For many Americans, the sport of choice was pickle-ball, a game played on a court that is part ping pong, part badminton and part tennis.

Highly social while being played both indoors and outdoors, it’s estimated 5 million play the game regularly, and 50% of them started during the pandemic. Between 2019 and 2021, pickle-ball is the fastest growing sport in the U.S. After surging 86% to 8.9 million players, UBS expects the figure to spike to 22.3 million this year. Based on these numbers, pickleball could spark between 250 million and 500 million health care utilizations and costs in 2023.

As the popularity increases, so too do the injuries. I have taken an informal survey in my community of 200 players over 55, approximately 1 out of 3 players have sustained an injury in the past year. This is likely due to the fact that pickle-ball players (pickle-ballers?) tend to be over 50, many of whom were largely sedentary before picking up their paddles.  90 % of the patients showing up in the ER are over 50. Although previous tennis players are taking up the sport in large numbers and giving up tennis in favor of pickle-ball. The greater your previous athletic ability the better you will become although there are many players who do not have athletic prowess who are taking up the game because it is so easy to learn and there are leagues that are geared toward the less athletic players. The sport is very popular among woman as well because it is easy to learn and you don’t have to be a accomplished athlete. The game is attracting the younger set as well. Many summer camp programs include the sport and public schools are offering the game along with tennis. I predict that colleges will also get on the bandwagon and in several years, it will become an Olympic sport.

While exercise positively impacts health outcomes, the can-do attitude can pose greater risks. Non-injuries include cardiovascular events which are found in 21%. Actual injuries suffered were 32% sprains, 28 % fractures, 10% contusions.

Among the top ailments associated with pickle-ball are:

• Shoulder inflammation
• Rotator cuff injuries
• hand injuries
• tendon ruptures
• Achilles tendon tears and ruptures
• lateral epicondylitis, commonly known as tennis elbow — now pickleball elbow
• wrist sprain and fractures
• ankle sprains and fractures
• knee-menisci tears, synovitis, ligament tears
• lower back injuries included herniated discs and muscle strains

Most injuries are minor and just require RICE (rest, ice, compression and elevation). I also suggest a NSAID such as Advil or Aleve. However, some injuries are more serious and may require surgery. ie. fracture repair, back surgery, joint replacement, tendon repairs, rotator cuff repairs.

It’s a fast-paced game, requiring a lot of quick reactions. There’s not a lot of running, but there’s lots of quick pivots, lunging, rotating and twisting. These motions can put a lot of strain on the body, especially when in a compressed position. If you were previously sedentary, you certainly need to warm up. Stretch or activate muscle groups in advance. If you do get hurt while playing, an immediate assessment should be: Is this something you’ve previously experienced and know how to manage? Or is it a new pain or issue? If it’s new to you, stop playing immediately and seek medical attention.