Key Takeaways (TL;DR):
- While pickleball is a popular, low-barrier sport, it is also a leading cause of emergency room visits due to the frequency of falls, especially among players over 50.
- Players commonly experience acute sprains, strains, and fractures (most often in the wrist or forearm) resulting from falls, as well as chronic overuse injuries like Achilles tendonitis, tennis elbow, and plantar fasciitis.
- Younger players are usually hurt by getting hit with paddles, while middle-aged “weekend warriors” mostly experience severe muscle strains. Middle-aged players are at high risk for sprains, strains, and even cardiac events if they play intensely without regular conditioning.
- Prevent injuries by stretching, drinking water, playing indoors when courts are wet, and wearing court shoes instead of running shoes.
- Treat minor pains at home with rest and ice. If you suffer an acute injury like a sprain or can’t bear weight on a joint, seek immediate medical care.
Pickleball is one of America’s fastest-growing sports because the game’s low barrier to entry draws players of all ages and fitness levels. But “low barrier” doesn’t mean “no risk”— pickleball is also one of the fastest-growing reasons for emergency room visits.
Knowing the risks of pickleball and how to prevent injuries is the first step toward staying on the court, and keeping your joints healthy.
Common injuries from pickleball
Directly comparing the incidence of pickleball injuries to other sports can be misleading because the broad appeal of pickleball to all ages, especially older players, results in a unique distribution of injuries.
A 10-year national study found that 91% of pickleball injuries occur in players over 50 — a reflection of the sport’s particular popularity among older adults, who are also more vulnerable to joint issues and serious harm when they fall.
Due to lateral or pivoting movements on the court, sprains (ligament stretching/tearing) or strains (muscle or tendon injuries) occurred most commonly in players’ wrists, knees, or ankles.
While fractures and sprains/strains each made up 27% of total injuries, fractures (broken bones) were more common among older players, particularly women, likely exacerbated by postmenopausal bone loss.
About two-thirds of acute pickleball injuries result from falls during play. Across all players, bone fractures were most common in the forearm or wrist, with broken hips or ribs being less common, but not unheard of.
Injuries in younger players
Although older players are at much higher risk, younger players also experience injuries while playing pickleball. Among teens and young adults, the most common injury is being hit with a paddle – elsewhere described as “misuse of equipment” – in other words, horsing around.
But pickleball is not risk-free for players in middle age, either. For this age group (approximately 40-65 years old), the “weekend warrior” effect tends to lead to more sprains and strains, as well as an elevated risk for cardiac events triggered by play.
Chronic overuse injuries from pickleball
Among regular pickleball players, overuse injuries may develop over time, and these occur among all age groups.
Common overuse injuries from pickleball include:
- Achilles tendonitis
- Tennis elbow
- Rotator cuff strain, and
- Plantar fasciitis
These tendon and ligament injuries are more common than other injuries like broken bones, especially among middle aged players.
Achilles tendonitis and other ankle injuries are also widespread among pickleball players.
Like other racquet sports, pickleball can also lead to lateral epicondylitis, commonly known as tennis elbow.
Most common among both high-level players who play intensely and newer players who play with poor form, rotator cuff injuries can lead to chronic shoulder pain and reduced range of motion.
Plantar fasciitis may flare up or be worsened by pickleball’s explosive lateral movements and hard court stops. It usually shows up as sharp heel pain, especially during a person’s first steps in the morning.
Overall, these types of overuse injuries rarely result in emergency room visits.
How to prevent pickleball injuries
Although pickleball is not risk-free, it’s still a healthy exercise option that’s more accessible than many other sports – especially for older or less active players.
Players can make pickleball safer by following a few reasonable precautions that may also improve their game:
Stretching + strength training
Because pickleball is often perceived as a way for otherwise unathletic people to get exercise, it may seem counterintuitive to recommend exercise to prevent pickleball injuries.
But slow, controlled stretching and strength training are effective ways to prevent acute injuries that result from sudden movement. These activities also correct muscle imbalances and stabilize limbs to withstand repetitive stress from the sport.
In older women (over 65), weight training improves bone density, and reduces the risk of fractures in the event of a fall. Even if you don’t participate in exercise outside of pickleball, thoroughly stretching before and after play will help to prevent cramps, pulled muscles, and joint injuries.
Play indoors
Perhaps due to wet or icy courts, falls during a pickleball game are far more common in winter. In wet climates like the Puget Sound, moving your game indoors during winter months or on rainy days can help prevent injuries.
Get the right shoes
Wearing court shoes designed for pickleball or tennis reduces the risk of falls and provides support and cushioning to minimize strain on the feet and ankles.
Running shoes may not provide sufficient lateral support to protect the ankles. Make sure that your shoes are in good condition; worn shoes will not provide the traction or necessary support to keep you safe during play.
Hydrate
Maintaining good hydration does more than just prevent the discomfort of thirst, it regulates body temperature, lubricates joints, and minimizes muscle fatigue.
Treatment for pickleball injuries
If you suffer a sprain or other acute injury on the pickleball court and need an X-ray, call your WWMG primary care provider’s clinic to request a same-day appointment (on weekdays) or visit your nearest urgent care clinic. If you can’t move or put weight on the joint, seek immediate medical care at the emergency room.
Chronic pain, sprains and strains can be treated at home using the RICE method:
- Rest for up to 72 hours
- Ice in 20-minute increments, and
- Use compression and elevation to reduce swelling.
But if your pain doesn’t improve after a few days, request an appointment with a WWMG primary care provider. They can assess the injury and recommend treatment, or refer you to WWMG Podiatry (for foot and ankle issues) or to WWMG’s Orthopedic Sports, Spine & Hand Clinic (for hip, knee, wrist, hand, and elbows) to get you back into shape and back on the court in no time.