What is the Most Common Pickleball Injury? Key Facts

Pickleball has experienced a huge surge in popularity in the United States, becoming a leading recreational sport for adults. The abundance of courts, easy-to-understand rules, inexpensive equipment, and readily available opponents and teammates explain why USA Pickleball boasts over 78,000 registered members.

Pickleball paddles are now frequently seen in communities for people aged 55 and over, and senior centers, as many older Americans are taking up the sport. However, as with any sport, increased participation leads to more injuries. Emergency rooms nationwide have reported a notable increase in injuries, particularly among players over 60.

Is Pickleball Suitable for All Ages?

Generally, yes. For most individuals, the advantages of exercise, especially in a social setting, significantly outweigh the risks, particularly for those who have limited opportunities for physical activity or social interaction. The Centers for Disease Control and Prevention recommends that adults of all ages engage in at least 150 minutes of moderate-intensity exercise weekly. Research indicates that regular social engagement among older adults can help reduce depression, loneliness, and even cognitive decline.

However, there are exceptions. The intense cardiovascular activity of moving quickly across the court can be risky for individuals with heart conditions. Rapid movements on hard court surfaces pose a fracture risk for those with low bone density. Playing while injured can hinder the recovery of existing bone and muscle injuries. Outdoor play in wet conditions can increase the risk of falls, while playing in hot weather can lead to heatstroke.

Experts advise players, especially those with pre-existing health conditions or a high risk of injury, to consult their doctors before making significant changes to their exercise routines.

What Are the Most Frequent Injuries?

The most common injuries result from either sudden incidents on the court, such as falls or slides, or overuse injuries similar to tennis elbow. Analyses of emergency room data from several studies show that the majority of injuries requiring hospital visits affect the lower leg and wrist. Different players are susceptible to different types of injuries.

A study analyzing medical data from 2000 to 2022 tracked the rate of bone fractures as pickleball became more popular. It revealed a significant rise in injuries, including an elevenfold increase in injuries among seniors between 2010 and 2019. The majority of the 397 fractures studied occurred in women over 60, which is expected given that postmenopausal women are prone to bone loss.

Falls accounted for a staggering 92 percent of the bone fractures in that study, including falls when players slid or dived for the ball and misjudged their landing. Most injuries involved the radius, humerus, and ulna – the main bones in the arm. Broken legs and ankles are also possible. Five players in the study fractured ribs, and twelve sustained head injuries. However, almost 80 percent of patients were discharged on the same day; those who were not tended to be older (average age 70) and had a higher incidence of torso injuries, including four of the five patients with rib fractures.

Sprains and muscle strains are even more common than fractures and can be equally challenging to heal. Another study found that patients aged 50 and older made up 90.9 percent of pickleball-related injuries, with strains and sprains accounting for 28.7 percent of injuries – slightly more than fractures. Strains and sprains were more likely to occur in the leg than fractures, and only 12 percent of patients required extended hospital stays.

Some pickleball players have visited the ER due to cardiac problems or heatstroke. Pickleball appears to be no riskier than other forms of exercise regarding dehydration and circulatory issues, but players should ensure they stay hydrated and be mindful of any symptoms.

How Much Does Age Matter?

Age-related limitations vary greatly from person to person. While age can be a barrier to starting a new sport, it is just one factor among many. Starting a high-cardio sport at any age can be challenging for individuals who have not been exercising regularly. Experts recommend that anyone planning to significantly increase their cardio exercise should consult a doctor to check their heart health and identify any new or previously undetected heart issues. Similarly, while bone density often decreases with age, especially after menopause, younger players with osteoporosis or other bone issues should also consider whether the benefits of pickleball outweigh the risk of fractures. Overall, age itself is less critical than the health conditions that often accompany aging. Seniors who have regular medical checkups and follow their doctors` advice can consider pickleball a relatively safe way to exercise.

How Do These Injuries Compare to Similar Sports?

Comparing injury rates to other sports is surprisingly difficult, especially given pickleball`s rapid growth in popularity among older adults and those new to sports. Ches Jones, an injury control researcher, noted that he doesn`t recall any other sport becoming so rapidly popular among players over 50.

Tennis is the most frequent comparison, which is understandable given that pickleball often uses tennis courts. In pickleball, the smaller court and lower net, along with the “kitchen” rule requiring the ball to bounce in the area near the net, result in slower-moving balls, reducing the risk of being hit by a fast ball or injured while chasing one. Additionally, tennis has been established for decades, so many players who are at higher risk due to age or pre-existing conditions may already be aware of tennis`s physical demands.

Another factor is the average age of new players. Over a third of new pickleball players are 55 or older, and many play frequently. In 2018, emergency room visits for senior pickleball players reached the same rate as senior tennis players. Over the years, injury rates have remained relatively constant for pickleball players under 40, with a slight increase for those aged 40-59 and a sharp rise for those 60 and older.

In both tennis and pickleball, eye injuries were rare and typically caused by ball hits. Injury analysts suggest that pickleball might be safer than tennis for cardiovascular events, possibly due to the less intense exertion required by pickleball`s lighter ball, smaller court, and the popularity of doubles games, which reduce the amount of running per player.

How Can Injuries Be Minimized?

While some injuries are caused by collisions with balls and paddles, most result from trips, falls, sudden turns, and other abrupt movements. This is encouraging for prevention, as general fitness measures can significantly reduce the risk or severity of injuries.

Experts recommend stretching and conditioning exercises for both muscles and cardiovascular health. Adding activities like running, swimming, cycling, or regular gym workouts can enhance endurance for pickleball. For individuals starting pickleball after a long period of inactivity, it’s advised to begin with short games and gradually increase exercise intensity. Furthermore, as most injuries affect the arms and legs, braces and stabilizers can be beneficial for those prone to sprains or twists.

Is Pickleball a Good Way to Get Active?

Yes, according to experts. The smaller court, lighter ball, and shorter game times make pickleball accessible for beginners. However, it’s important to avoid injuries to ensure you can keep playing.

For new players, it’s helpful to compare pickleball to their current exercise routine. Those who already exercise regularly and work out their entire body should still start slowly on the court to avoid overexertion. Individuals who haven`t been active recently, even if they were athletic in the past, should always consult a doctor. Experts emphasize the importance of cardiac check-ups for this group, as heart issues are common in older adults and can often go unnoticed in those newly becoming active.