Pickleball Popularity Still Surging, But So Are Related Injuries, Especially Among Older Adults

As you may have heard, pickleball has been the fastest-growing recreational sport in the U.S. for years – and its rising popularity refuses to wane. But before you grab a paddle and volley serve – or drop serve – the ball, keep this in mind: Pickleball injuries are also on the rise, especially among older players who are attracted by the game’s seemingly less-physical demands – at least compared to tennis or badminton.

Pickleball is basically a mix of tennis, badminton and table tennis. Since the playing court is smaller than in tennis, and the ball moves slower, players of all ages are drawn to the sport -- from teenagers to retirees.

Alex Mafdali, M.D., a primary care sports medicine physician with Baptist Health Orthopedic Care..

Essentially, it’s a sport that appears easy to pick up. And that way it can lead to overuse injuries or overexertion, explains Alex Mafdali, M.D., a primary care sports medicine physician with Baptist Health Orthopedic Care.

“The most common injuries in Pickleball are lower extremity sprains/strains and core injuries, which we see in other racquet sports,” said Dr. Mafdali. “Many seniors are playing the game, and they are more apt to be injured because of a lack of strength, coordination, and stability. Additionally, most of these seniors have pre-existing injuries that they'll aggravate with activity. Most of them do not train specifically for the sport.”  

Groin injuries, sports hernias and abdominal muscle injuries are the more common “core muscle” injuries. Core muscles can include the abdominal muscles, oblique muscles, and thigh muscles.

Overuse or "wear and tear" injuries – particularly in the shoulders, arms and knees -- are associated with pickleball. They include low back strains or general muscle strains. Pickleball elbow, similar to “tennis elbow,” is usually due to overuse of the forearm muscles, resulting in inflammation and pain.

“Since it's a sport that requires less stress on the body and it's easy to learn and play, a lot of the community is playing it more frequently and for longer periods of time,” explains Dr. Mafdali. “And that is increasing stress on joints, muscles and tendons.”

Other overuse injuries may include conditions in the foot (Achilles tendonitis, plantar fasciitis) and the core muscles, which can include exacerbation of low back pain due to poor mechanics or hinging at the hips. Groin or hamstring tightness can also occur from a lack of strength, stability or overall conditioning for pickleball.

Dr. Mafdali adds that traumatic injuries from pickleball can include the following:

• Knee: Meniscal injuries, ACL, MCL sprains/tears;
• Shoulder: Rotator cuff tears; impingement
• Wrist/Hand: Sprains, fractures;
• Hamstring: Tears;
• Ankle: Sprains, fractures;
• Achilles tears, ruptures.

What’s the best advice for anyone wanting to start Pickleball - - especially if they're not accustomed to taking part in competitive physical activities?

Responds Dr. Mafdali: “Ease into the sport and cross-train -- which involves days of strength training, specifically for pickleball movements, mobility and recovery. Also, good nutrition and hydration are vital, particularly in Florida.”