Pickleball Boom Brings Increased Injury Risk: What Players Need to Know

The rapid rise in popularity of pickleball, a sport blending elements of tennis, badminton, and table tennis, is bringing with it a concerning increase in injuries. While often touted as a low-impact activity suitable for all ages, medical professionals are urging players to take precautions to avoid strains, sprains, and even more serious orthopedic issues. Understanding the risks and implementing preventative measures is crucial for enjoying this increasingly popular pastime safely.

A Growing Trend in Pickleball Injuries

Recent data indicates a significant uptick in pickleball-related injuries. A report from the Hospital Central de Hue in Vietnam has documented a rise in cases, though the numbers remain lower than those seen in other sports. The majority of these injuries are classified as mild to moderate, including sprains (Grade I-II), meniscus tears, and rotator cuff tendon injuries. These are typically managed conservatively with short-term immobilization, physiotherapy, and medical treatment, though some meniscus tears may require arthroscopic intervention for debridement or repair.

The trend isn’t isolated to Vietnam. A new analysis presented at the annual meeting of the American Academy of Orthopaedic Surgeons revealed that fractures related to pickleball have increased ninetyfold over the past two decades. The majority of these fractures occur in adults aged 60 to 69, highlighting the vulnerability of this demographic. According to Dr. Kurt Spindler, an orthopedic surgeon at the Cleveland Clinic in Florida, “Despite its reputation as a low-impact sport, pickleball can pose a serious risk to players, especially if they have weaker bones due to osteoporosis.”

Common Injuries and Why They Occur

Pickleball’s unique demands contribute to specific injury patterns. The sport is played on a smaller court than tennis, requiring quick, multidirectional movements. While this can be beneficial for cardiovascular health, strength, flexibility, and reflexes, it also places stress on joints and muscles. Common injuries include:

• Rotator Cuff Tears: Overhead motions and repetitive reaching can strain the shoulder.
• Achilles Tendinitis: Sudden stops and starts can inflame the Achilles tendon.
• Lateral Epicondylitis (Tennis Elbow): Repetitive wrist movements can lead to pain on the outside of the elbow.
• Ankle Sprains: Quick changes in direction increase the risk of ankle instability.
• Shoulder Dislocations: Less common, but possible with forceful swings or falls.
• Meniscus Injuries: Twisting motions, as experienced by a 42-year-old patient recently treated at the Hospital Central de Hue after a sudden twisting movement, can damage the meniscus. This patient required arthroscopic surgery following a diagnosis of a medial meniscus tear and Grade II osteoarthritis.
• Fractures: Particularly in older adults with osteoporosis, falls are a major cause of fractures. Ninety-two percent of fractures observed in a recent study occurred during falls.

It’s important to note that while pickleball is generally considered less strenuous than tennis or badminton – featuring a smaller court, less torsional stress on the spine and knees, moderate intensity, and lower average speed – it’s not without risk. The rate and severity of injuries are generally lower, except for fractures resulting from falls in individuals with osteoporosis.

Preventing Pickleball Injuries: A Proactive Approach

Fortunately, many pickleball injuries are preventable. Dr. Nguyen Thai Bao, head of the Department of Joint Surgery and Sports Medicine at the Hospital Central de Hue, emphasizes the importance of preparation and technique. Players at higher risk – including older adults with reduced bone density or osteoporosis, beginners still developing proper movement patterns, and individuals with pre-existing musculoskeletal conditions – should be particularly diligent.

Here are key preventative measures:

• Warm-up and Stretching: Dedicate at least 10-15 minutes to a thorough warm-up, focusing on the back, shoulders, knees, and ankles.
• Proper Footwear: Wear specialized shoes with ankle support designed for court sports.
• Safe Court Surface: Ensure the playing surface is not slippery.
• Correct Technique: Practice proper movement techniques, avoiding excessive twisting or abrupt changes in direction. Consider lessons from a qualified instructor.
• Gradual Progression: Increase exercise intensity gradually, allowing the body to adapt, especially for beginners or those returning to activity.
• Pre-Exercise Screening: Consult a healthcare professional to address any underlying musculoskeletal conditions before starting a regular pickleball routine.

Treating Acute Injuries: The RICE Protocol

For minor to moderate acute injuries, the RICE protocol – Rest, Ice, Compression, and Elevation – can provide immediate relief. Discontinue activity immediately and avoid putting weight or stress on the injured area. Apply ice packs for 15-20 minutes every 2-3 hours for the first 48 hours, using a towel to protect the skin. Employ an elastic bandage to provide moderate compression and elevate the injured limb to reduce swelling. Avoid massage, heat, or strenuous exercise in the early stages of recovery.

Dr. Nguyen Thai Bao stresses that severe injuries – such as joint or limb deformities, intense pain, loss of mobility, or discoloration of the extremity – require immediate medical attention and immobilization. Do not attempt to self-treat and seek professional medical care as soon as possible.

Looking Ahead: Continued Growth and Injury Awareness

Pickleball’s popularity shows no signs of slowing down. As the sport continues to grow, so too will the need for increased awareness of injury prevention and proper treatment protocols. By prioritizing safety and adopting a proactive approach, players can minimize their risk and continue to enjoy the many benefits of this engaging and accessible sport. The USA Pickleball association continues to promote safe play guidelines and resources for players of all levels.

The next major event on the professional pickleball calendar is the PPA Tour’s Desert Open in Palm Springs, California, from March 14-17, 2026. Expect increased scrutiny on player health and safety as the sport gains further mainstream attention.

What are your thoughts on the rise of pickleball injuries? Share your experiences and tips in the comments below!