Understanding the Risks of Pickleball and How to Prevent Injuries
Opinion Advocates for ideas and draws conclusions based on the author/producer’s interpretation of facts and data.
By Dr. John Jude Shlimoun
Pickleball is the fastest growing sport in America, gaining popularity and new players in all age groups every day.
Pickleball is a racquet sport that can be played indoors or outdoors on a court that is substantially smaller than a tennis court, which requires less running, but with similar lateral movement, cutting and jumping.
Though pickleball is a game played by all ages, the core group of participants tend to be older, with 75 percent of players being 55 years old and up, according to USA Pickleball. The combination of picking up a novel sport, age and previously sedentary lifestyles has severely increased the risk of injury when playing pickleball. As the popularity of the sport continues to grow, the risk of injury does as well.
When reviewing injuries associated with playing pickleball, here are the most common.
Ankle Sprains. This injury mainly occurs with inversion, or a rolling of the ankle inward, which is very common in tennis. The mechanism for this injury would be similar for pickleball. Depending on the severity, ankle sprains could result in reduced movement or inability to bear weight without pain.
If weight bearing is painful, initial treatment may initially include crutches or immobilization with an ankle brace. Further treatment consisting of relative rest, icing, compression and elevation (RICE) are generally useful in the treatment of ankle sprains. Depending on severity, ankle sprains can take several weeks to resolve, but patients can generally resume their previous level of play if proper steps are taken during the healing process.
Achilles Strains/Tears. Most commonly this injury is associated with pain along the Achilles tendon, which will be predominantly felt at the posterior portion of the lower leg down to the heel bone.
Treatment of Achilles tendon strains includes rest, focused stretching of the tendon and controlled strength training of lower leg musculature. This injury can take numerous weeks to heal.
A less common but more severe injury, Achilles tendon rupture can occur with forceful movement of the ankle, usually a rapid change of direction and abrupt plantarflexion of the foot and ankle. This injury usually results in severe pain in the posterior ankle and an inability to bear weight or actively plantarflex the foot. This type of injury will often require surgical repair and should be evaluated promptly.
“Pickleball Elbow.” An overuse injury associated with repetitive forceful gripping, repeated ball striking and improper technique. These chronic injuries respond well to rest, flexibility training and gentle resistance exercise targeting the forearm, elbow and shoulder musculature. Bracing of the wrist or elbow can also potentially provide increased comfort and stability while healing.
Wrist Fractures. Falls onto an outstretched hand are a common mechanism for wrist sprains and can also result in a fracture. Typically, bruising and swelling will occur and an x-ray is usually needed to determine whether there’s been a fracture. Early mobilization and the RICE protocol are common forms of treatment.
Knee Meniscus and Ligament Damage. A sprain of the knee can affect both the ligaments and menisci, which is most commonly caused by rapid change of direction or lateral or pivoting movements. A sprain will often result in pain while bearing weight, and is usually worse with lateral movement. Acute injuries of the meniscus can include tears, which can present similarly as ligament sprains, but often will result in the inability to bear weight, decreased range of motion and significant swelling.
Falls tend to be the leading cause of injury while playing pickleball due to the fast pace of the sport and the constant change of direction and position.
Physical therapy can play a crucial role in injury prevention and rehabilitation in the most timely and effective manner. When returning following an injury or before beginning a new sport such as pickleball, a physical therapy screening should be conducted to test for strength, motion and balance impairments. Once the impairments are noted, a guided strength and flexibility program will be developed and a dynamic warm-up and cool-down will be provided.
A physical therapist will ultimately guide the patient each step of the way in terms of strengthening proper musculature as well as performing dynamic warm-ups to ultimately reduce the risk of injury and optimize function.
Dr. John Jude Shlimoun is a physical therapist at ProClinix Sports Physical Therapy & Chiropractic in Larchmont. For more information about this article or physical therapy, he can be reached at jshlimoun@proclinix.com. You may also visit www.proclinix.com.
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