Physical Activity Intensity of Singles and Doubles Pickleball in Older Adults

The perils of pickleball: A two decade analysis of upper and lower extremity injuries from America's fastest growing sport

This study seeks to evaluate the epidemiology of pickleball upper/lower extremity injuries presenting to US emergency departments (E.D). The National Electronic Injury and Surveillance System (NEISS) database was queried from 2003-2022 to identify patients presenting to the ED with injuries sustained during 'pickleball' to upper/lower extremities. Patients were subsequently divided into pediatric, adult, and geriatric age groups. Demographic and clinical variables were assessed among age groups utilizing two-proportion z-tests with Bonferroni correction. A total of 749 patients with extremity pickleball injuries were identified from NEISS (33 pediatric, 286 adult, 430 geriatric). Pickleball extremity injuries dramatically increased from 2012 to 2022 by 3,650%. Geriatric and pediatric patients had greater frequencies of upper extremity injuries relative to adults (60.2% vs. 40.6%; p < 0.001 and 63.6% vs 40.6%; p = 0.022, respectively). Adults had a significantly greater frequency of lower extremity injuries (59.4%) relative to both pediatric (36.4%; p = 0.022) and geriatric (39.8%; p < 0.001) patients. Patients who were hospitalized after injury were significantly older (68.8 vs. 62.5; p = 0.033) and most commonly incurred a fracture (88.9% vs 34.8%; p < 0.001). This study provides a critical epidemiological analysis of injury trends captured in this popular sport.

Injury Epidemiology and Risk Factors in Older Pickleball Players

This study aimed to identify pickleball-related injury prevalence and risk factors in older adults and evaluate injury incidence during a pickleball tournament. A cross-sectional study analyzed self-reported injuries from the past 12 months and new injuries during the 2018 US Open Pickleball Championships. Data were collected on demographics, play characteristics, and psychological attributes. Injury details came from self-reports and medical tent records. Hierarchical logistic regression identified significant injury predictors. Of 237 participants, 32.1% reported past-year injuries, mainly in lower extremities (57.9%) and muscle/tendon tissues (61.8%). The tournament had a 5.8% incidence of new injuries, primarily in lower extremities and skin/muscle tissues. Key risk factors were male gender, lower BMI, and increased weekly play hours. No significant associations were found with psychological variables. Pickleball players have a high injury prevalence, especially in lower extremities, linked to longer play hours, male gender, and lower BMI.

Hip Strength, Change of Direction, and Falls in Recreational Pickleball Players

Background

While a high incidence of pickleball-related falls is reported, little is known regarding factors differentiating persons with and without a fall history during play.

Purpose

This study aimed to determine differences between recreational pickleball players who fell while playing and those who did not. Additional aims were to determine reasons for falling and to investigate associations among assessed factors.

Study design

Cross-sectional study.

Methods

Participants completed a survey reporting age, fall history, and reasons for falling during play. Hip abduction strength, single leg squat form, ankle dorsiflexion, and change of direction time using a modified T-test on a pickleball court (i.e. pickleball T-test) were assessed.

Results

Among the 92 individuals participating in the study, 42% reported a fall while playing and 30% reported falling more than once. Leading reasons for reported falls were lunging and moving backward. Participants who reported falling were significantly older (z = -2.60, p = 0.009) and slower on the pickleball T-test (z = -2.10, p = 0.036) than those who did not report falling. Hip abduction strength was not associated with fall history but was associated with faster time on the pickleball T-test (left rs = -.41, p < 0.001, right rs = -.48, p < 0.001). Single leg squat form and dorsiflexion were not related to fall history.

Conclusion

Falls are common among recreational pickleball players, particularly older players. Fall prevention programs for pickleball players should be considered including multi-directional lunging, lower extremity strength and power development, and change of direction training that includes moving backward.

Level of evidence

2.

Pickleball Participation and the Health and Well-Being of Adults-A Scoping Review

BACKGROUND

Pickleball has grown tremendously in recent years, yet little evidence exists regarding pickleball-related injuries. This scoping review extends current work on pickleball participation by identifying positive and negative health effects associated with the sport. We summarize how pickleball impacts the health and well-being of adult participants.

METHODS

Searches were conducted on MEDLINE, CINAHL, ProQuest Nursing, ERIC, SPORTDiscus, PsycINFO, Scopus, CBCA Complete, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, and ProQuest Dissertations and Theses. Selected studies considered aspects of health and/or well-being of adult pickleball participants. Using the population/concept/context framework, participants were healthy, able-bodied adults 18 years of age or over, who had played pickleball at least once. The positive and negative outcomes of pickleball on participants' health and well-being (concept) within the context of pickleball participation were examined. Full-text articles written in English since 2013 were included. Extracted data were tabulated, and a descriptive summary with thematic analysis was completed.

RESULTS

This scoping review comprised 27 articles that met the inclusion criteria. Pickleball is promising as an exercise intervention for all adults, and there is evidence of positive social and psychological effects, and health and fitness benefits to participating in pickleball by older adults.

CONCLUSIONS

Although we are still in the early stages of studying pickleball, there have been some documented health benefits of using the sport as a physical exercise intervention for adults. More research is needed on the types, prevalence, and severity of pickleball injuries and the sport's impact on younger players.

Validity and Reliability of Wearable Technology Devices during Simulated Pickleball Game Play

Pickleball is a popular sport. Also popular is wearable technology usage. Because the validity and reliability of wearable technology during pickleball is unknown, the purpose of this research was to evaluate the ability of common devices to return heart rate and estimated energy expenditure during pickleball activity. Twenty adult participants were outfitted with a portable metabolic unit and heart rate monitor (criterion measures). Experimental devices were a Garmin Instinct, Polar Vantage M2, Polar OH1, and Polar Verity Sense. Participants played simulated pickleball for 10 min. Validity measures included mean absolute percent error (MAPE) and Lin's Concordance Correlation Coefficient (CCC), whereas reliability measures included coefficient of variation (CV) and intraclass correlation coefficient (ICC). The heart rate returned lower than 10% MAPE across all devices (Instinct = 5.73-6.32%, Verity Sense = 2.92-2.97%, OH1 = 3.39-3.45%) and greater than 0.85 CCC (Instinct = 0.85-0.88, Verity Sense = 0.96-0.96, OH1 = 0.93-0.94). The CV was below 10% (Instinct = 9.30%, Verity Sense = 2.68%, OH1 = 5.01%), and ICC was above 0.7 (Instinct = 0.77, Verity Sense = 0.98, OH1 = 0.91). The energy expenditure MAPE was greater than 10% (Instinct = 27.67-28.08%, Vantage M2 = 18.87-23.38%) with CCC lower than 0.7 (Instinct = 0.47-0.49, Vantage M2 = 0.62-0.63). Reliability thresholds were met in the Vantage M2 (CV = 6%, ICC = 0.98) but not in the Instinct (CV = 15%, ICC = 0.86). The Instinct was neither valid nor reliable for estimated energy expenditure, while the Polar Vantage M2 was reliable but not valid. All devices returned valid and reliable heart rates during pickleball.

Treating Geriatric Sports Injury Among Pickleball Players: A Narrative Review of an Exercise Craze Among Seniors

The sudden and enormous popularity of pickleball has included a surprising and large contingent of geriatric players. Similar to tennis and badminton, pickleball is a game with a short learning curve that offers low-impact cardiovascular benefits. Unlike tennis, most injuries in pickleball are sustained by older rather than younger players. In fact, pickleball-related injuries increase with increasing age. Such injuries include strains, sprains, joint pain, falls, and fractures. The most affected joints are the wrists, shoulders, knees, and ankles. Clinicians can advise their older pickleball patients on strategies and tips to minimize the risk of injury. This may be particularly important because many older individuals playing pickleball today were previously sedentary. Older people may be attracted to pickleball because it is an inclusive sport with a high socialization factor. Nevertheless, pickleball can deliver an excellent cardiovascular workout and it may be an example of a successful way to promote exercise among older people and those who resist exercise.