Non-fatal senior pickleball and tennis-related injuries treated in United States emergency departments, 2010–2019

Abstract

Background Pickleball is growing rapidly with a passionate senior following. Understanding and comparing players’ injury experience through analysis of a nationally representative hospital emergency department sample helps inform senior injury prevention and fitness goals. Methods A cross-sectional descriptive study was performed using 2010 to 2019 data from the U.S. Consumer Product Safety Commission’s (CPSC) National Electronic Injury Surveillance System (NEISS). Tennis was selected for comparison purposes because of the similarity of play, occasional competition for the same court space, and because many seniors play both sports. Non-fatal pickleball and tennis-related cases were identified, examined, recoded, and separated by injury versus non-injury conditions. Since over 85% of the pickleball injury-related cases were to players ≥60 years of age, we mostly focused on this older age group. Analyses consisted of descriptive statistics, injury frequency, type and trends over time, and comparative measures of risk. Results Among players ≥60 years of age, non-injuries (i.e., cardiovascular events) accounted for 11.1 and 21.5% of the pickleball and tennis-related cases, respectively. With non-injuries removed for seniors (≥60 years), the NEISS contained a weighted total of 28,984 pickleball injuries (95% confidence interval [CI] = 19,463–43,163) and 58,836 tennis injuries (95% CI = 44,861-77,164). Pickleball-related injuries grew rapidly over the study period, and by 2018 the annual number of senior pickleball injuries reached parity with senior tennis-related injuries. Pickleball-related Slip/Trip/Fall/Dive injury mechanisms predominated (63.3, 95% CI = 57.7–69.5%). The leading pickleball-related diagnoses were strains/sprains (33.2, 95% CI = 27.8–39.5%), fractures (28.1, 95% CI = 24.3–32.4%) and contusions (10.6, 95% CI = 8.0–14.1%). Senior males were three-and-a-half times more likely than females to suffer a pickleball-related strain or sprain (Odds Ratio [OR] 3.5, 95% CI = 2.2–5.6) whereas women were over three-and-a-half times more likely to suffer a fracture (OR 3.7, 95% CI = 2.3–5.7) compared to men and nine times more likely to suffer a wrist fracture (OR 9.3 95% CI = 3.6–23.9). Patterns of senior tennis and pickleball injuries were mostly similar. Conclusions NEISS is a valuable data source for describing the epidemiology of recreational injuries. However, careful case definitions are necessary when examining records involving older populations as non-injury conditions related to the activity/product codes of interest are frequent. As pickleball gains in popularity among active seniors, it is becoming an increasingly important cause of injury. Identifying and describing the most common types of injuries may can help inform prevention and safety measures.

Exploring Training Strategies to Optimize Court Performance in Older Pickleball Athletes

“…The most common mechanism of injury was classified as a slip, trip, fall, or dive comprising just over 63% of cases. Similar to the analysis from Forrester et al (15), strains or sprains were the most common injuries reported (33.2%); fractures were the second most common pickleball injury (28.1%) reported (35). However, in the analysis by Weiss, upper-body injuries, such as to the wrist, were slightly more common than lower-body injuries (13.2%, 12.9%) (35).…”

“…An injury analysis conducted by the authors yielded 4 recent references which discussed pickleball injuries (2,15,34,35). A case-report analysis of an older pickleball athlete (age 71 years) presented a unique hamstring injury coupled with a full-width tear of the left adductor magnus tendon at its ischial attachment (34).…”

“…Lower-body injuries were reported at a higher frequency than upper-body injuries (15). Weiss et al explored nonfatal pickleball and tennis injuries using data from the Consumer Product Safety Commission compiled between 2010 and 2019 (35). The total number of pickleball injuries reviewed was 523 cases.…”

“…The total number of pickleball injuries reviewed was 523 cases. The average age was 66 years; however, ages 60–79 comprised over 81% of reported injuries (35). The most common mechanism of injury was classified as a slip, trip, fall, or dive comprising just over 63% of cases.…”

Pickleball and mental health in adults: A systematic review

“…In addition, as suggested by numerous authors such as Greiner (2019), Quail (2019), Forrester (2020), Vitale and Liu (2020), Weiss et al (2021), Atkinson et al (2022); pickleball is a sport-physical activity with a very low prevalence of accidents and injuries. This means that it is a safe sport with few risks to people's health.…”