The Pickle and Paddle Disaster
Pickleball in the US and paddle tennis in Spain and Argentina are behind the new high-volume referrals to orthopaedic offices. So much fun and so many injuries. Here is an update.
Pictured: Stone Clinic patient Kathy M. Kathy plays pickleball every day after a robotic partial knee replacement in 2017. Here she is celebrating a mixed doubles silver medal with her husband Richard after a pickleball tournament competition.
Pickleball, played at a high pace on a 20’ x 44’ court, started in the 1960s but has exploded in popularity over the past 15 years. The game initially attracted the attention of 60–80-year-olds who had reluctantly given up tennis but loved court games. With lighter rackets and a whiffle-like ball, pickleball is often played as a doubles game. The camaraderie and excitement become infectious. Lately, the game has attracted a much younger population, and the speed and competitiveness ramped up. Together, the combination of older people reentering an aggressive court game and younger people attacking the net has led to a parade of the injured into orthopaedic offices.
Paddle tennis, while not yet widely known in the US, also began in the 1960s. The court is 20’ x 40’, with walls that can be used to ricochet the ball. More a mixture of tennis and squash, the game initially attracted a younger age group and took off in the early 2000s. Given the balls’ weight and the rotation required to hit balls bouncing off the side and back walls, the injury patterns are more in the elbows and the back, whereas pickleball induced more Achilles, knee, and rotator cuff injuries.
Both sports are super fun and both, if you want to stay out of our offices, require a high level of preparation. As with skiing (if people really knew how dangerous the sport is they might never do it), pickle and paddle appear so easy to enter that people never fully understand the risk until they and/or their friends get hurt. And injury rates in these sports are skyrocketing, with pickleball estimated to have reached $500 million in healthcare costs in 2023 alone1.
So, not to be a downer, here is the message: Train for your sport. Sport is the wild, wonderful juice of life, which you need to squeeze progressively if you don’t want it to splatter all over. Enter these games after a good stretching and warming-up program. Pick partners who will play to your level, focusing on your strengths and avoiding your weaknesses. Remember that swinging a racket with speed requires rotation of the shoulder, back, and knees and that the tendons attached to them may not have seen such sudden dynamic loads for years.
Fortunately, the injuries caused by these two sports are all mostly fixable. The Achilles tendon can be sewn together without open surgery, the sore rotator cuffs treated with injections of growth factors, the injured meniscus and ACLs repaired and replaced, and the arthritic joints lubricated.
Think about the amount of time you’d spend in a post-injury rehab facility. Using this time for training before you get injured is a far better investment. Find a great trainer, a smart physical therapist, and a coach, and treat yourself the way a professional athlete would. Create a pre-season program using all the expertise available to you, and see yourself as an athlete in training—rather than as a patient in rehab.
- Cerullo M. Pickleball injuries could cost Americans up to $500 million this year, analysis finds - CBS News. www.cbsnews.com. Published June 27, 2023. Accessed August 25, 2023.
