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%; <i>p</i> < 0.001 and 63.6% vs 40.6%; <i>p</i> = 0.022, respectively). Adults had a significantly greater frequency of lower extremity injuries (59.4%) relative to both pediatric (36.4%; <i>p</i> = 0.022) and geriatric (39.8%; <i>p</i> < 0.001) patients. Patients who were hospitalized after injury were significantly older (68.8 vs. 62.5; <i>p</i> = 0.033) and most commonly incurred a fracture (88.9% vs 34.8%; <i>p</i> < 0.001). This study provides a critical epidemiological analysis of injury trends captured in this popular sport.