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Pickleball is the fastest growing sport in the US — more than 36 million played just last year. But reports of injuries are also growing fast. Achilles’ tears, rotator cuff injuries, broken wrists, damaged knee and elbows — you name it, my fellow doctors and I are seeing it.

Look, this sport is fun. I play it myself. But, it can also cause a lot of pain if you’re not careful. I’m not sure if it’s the fun name, the smaller court or the fact that a lot of weekend warriors are taking part, but I am finding that many people are underestimating the physicality that comes with pickleball and that is leading to a lot of injuries.

This is a sport to take seriously. It involves running, reaching, stretching and injuries can come from that. So here are 5 tips to keep pain out of your pickleball game.

Start with Stretching

I know you hear about the importance of stretching all the time but despite that — people just don’t take the time to do it. If they do — they often focus on their legs. Stretching your achilles and hamstrings are really important for this game. But don’t forget your back! Few people ever remember to stretch their back.

Some do slow and gentle twists, bend forward to your toes, reach both arms to the sky, tap your right foot with your left hand and then swap and do the other side. There is a lot of upper body involvement in this sport with all the swinging — so take the time to stretch yourself out. Five minutes should be enough.

Invest in the right equipment

The #1 piece of equipment I want you to focus on is your shoes. Don’t just grab an old pair of sneakers. You are moving in all directions, hustling, shuffling, lunging and more and you need really supportive court shoes to do that. If it’s been a while since you bought a new pair — do it before your next game. I just did because I realized my older running shoes just weren’t supporting me in the way I needed to.

Pay attention to your paddle too. It seems counterintuitive but light paddles aren’t actually a good choice for beginners. They may cause you to swing too hard, which could hurt your wrist, arm, elbow or shoulder. You also want a paddle with the right size handle for your hand so you don’t grip too hard or accidentally bend your wrist in awkward ways

Start slow

Most people playing pickleball are pretty competitive. The game can get fierce….fast. But starting slow is smart. Start by playing on the short court. Do some gentle volleying and a few dinks to warm up before you step back and go for longer shots or a powerful backhand, lob or smash.

Focus on your form

One of the most important things to remember is that you want to get to the ball with your feet — not your arms. So take multiple steps to move toward the ball — rather than overextending with your reach. That’s where bad back and neck pulls can easily happen.

This game can move pretty fast. That means there’s a lot of hustling backwards and sideways — which can increase the chance of injury more than running forward. You may need to slow it down a bit when you’re moving in different ways than you typically do.

And believe it or not — people often pull their back with the repetitive motion involved in continuously bending over to pick up the balls. So try rolling it over to your foot with your racket and then bouncing it once so you don’t have to reach down so far to get it.

Finish strong

After you’ve shaken hands with your opponent and the game is over — don’t downplay or ignore recovery. Do a little cool down — that means walking slowly and yes — a few more stretches — especially slow and steady moves to loosen up your back one last time.

If you have pain from overuse — take it seriously. Don’t head back on the court. Instead, rest a few days. And if that pain lasts longer than 2 or 3 weeks — call someone like me.

Bottom line — I’m all about pickleball fever. Anything that gets us all out exercising and having fun is great in my book. But like any sport — an ounce of prevention goes a long way to preventing a lot of pain.