Pickleball is a recreational sport growing in popularity in the United States. In fact, it’s become one of the fastest growing sports in America, and in the past three years, the player number has soared from 3.5 to 8.9 million! It’s easy to learn, promotes competitiveness and socialization, and is an excellent form of low-impact exercise. Unfortunately, pickleball is not without risk, and a game can result in an injury.

In 2021, researchers looked at data from emergency department visits between 2010 and 2019 and identified nearly 29,000 pickleball-related injuries among older adults. The most common diagnoses involved sprain/strains (32.2%), fractures (28.1%), and contusions (10.6%) with older men 3.5 times more likely than older women to suffer a sprain or strain injury and older women 3.7 times more likely than older men to sustain a fracture—including a nine-times greater risk for wrist fracture! These acute traumatic injuries can arise from falls, sudden turning or pivoting movements getting hit by a racket or paddle, getting hit by a ball, sudden bending over or hyperextending the spine, rolling an ankle, and running into the net, a fence, a wall, a chair or bench, a tree, or a fellow player.

Because the physical motions are similar to tennis, frequent pickleball players may also be at increased risk for lateral epicondylitis, also known as tennis elbow, a painful condition that occurs when tendons that attach to the elbow become overloaded. Pickleball players may also be at risk for other musculoskeletal conditions associated with repetitive movements, including carpal tunnel syndrome.

As such, doctors of chiropractic may begin to notice an influx of patients with both acute traumatic musculoskeletal injuries and repetitive stress injuries over time. Treatment will typically involve a multimodal approach that utilizes manual therapies, specific exercises, modalities, nutrition recommendations, and activity modifications to restore normal motion to the affected joints, reduce inflammation, and give the injured site the opportunity to heal.

Of note, the 2021 study found that 1 in 10 emergency room visits that involved pickleball were due to cardiovascular events. This in mind, if you are getting older and haven’t been physically active, talk to your doctor before starting an exercise routine—including pickleball. Additionally, dress appropriately for play, stretch before taking the court, drink plenty of water, and take breaks as needed. Don’t push yourself beyond your limits, pace yourself, and focus on having fun and being social with the other players.