Picking Up Pickleball Might Be Picking Up Injuries
Authors: Corinne Rivard, DO and Gianpaolo Rufo, DO
America's fastest-growing sport is sending players to 
emergency rooms at an alarming rate. Pickleball 
injuries have skyrocketed 3,650% from 2012 to 2022, 
a seven-fold increase despite only a three-fold rise in 
players.1-2 Understanding why these injuries occur 
and how to prevent them is critical for anyone step-
ping onto the court.
The Numbers Tell a Sobering Story
Over 90% of injured players are age 50 or older, but 
the sport is now affecting athletes of all ages.3 Injury 
patterns differ dramatically by age. Players under 60 
primarily experience soft tissue injuries (sprains, 
strains, and inflammatory conditions) while those 
over 60 face higher rates of fractures requiring more 
invasive treatment.2 Women are three times more 
likely than men to sustain fractures, particularly of 
the wrist, while men are three times more likely to 
experience muscle strains and joint sprains.6 Across 
all ages, foot and ankle injuries alone increased 
6.5-fold from 2019 to 2023, with Achilles tendon 
rupture being the most common diagnosis and 63% 
of those injuries requiring surgery.4 Among pediatric 
players (ages 18 and younger), facial injuries and 
lacerations dominate, with 58% of all pediatric 
pickleball injuries occurring in 2024 alone.5
Why Injuries Are Happening
There are a multitude of reasons why injuries occur. 
These include, but are not limited to improper warm 
up, multiple players in close proximity, and physio-
logical changes related to age. Pickleball’s physical 
demands are often underestimated. The sport requires 
rapid lateral movements with frequent stops and 
starts in a confined space near the net which increase 
the risk of collision.2 Many players, especially older 
adults, jump in without proper conditioning or tech-
nique training.2 
Age-related physiological changes also compound 
the risk of injuries. These include declining collagen 
quality in tendons and ligaments, decreased muscle 
mass leading to easier fatigue and falls, reduced bone 
density (especially in postmenopausal women), and 
diminished balance and coordination all increase 
vulnerability.2 Overuse injuries account for 78% of 
reported cases, highlighting the importance of gradu-
al progression.7 
Evidence-Based Prevention Strategies
Prevention starts before you step on the court. Play-
ers over the age of 50 or with pre-existing medical 
conditions should consider obtaining a physical 
examination to assess endurance and bone density, 
and consult with a trainer or physical therapist to 
evaluate range of motion, strength, balance, and 
coordination.2 Taking classes or joining clinics to 
learn proper technique is essential to build good 
fundamental skills and mitigate the risk of injuries.2 
Easing into the sport gradually rather than jumping in 
at full intensity reduces injury risk substantially. 
Higher self-rated skill level is associated with 
reduced injury risk, emphasizing the importance of 
proper instruction.7 Protective equipment matters. 
Proper eye protection significantly reduces the risk of 
ocular injuries. Athletes are advised to wear nonshat-
ter goggles, such as those worn to play racquetball.2 
Shoes offering lateral support and proper traction 
reduces the risk of falling, and the use of wrist and 
knee braces will reduce the risk of fractures and 
abrasions.2 Court quality deserves attention. Cracks 
and bare spots increase fall risk, while acrylic and 
rubber courts may be easier on joints than concrete 
surfaces. Players are advised to seek courts that are 
well maintained if possible.2
3

View this content as a flipbook by clicking here.