Pickleball has seen an explosion in popularity in recent years, and along with the rise in players, doctors are seeing a spike in serious injuries.

The American Academy of Orthopaedic Surgeons (AAOS) reported in February that bone fractures as a result of pickleball have increased by 900% over the last 20 years. Researchers conducting what is believed to be the first study of its kind identified that male and female pickleballers experienced higher rates of injuries than in years past, and the genders also experienced different types of injuries.

“Despite its reputation as a low-impact sport, pickleball can pose a serious risk for players, especially if they have weaker bones from osteoporosis,” said Dr. Kurt P. Spindler, an orthopedic surgeon at Cleveland Clinic in Florida. “It’s important to understand your risk profile of injury and to speak with your physician to see how you can lower your risk. For example, if you know you’re at risk for weakened bones, it’s important to build your bone mass as you age with appropriate nutrients such as calcium and Vitamin D and choosing weight-bearing activities.”

The study presented at the annual AAOS meeting in February was compiled by fourth-year medical student Yasmine Ghattas, who herself is a pickleball player. She decided to begin researching injuries related to the game after realizing there was no research published on the topic.

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“To date, there weren’t any studies with a detailed analysis of pickleball-related fractures,” Ghattas said, per an AAOS news release. “With paucity in the literature, we wanted to determine the risk factors and prevalence of demographic variables associated with more serious injuries such as fractures since these can lead to hospitalization and surgery.”

Ghattas found that women over the age of 65 were more likely to suffer fractures to the upper extremities, such as fingers, wrists, and arms, often from falls. Men, who were more likely to be hospitalized than women, more often had fractures to hips and legs. Women were found to suffer more fractures than men despite being less likely to be hospitalized.

She attributes the difference to the fact that many upper extremity fractures are not serious enough to require hospitalization, whereas an injury such as a broken hip is severe and could result in a significant hospital stay during recovery.

A significant factor Ghattas believes contributes to the fact that injuries in women over 65 are more common is osteoporosis. Severe injuries such as fractures are rising mainly because of the increase in popularity of the sport. The Sports & Fitness Industry has named pickleball the fastest-growing sport in the U.S. for three consecutive years, climbing from 4.8 million players in 2022 to 8.9 million in 2023.

Christopher Wu, M.D., a sports and internal medicine physician at Atlantic Health System, said the rate of injuries is likely higher than reported, as many injuries are minor soft-tissue injuries like sprains and strains. He said proper stretching, hydration, and wearing appropriate shoes are important ways players can avoid common injuries.

“A general principle that we always tell patients we see is: If something hurts or if something bothers you, of course, don’t do it. That’s your body’s way of telling you that it doesn’t like that movement or that position. So, it’s something you want to avoid,” Wu said, according to the American Medical Association. “In terms of injury management, a lot of the overuse injuries can be managed conservatively. In other words, not everything requires surgery, but some of those more significant injuries like a fracture or something gets dislocated … potentially may need surgery.”

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