Pickleball Pleasures and Pitfalls

The Game Requires Agility and Quick Thinking. But it Can Leave You in a Pickle if You Overdo it or Fall

One of the fastest growing and popular sports among older adults is easy to play and lots of fun. But pickleball, with its funny name, comes with some serious risks. "It has a quick pace and a lot of stops, starts, and changes in direction that can lead to leg injuries and falls," says Clare Safran-Norton, clinical supervisor of rehabilitation services at Harvard-affiliated Brigham and Women's Hospital.


Pickleball is a hybrid racquet sport that combines aspects of tennis, table tennis, and badminton. The game is played indoors or outdoors on a small court (20 feet by 44 feet, about the size of a badminton court) resembling the top of a giant Ping-Pong table. The net dividing the court is a few inches shorter than the net on a tennis court.

You play pickleball in singles (one against one) or doubles (two against two) with large, lightweight paddles that are a little bigger than Ping-Pong paddles.

The pickleball itself is similar to a Wiffle ball, full of holes. It travels slower and bounces lower than a tennis ball, making it easier to hit.


Pickleball has many benefits. It's less taxing than tennis -- you don't have to hit the ball as hard or run as far to reach it, which is easier on the knees. Overhead serves are not allowed in pickleball, which is good for tight shoulders. The fast pace of the game (like table tennis) requires a lot of eye-hand coordination, which keeps thinking skills sharp, and lateral (side-to-side) motion, which boosts balance and strength. The sport engages your leg, core, arm, and shoulder muscles, and it's a weight-bearing activity, which is good for your bones. Also: because the pickleball court is small, you're in close proximity to the other players, making the game very social.


"Social networking and the number and quality of social connections are emerging as huge determiners of health and longevity. Particularly for older people who might tend to be isolated, this is a great way to get out into the community and enjoy the camaraderie of a fun sport," says Dr. Aaron Baggish, director of the Cardiovascular Performance Program at Harvard-affiliated Massachusetts General Hospital.


Ben Johns is the US Open and Nationals Champion and ranked #1 in the world for pickleball. (Getty)


Pickleball has some drawbacks. One is that it's not an aerobic workout. "Playing pickleball won't provide the same cardiovascular benefits as 30 minutes of jogging," Dr. Baggish says. "The game is best as a complement to your exercise regimen, not a replacement for aerobic activity." Another drawback: like any sport, pickleball has injury risks, including the following.


Ankle injuries. A quick change of direction or lateral motion could cause an ankle strain (an overstretched Achilles tendon) or an ankle sprain (a tear of the anterior talofibular ligament on the front and outside of the ankle).


Knee injuries. Lateral motion can also lead to a knee sprain -- a tear in the medial collateral ligament, which supports the inner side of the knee.


Leg muscle injuries. Taking big strides with tight hamstrings (in the back of the thighs) could cause strains or tears in those muscles.


Elbow injuries. Twisting your wrist repeatedly as you prepare to hit the ball with your paddle can cause tiny tears in a tendon in your forearm. The inflammation, tenderness, and pain in the elbow (where the tendon attaches) are characteristic of lateral epicondylitis, informally known as tennis elbow.


Shoulder strains. Reaching up for an overhead shot may lead to a tear in the rotator cuff (the group of tendons and muscles that helps you raise and rotate your arm).


Falls and fractures. Taking quick steps backward to hit the ball may cause you to lose your balance. "When we fall, we put our hands out for protection. It's a natural reaction. But you can break your wrist," Safran-Norton says.


A group of seniors participate in a coed recreational pickleball league at the Milliken Park Community Recreation Centre. (Getty)


With your doctor's okay (especially necessary if you have heart, endurance, or balance problems), prepare for pickleball by wearing the right clothing (shorts, not loose pants that can make you trip), shoes (court sneakers, not running shoes), and goggles to protect your eyes from fast-flying balls.


Before playing, warm up your muscles with five minutes of brisk walking around the pickleball court. This gets blood flowing to your muscles and makes them more amenable to the demands you're about to place on them.


During the game, don't risk falls. "Don't scoot backward to get to the ball if your partner is closer and can get the shot," Safran-Norton advises.


After the game, stretch your muscles. "Focus on your hamstrings, calf muscles, shoulders, and wrists. Hold the stretches for at least 30 seconds," Safran-Norton advises. Stretching will keep your muscles long and flexible, which will help prevent injuries the next time you're on the pickleball court for fun and friendly competition.