(Photo by David Maialetti, The Philadelphia Inquirer)
Doctors who hadn’t heard of the game or taken care of anyone with a pickleball injury as recently as two years ago now report treating many more players, most of whom are over 55, for fractures and soft-tissue maladies. Preventive measures such as warmup stretching, using resistance-exercise bands and wearing supportive shoes tied tightly with a double knot are now being stressed.
More than three million people in the U.S. now play pickleball, the mash-up of Ping-Pong, badminton, and tennis, according to the Sports & Fitness Industry Association’s (SFIA) 2018 Pickleball Participant Report. That figure represents an increase of 12% over the previous year—but along with the gain in popularity have come more injuries, The Philadelphia Inquirer reported.
While there’s no database that tracks pickleball injuries specifically, “the conversation has become much more prevalent in my clinic,” said Samir Mehta, chief of the orthopedic trauma and fracture service at Penn Medicine, told The Inquirer.
“Two years ago, I hadn’t heard of pickleball or taken care of anybody with a pickleball injury,” Mehta said. But in the last year, he added, “I’ve taken care of three ankle fractures and one wrist fracture [incurred while playing pickleball]. That’s a relatively dramatic rise.”
Injuries include broken ankles, wrists, and shoulders, injured knee ligaments, and soft-tissue injuries such as tennis elbow, golfer’s elbow, rotator cuff tendinitis, and tears, The Inquirer reported. Most of Mehta’s patients who suffer pickleball injuries are over age 55, which coincides with that SFIA’s report that 75% of core pickleball participants (those who play eight or more times a year) are 55 and older.
“With older people playing, osteopenia and osteoporosis are a large contributor to the injury risk,” Mehta told The Inquirer. “If a 20-year-old had the same injury event, they probably wouldn’t have the same injury.”
Older people may already have existing problems, such as arthritis, that playing pickleball may aggravate, or that may affect agility, The Inquirer reported.
“I would certainly encourage people to play [pickleball], especially if they like it,” Marc Harwood, chief of the nonsurgical sports medicine division at the Rothman Institute, told The Inquirer. “The challenge, though, is that it is a higher-impact activity and if you’re already dealing with some baseline wear and tear, it’s a setup for a potential injury.”
To try to avoid soft-tissue injuries, Harwood encourages players to warm up with gentle movements and stretch before playing. For instance, resistance-exercise bands are useful to stretch calf muscles. If you are sore before exercise, heat is helpful to warm up muscles, and if you get sore afterward, ice can help to control inflammation. Mehta also suggests taking the anti-inflammatory medication your doctor recommends, as needed. (Making a habit of taking too much ibuprofen, however, can lead to serious gastrointestinal trouble, The Inquirer noted.)
Plantar fasciitis an, inflammation of a thick band of tissue that connects the heel bone to the toes, tends to be a chronic condition, but a person who doesn’t get much exercise may not feel the symptoms, Harwood said.
“People who tend to get that from pickleball may not have been terribly active before,” Harwood noted. “Then you start doing high-impact activity, running, or specific jumping motions that you weren’t doing before, and it can irritate the plantar fascia. Going from being sedentary to playing a lot of pickleball is a risk factor, so you have to build up the amount of activity that you’re doing.”
Listen to your body, Mehta advised. “If you’re starting to fatigue or hurt, it means you need to take a couple weeks off to let it calm down, because pushing through it is like driving your car with a tire that’s out of air. The tire is not going to fill up with air all on its own.”
There’s no short-term fix for osteopenia or osteoporosis, Mehta added. “It’s something people should have already been managing, because you’re not going to all of a sudden get rid of osteopenia before a big pickleball game,” he said. The good news, The Inquirer reported, is that pickleball is an impact sport that will help with bone density.
Mehta also encourages players to wear supportive sneakers, tying their shoelaces tightly with a double knot, The Inquirer reported. Sometimes a brace or sleeve will give extra support, especially for those with a history of ankle or knee problems. Protective eyewear is also important, to help prevent eye injuries.
Guy Smith of Philadelphia now plays pickleball about four times a week and is diligent about stretching before each session, The Inquirer reported. Smith, 48, has had lower-back issues for many years and as a bartender spends a lot of time on his feet, so he said he is “being proactive by doing a lot of core and ab exercises [and that] has helped with my back problem.”
Smith took up pickleball about a year ago, enjoying the workout and competition, The Inquirer reported. But in the last two months, he began suffering from plantar fasciitis. “In between my ankle and heel, if I moved in a certain way I would get this shocking, stabbing pain,” he said. A doctor gave him a cortisone shot, but Smith thinks stretching exercises and orthotics have helped him the most.
Nancy Freedman, 68, loves playing pickleball, despite fracturing her hip during a game in 2017, The Inquirer repored. At the time, she had been playing two or three times a week, so she was in good shape. But she lost her footing on a routine shot, landing on her right hip.
After having surgery to insert a plate and pin, 11 months later she fractured her femur, though not while playing pickleball. Then she had to get the right hip replaced entirely.
No matter, The Inquirer reported—Freedman is now back on the pickleball court.
“It’s a very social game and is easy to pick up beyond a beginner level,” she said. “But then after you’ve played a half-dozen times, you see there’s a lot more strategy to the game than just banging the ball back and forth.”
When Freedman returned to the game, The Inquirer reported, she started back slowly, playing at a beginner level to regain her confidence. She’s careful to wear proper all-court shoes and stretch before playing.
“I’m still loving the game,” she said, though she is more wary than before. “Unlike in the past, I hold myself back from playing with people much better than me, or really hard hitters.”
Yet, The Inquirer reported, doctors like Mehta insist that “You should not change your lifestyle because of what might happen. The beauty of modern medicine is that we can fix things if something bad happens.”
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