The Pickleball Injury Nobody Talks About: Combined Hamstring + Adductor Tears

Most people think of pickleball as low-risk. But one injury challenges that idea: a rare, severe muscle tear that’s underreported, hard to diagnose, and completely preventable.

Consider this case:

A 71-year-old regular pickleball player was returning a volley during a routine match when he felt a sharp pain and popping sensation in his back thigh. What seemed like a typical hamstring pull turned out to be something much rarer: a complete tear of both his hamstring AND a deep inner thigh muscle called the adductor magnus, leaving gaps of over 4 centimeters where the muscles had torn away from the bone.

This was the first publicly documented case in medical literature specific to pickleball.

What Makes This Pickleball Injury So Serious

The adductor magnus isn’t just another groin muscle. It’s the largest, most powerful, and most complex muscle in the adductor group, with a unique dual personality that makes it especially prone to injury during explosive moves like overhead shots.

Here’s what makes it special (and dangerous):

The adductor magnus is essentially two muscles masquerading as one. The muscle has both an “adductor portion” and a “hamstring portion:” one part pulls your leg in, and the other extends your hip.

This dual role is why routine exams can mistake a tear for a simple hamstring strain.

This anatomical overlap is also why sports medicine researchers have nicknamed it the “mini-hamstring” and why combined injuries to both the hamstring complex and adductor magnus can be so severe.

Research on adductor magnus injuries in elite tennis players revealed the sobering truth: when the muscle tears during athletic activity, it’s often misdiagnosed as a simple hamstring strain. 

Why This Injury Happens in Pickleball

The same research noted above revealed that it’s the overhead movements in tennis, like serving, that create the exact conditions for these muscle tears. Pickleball’s overhead volleys and smashes involve nearly identical biomechanics. 

While the exact type of volley isn’t specified in the documented case of the 71-year-old, it’s safe to assume that explosive overhead movements in pickleball can cause this rare injury. 

Despite seeming like a simple shot, an overhead smash creates a forceful combination of movements that overload the back and inner thigh:

1. Setup phase: Your hip flexes and rotates as you position under the ball
2. Contact phase: Explosive hip extension as you drive through the overhead shot
3. Follow-through phase: Sudden deceleration forces the adductor magnus to work overtime

Why Pickleball Players Are Particularly Vulnerable

Unlike tennis, where players develop serving mechanics over years, many pickleball players:

• Jump into competitive play without gradually building up to explosive movements
• Use excessive force to compensate for shorter court dimensions
• Lack hip mobility from sedentary lifestyles before taking up the sport
• Have age-related muscle imbalances that puts them at a higher risk for injury 

Why This Injury Flies Under the Radar

The reason you’ve never heard of combined hamstring and adductor magnus tears isn’t because they don’t happen. It’s because they’re underreported or misdiagnosed.

Here’s how the wrong diagnosis sometimes happens:

1. Player feels back of thigh pain during/after an overhead shot
2. Initial clinical diagnosis: “Hamstring strain” (because pain is in back of thigh)
3. Treatment approach: Standard hamstring rehabilitation plans
4. Poor response to treatment because the adductor magnus component is missed
5. Delayed or incomplete recovery leading to chronic issues

Here’s why this injury is so problematic:

1. Prolonged Recovery Times: While isolated hamstring strains typically resolve in 2-6 weeks, combined injuries involving the adductor magnus can take 8–12 weeks to get back on the court. That’s best case with the right diagnosis and rehab.
2. Chronic Hip Dysfunction: The adductor magnus plays a key role in hip stability and movement patterns. When injured, it can lead to tightness that makes it harder to bend for dinks or power through groundstrokes.
3. Increased Risk of Re-injury: Perhaps most concerning, incomplete healing of adductor magnus tears creates ongoing weakness that makes players more susceptible to re-injury. 

Proper treatment starts with getting the right diagnosis through an MRI scan to see exactly what’s torn, then following a specialized rehab plan that targets both the hamstring and inner thigh muscles.

How to Prevent This Hidden Injury

The good news? This injury is almost entirely preventable with the right approach. Since we know the mechanism that causes it, we can train to prevent it.

1. Strengthen the Right Spots

• Deep Squat Holds: Builds strength in your adductor and hamstring groups
• Copenhagen Planks: This exercise has been shown to reduce groin injury risk
• Medicine Ball Overhead Slams: Mimics the overhead shot motion and builds explosive hip extension power

See how to get started with Copenhagen planks at home:

2. Improve Hip Mobility

Incorporate dynamic stretches like the 90/90 hip stretch and deep lunges to open up your hips. Better mobility means your muscles won’t have to work so hard to compensate during overhead shots

3. Progress Your Overhead Shots Slowly

Work your way up to powerful overhead volleys and smashes:

• Weeks 1–2: Practice at 50% effort to focus on form
• Weeks 3–4: Increase to 75%, watching for any tightness
• Week 5 and beyond: Progress to full power only after establishing proper movement patterns

Learn proper technique for overhead smashing:

4. Recognize the Warning Signs

 Keep an eye out for:

• Mild tightness in the inner thigh after overhead shots
• Discomfort during hip adduction or rotation (bringing your leg toward your body or twisting your hip)
• Gradual onset of weakness, which may be a warning sign before an acute “pop”

If you experience any of these symptoms, stop playing and seek evaluation from a sports medicine professional familiar with adductor magnus injuries.

The Bigger Picture: What This Means for Pickleball

As pickleball grows in popularity, players are pushing their limits and new injury patterns naturally follow. Even though pickleball is low-impact, it isn’t no-risk. This rare muscle tear shows how changes in the sport demand smarter training:

• Focus on quality movement over high volume
• Strengthen your entire hip complex, not just the obvious muscles
• Work with experienced coaches who understand the sport’s unique demands
• Educate yourself and fellow players: low-impact sports can still pose high risks

This injury doesn’t have to be feared. With the right strength work, mobility exercises, and gradual skill build-up, you can play with confidence.