The Epidemiology of Pickleball Injuries Presenting to US Emergency Departments

Abstract

Background:

The popularity of pickleball as a recreational and competitive sport has increased dramatically over the last decade in the United States.

Hypothesis:

To evaluate trends in pickleball injury rates and specific injury characteristics.

Study Design:

Descriptive epidemiology study.

Level of Evidence:

Level 3.

Methods:

The National Electronic Injury Surveillance System database was queried from 2014 to 2023 for national weighted injury estimates and injury characteristics from recreational pickleball players presenting to US emergency departments.

Results:

Annual national estimates of pickleball-related injuries increased significantly (P < .001) from 2014 (1313; CI, 550-2078) to 2023 (24,461; CI, 3837-45,086). A transient 19.3% reduction in injury rates occurred in 2020, coinciding with the COVID-19 pandemic. Most injuries affected people aged 60 to 79 years, with nearly equal sex distribution (51.2% men vs 48.8% women). Most patients were discharged, although 5 deaths due to cardiac arrest were reported. Women had higher odds of upper extremity injuries (odds ratio [OR], 1.66), hand/wrist injuries (OR, 3.22), and fractures (OR 3.03). Men experienced more lower extremity injuries (OR, 1.71), trunk injuries (OR, 1.28), lacerations (OR, 1.71) and strains/sprains (OR, 1.87). Women were more likely to fall (OR, 2.08), while men were more often hit (OR, 1.92) or overexerted themselves (OR, 1.89). Older adults, aged 60 to 79 years, had increased odds of wrist/hand injuries (OR, 1.47) and fractures (OR, 1.75), with falls being 2.10 times more likely in this cohort. People aged 40 to 59 years had higher odds of lower extremity injuries (OR, 2.09), whereas those <19 years had higher odds of dislocation (OR, 5.25), head injury (OR, 1.95), and laceration (OR, 2.83).

Conclusion:

Pickleball injuries affect predominantly older adults, with distinct sex and age-related patterns.

Clinical Relevance:

There is a need for age and sex-specific injury prevention strategies to enhance safety in pickleball participation.