The popularity of pickleball just continues to grow – despite the oddball name. With its unique blend of tennis, badminton and ping pong, pickleball was the fastest growing sport in America in 2024 for the third year in a row.
According to the Sports & Fitness Industry Association, more than 36.5 million people played the game at least once in 2024, with ever-increasing numbers engaging in the sport daily. With that growth has come an increase in “pickleball injuries,” seen by doctors across the country.
“It’s a game that all ages can play and it improves the overall health of everyone,” said Dr. Asha Shah, a primary care physician with Indian River Hospital Pointe West Primary Care. “It’s especially popular with older people because it’s an easy game to learn and it keeps them from being isolated after they’ve retired. It’s great for their mental health and it improves their muscular stamina, bone health, balance and coordination.
“The game can be played at any level, and it’s adaptable to people with physical limitations. Plus, it an affordable sport to pursue since all you need is a paddle, court shoes and ball.”
While it’s often associated with older adults, more than 70 percent of pickleball players are under the age of 55, and the fastest-growing age group is 19 to 24. According to USA Pickleball’s Places2Play database there are more than 11,000 pickleball venues in the U.S., with hundreds more being added each year.
“It seems like all the new home and condo developments are factoring pickleball into their plans,” said Dr. Shah. “In my development, they’ve actually converted tennis courts into smaller pickleball courts because of its popularity. But while the game is easy to learn and readily accessible to a wide swath of the population, it doesn’t come without some risks.”
Dr. Shah stresses that people should know their level of physical fitness prior to getting started and be aware of their limitations.
Sudden stops, quick lateral movements, or backpedaling to hit a lob can lead to strains, sprains and falls – the most common cause of injury. Pickleball-related injuries account for nearly $400 million in healthcare costs annually, with hip fractures and wrist injuries topping the list.
Players also report sprained ankles, pulled hamstrings and strained shoulder muscles – particularly when playing without a proper warm-up or using improper footwear. The quick pivoting and lunging movements required during play can aggravate the knees or lead to Achilles tendonitis, and the repetitive swing motion can affect the tendons in the forearm that leads to pain and stiffness well after the game is over. The pickleball equivalent of tennis elbow is another complaint.
“I’ve seen people playing with knee braces and they do quite well,” Dr. Shah said. “But knowing their limitations and being aware of the consequences if they fall is the key to staying injury free.
Warm up and stretch before playing, focusing on the shoulders, legs and lower back.
“Proper footwear is imperative, too. Many of the injuries I see were a result of someone wearing running shoes on the court instead of designated court shoes.
“Keep yourself hydrated and be sure of your movement on the court,” Dr. Shah continues. “You don’t have to go after every ball. Most injuries happen when a player is trying to make lateral and backward movements, so if you are new to the game, play the balls that come to you and let the ones that go behind you be. Don’t go backwards to get that ball. Turn and run instead. Go slow and increase your play level as you progress and become more confident.”
While more indoor pickleball courts are being built, most are still outdoors and prone to the elements. In Florida, sun and heat exposure are common hazards for players.
“Stay hydrated and take precautionary measures like refraining from play in the middle of the day and wearing a hat and plenty of sunscreen,” Dr. Shah cautioned. “I myself had to take a break from playing because of my sun toxicity. If I can’t play indoors or at night, I’m sidelined.”
Those with pre-existing conditions should consult with their doctor before tackling the sport.
“If someone has had bypass surgery or has a stent and they are not active, they should probably not rush to play pickleball,” Dr. Shah advised. “It’s a lot of cardio exercise and it could be dangerous for some.”
When asked how a player would differentiate muscle soreness from a more acute injury, Dr. Shah replied, “The main problem would be the ankle. If there’s a fracture, a person cannot bear weight, and they have to get out of the game and see a doctor.
“If it’s a muscle injury, the player could still bear weight, but it would be sore. In that case, it would be good to stop playing and give yourself a day or two to recover. Fractures and sprains generally show bruising, whereas muscle strains do not.”
Should an injury occur, see a doctor to find out whether it is a fracture or muscle injury. If it’s a fracture, or other acute injury like a torn ligament, then a referral to an orthopedic surgeon might be necessary.
“I think anyone just getting into the sport should take some lessons first to learn if it’s suited for them and find out what adjustments can be made for their own individual limitations,” Dr. Shah said.
In brief, pickleball offers an unbeatable combination of fitness, fun and friendship, making it one of the most inclusive sports out there. But with its fast pace and sudden movements, it carries some risk, especially for older players.
Playing when heat is not intense, warming up, staying mindful of proper technique, and listening to your body will enable you to enjoy the many health and social benefits of pickleball while minimizing your risk of injury. So grab a paddle and hit the court – just don’t forget to stretch.
Dr. Asha Shah completed her medical education at R.G. Kar Medical College in India and her residency at Ellis Medicine Family Practice Residency Program in New York. Her office is located at 1960 Pointe West Dr., Vero Beach. Call 772-564-7828 to schedule an appointment.
