red Flags That Need Immediate Evaluation

Contact your surgeon immediately if you experience:

• Sudden onset of severe pain during or after playing
• Joint swelling that doesn't improve with rest and ice
• Feeling like your joint is "giving way" or unstable
• Any signs of infection (fever, warmth, redness)

Routine Follow-up Considerations

Even if you're feeling great, regular check-ins with your orthopedic team are important:

• Annual X-rays to monitor your joint
• Discussion about any changes in your activity level
• Evaluation of any new aches or pains
• Updates on the latest research and recommendations

Working With Your Healthcare Team

Your orthopedic surgeon isn't the only person who can help you succeed. Consider building relationships with:

• Physical therapists who understand sports medicine
• Athletic trainers familiar with pickleball
• Fitness professionals experienced with post-surgical athletes

Key Takeaways for Success

After treating hundreds of joint replacement patients who want to stay active, here's what I've learned makes the difference between those who successfully return to pickleball and those who don't:

Patience with the process: The most successful patients understand that returning to sports is a marathon, not a sprint. Rushing back too quickly often leads to setbacks.

Commitment to preparation: Patients who take their rehabilitation seriously and go beyond basic physical therapy have the best outcomes.

Realistic expectations: Understanding that you might not play exactly the same way you did 20 years ago, but you can still enjoy the sport you love.

Long-term thinking: Making choices that protect your joint replacement while still allowing you to stay active.

The research is clear: most patients can safely return to pickleball after hip and knee replacement surgery. With proper preparation, realistic expectations, and ongoing communication with your healthcare team, there's no reason why joint replacement should end your time on the court.

Your journey back to pickleball starts with a conversation with your orthopedic surgeon about your goals and expectations. Every patient is different, and what works for your friend or neighbor might not be the right approach for you.

Ready to discuss your return to an active lifestyle after joint replacement? Contact Dr. Calendine's office to schedule a consultation and develop a personalized plan for getting back to the activities you love.

References

¹ Taylor AJ, Braathen DL, Blackburn BE, et al. Can I Pickle Doc? Return to Pickleball and Other Racket Sports After Total Joint Arthroplasty. J Arthroplasty. 2025;40(8):P1979-1986.

Disclaimer: This information is for educational purposes only and should not replace professional medical advice. Always consult with your orthopedic surgeon before returning to sports activities after joint replacement surgery. Individual results may vary, and your surgeon knows your specific situation best.