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Pickleball has become one of the fastest-growing sports in America, with the Sports & Fitness Industry Association reporting that pickleball participation almost doubled in 2022, increasing by 85.7% year-over-year and by an astonishing 158.6% over 3 years. [1] More than 8.9 million Americans over age 6 now play pickleball, the association said. [1]

With this increase in popularity comes an increase in the number of associated injuries. A new study presented at the American Academy of Orthopaedic Surgeons’ recent 2024 Annual indicates that there has been a 90-fold increase in fractures over the past 20 years, most occurring in players between the ages of 60 and 69.

“There weren’t [previously] any studies with a detailed analysis of pickleball-related fractures,” said Yasmine Ghattas, a fourth-year medical student at the University of Central Florida College of Medicine.

“[Given] the paucity [of research] 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.”

The research team used data from the National Electronic Injury Surveillance System, a publicly available database from the Consumer Product Safety and Commission, to identify pickleball-related fracture trends, mechanisms of injuries, anatomic locations, and gender distributions between 2002 and 2022.

Findings from the study include the following:

• Fractures increased 90-fold during the 20-year study period, with the number of fractures doubling from 2020 onward.
• The most commonly observed fractures were of the upper extremity in women aged 65-plus following a fall, potentially reflecting diminishing bone health among women in this postmenopausal population.
• More women than men went to the emergency department with a pickleball-related fracture (69% vs 31%). However, men were 2.3 times more likely to be admitted to the hospital. This may be a consequence of the anatomic locations and subsequent severity of their fracture, which often included lower extremity fractures of the hip and femur and some truncal fractures.
• Pickleball-related injuries were more likely to occur in the winter (December through February) than in any other season of the year: 36% for winter compared with 26% for spring, 16% for summer, and 22% for fall.

“Despite its reputation as a low-impact sport, pickleball can pose serious risk for players, especially if they have weaker bones from osteoporosis,” said Kurt P. Spindler, MD, an orthopaedic surgeon at Cleveland Clinic in Florida.

Dr. Spindler noted that physicians should discuss the risk of injury with their patients who play pickleball, including how the risk can be reduced. For example, patients with osteoporosis or at risk for osteoporosis should be encouraged to build bone mass, such as engaging in weight-bearing activities and taking calcium and vitamin D supplements as needed.

Source

Ghattas YS, Zeblinsky PJ, Cassinat JJ, Aceto M, Spindler KP, Cannada LK. Trends in Pickleball- Related Fractures in the United States: An Analysis of the 2002-2022 National Electronic Injury Surveillance System (NEISS) Database (ePoster 3212). Presented at the American Academy of Orthopaedic Surgeons’ 2024 Annual Meeting, February 12-16, 2024, in San Francisco, California.

Reference

1. Sports & Fitness Industry Association. Pickleball sees unprecedented growth: will require 25,000 courts built, $900 million investment to keep up with demand. 2023 August 10. Available at https://sfia.org/resources/pickleball-sees-unprecedented-growth-will-require-25000-courts-built-900-million-investment-to-keep-up-with-demand/. Accessed February 16, 2024.