Pickleball Pains: A 10-year Epidemiologic Analysis of Rising Upper Extremity Injuries

Background Pickleball has emerged as one of the fastest-growing sports in the United States, with participation expanding across all age groups. Pickleball is thought of as a low impact sport and a better understanding of injury patterns would help guide prevention strategies particularly in older, at-risk populations. Purpose The purpose of this study is to examine pickleball-related upper extremity injuries and report the incidence, type, and comparison to tennis-related injuries. Study Design Descriptive Epidemiology Study Methods Data from 2014 to 2023 were extracted from the National Electronic Injury Surveillance System (NEISS) to identify pickleball-related upper extremity injuries. Weighted national estimates were calculated and combined with Sports and Fitness Industry Association (SFIA) participation data to determine injury incidence per 100,000 participants. Injuries were categorized by anatomical location and type. Comparable tennis injury data during the same period were also analyzed. Results From 2014 to 2023, pickleball participation increased from 2.46 million to 8.95 million, reflecting an average annual growth rate of 24%. Weighted data showed that pickleball injuries were more common among individuals over 60 years (83.1%) and females (59.0%). The most frequent pickleball injury type was fractures (58.6%). Throughout the study period, females (n = 6311; 71.7%) suffered more fractures when compared to males (n = 2437; 39.8%). Tennis injuries predominantly affected individuals under 60 years (53.0%) and males (54.2%). The incidence of pickleball-related injuries per 100,000 participants increased from 5.27 in 2015 to a peak of 62.74 in 2021. Conclusion Pickleball-related upper extremity injuries have increased significantly over the past decade, with the highest incidence in older adults and female players. Fractures were the predominant injury type, suggesting that the sport poses a greater injury risk than commonly assumed. Physicians should proactively counsel patients on prevention strategies as the sport continues to grow in popularity.