Pickleball’s popularity brings more injuries

Photo by Aleksander Saks | Unsplash.com

By Dawn Fallik
Posted on February 06, 2026

Terry Landers’ pickleball injuries include two concussions, a broken wrist, a shoulder injury, a torn thumb and a black eye. None of those disasters kept her from the court. In fact, she had both knees replaced so she could keep playing.

The 69-year-old from Bridgton, Maine, was drawn to pickleball about a decade ago because it was a sport she could play year-round, and the community she found on the courts kept her coming back.

At one point, Landers taped her fractured wrist to her pickleball paddle to go to the emergency room.

“I broke it pretty good. I’ve got a plate and screws and all kinds of stuff going on in there,” she said.

Landers has a lot of company. Pickleball, a combination of tennis and ping-pong, has been the fastest growing sport in the country for three years in a row, according to the Sports & Fitness Industry Association.

Although the highest number of players fall in the 25-34 age bracket, it’s the older players who tend to run into walls and problems.

Taking a toll on the over-50 crowd

A 2024 study in Health analyzed nearly 17,000 pickleball-related injuries and found that 87% of emergency room visits involved people over 50. Orthopedic injuries were the most common, such as fractures, sprains and muscle tears, but cardiac incidents also stood out.

Ches Jones, an injury researcher at the University of Arkansas and lead author of the study, said the smaller court makes pickleball seem approachable, but too often players don’t realize they need to prepare physically.

“People think, ‘Oh, I can do this without getting proper doctor’s clearance,’” said Jones. “There’s a perception that pickleball is a less strenuous activity than other sports. But in actuality, pickleball can be very strenuous, especially on the cardiovascular system.”

‘Job security’ for surgeons

Frederick Azar is an orthopedic surgeon and director of the sports medicine fellowship at the University of Tennessee-Campbell Clinic. His clinic sees so many referrals to orthopedic surgeons from pickleball injuries that it became a joke that they invented the sport for job security, he said.

He said he started noticing that his patients who had pickleball injuries fell into certain patterns and wanted more information to help with injury prevention. In a 2024 review in the Journal of the American Academy of Orthopaedic Surgeons, he analyzed emergency room data from pickleball injuries from 2001 to 2017 and also surveyed clinic patients.

Like the Arkansas study, Azar found that wrist fractures and ankle sprains were common, along with soft-tissue injuries like tears and tendinitis.

Azar’s study also found that there were differences between genders — women were more likely to suffer fractures, often tied to bone health issues like osteoporosis, while men tended to sustain sprains and strains. Many issues stem from loss of balance as players move quickly front-to-back and side-to-side, he said.

Both studies highlighted another danger: the heart. In the Arkansas analysis of older players, one out of five injuries resulted in hospital admissions, with most admissions for cardiac arrest and 25% for fractures.

Azar said the cardiac numbers highlighted the need for a good check-up before hitting the court, particularly for sedentary people. In addition to a cardiac check-up, new players should ask their doctors about bone health, balance issues and medication side effects, like dizziness, that might result in injury, he said.

“It’s a new sport, so we’re trying to raise awareness and encourage people to take precautions because people can get hurt here,” he said.

Best to start slowly

Jon Herting, owner of Precision Performance Physical Therapy in Pennsylvania, holds a doctorate in physical therapy. He said many of the injuries he sees come from people jumping from a sedentary lifestyle onto the pickleball court without a lot of preparation.

One particular challenge with pickleball, Herting said, is that, like tennis, pickleball has a lot of sudden power-based movements, a skill that deteriorates as people age. Leaping suddenly for a ball or pushing off to run puts a lot of stress on the Achilles tendon, potentially causing tears.

“Obviously, we recommend that people maintain their strength to be able to play pickleball and maintain tissue elasticity,” Herting said. “But on top of that, think about introducing power-based exercise. It doesn’t have to be these big-box jumps that you see NFL players doing, but like simply jumping rope, which is a great activity. That’s a low barrier of entry.”

Start simply and build up, even if it’s starting with 10 repetitions, he said. People can start by holding onto a wall and practicing an explosive calf raise where the toes don’t leave the ground, building up to maintain balance.

For Terry Landers in Maine, the risks are worth it. After concussions, surgeries and a wrist held together by metal, she has changed nothing about the way she plays — except for wearing new pickleball shoes.

“No, no, I’m an idiot,” she said. “I play as aggressively as I always have.”