Pickleball injuries: what the studies show

Not medical advice. This page summarizes published studies and guidance from medical organizations. If you are hurt, or unsure whether you are fit to start playing, see a clinician.

Pickleball's growth has produced a steady run of injury studies. Nearly all of them count the same thing: emergency-department visits recorded in one federal database. Knowing how that database works explains why the studies agree on the pattern but not on the exact numbers.

Where the numbers come from

The National Electronic Injury Surveillance System (NEISS), run by the US Consumer Product Safety Commission (CPSC), collects cases from a probability sample of hospitals with an emergency department and turns them into national estimates. Three limits matter when reading pickleball figures:

• It covers injuries treated in hospital emergency departments. Visits to urgent care, a doctor's office or physical therapy are outside it.
• Researchers find pickleball cases by searching each case's short narrative, so search terms and exclusions differ between studies.
• Estimates rest on a few hundred real cases. CPSC's own query site treats an estimate as potentially unreliable if it is below 1,200, uses fewer than 20 records or has a coefficient of variation above 33%.

The main studies

Even single-year totals differ. For 2022, Cheng's team estimated 16,997 visits and Jones and Hammig 17,416, while Massillon and colleagues' 2025 review cites Yu's team at 13,690 cases that year (up from 611 in 2013).

• Cheng et al. 2024
• Jones & Hammig (2022 data)
• ValuePenguin 2026, not peer reviewed

1. 2018: 8,304 visits (ValuePenguin).
2. 2020: 8,894 (Cheng et al.).
3. 2021: 14,808 (Cheng et al.).
4. 2022: 16,997 (Cheng et al.).
5. 2022: 17,416 (Jones and Hammig), a separate estimate of the same year.
6. 2024: 32,960, the peak in ValuePenguin's series.
7. 2025: 31,463 (ValuePenguin).

What the injuries are

All the studies put fractures, sprains and strains at the top, and falls as the main cause, but the shares differ:

*Slips, trips, falls and dives combined. Part of the spread is coding: "other or unspecified injury and pain" was 25% of Cheng's estimate and the largest group in ValuePenguin's (29.6%).

Where on the body: Cheng's team found 31% upper extremity, 26% lower extremity, 25% trunk and 12% head or neck. Fractures were mostly upper extremity (63% in Cheng, 66% in Ghattas), while 62% of strains and sprains were in the legs (Cheng). Yu's team named the wrist the most injured site, at 12.7% of all injuries. A clinic series by Kasper and colleagues (2023), cited in Pergolizzi's 2023 review, found the wrist was the most frequent site (44.7%) among 204 patients with acute arm injuries from pickleball or paddleball; 19.1% had surgery. Massillon's 2025 review notes that Achilles tendon rupture and displaced wrist fractures are often strong indications for surgery.

Who gets hurt

• Age. Cheng's patients averaged 63.9 years, and ages 60–79 made up 73% of injuries. In Yu's data, paddle strikes led among players 17 and under and twisting injuries among those 18–34; Massillon's review reports that younger players more often injure their legs, and older players more often their arms, with more fractures.
• Sex. Cheng's estimate was 51% female. In Weiss's data women had 3.7 times the odds of a fracture and 9.3 times the odds of a wrist fracture, and men 3.5 times the odds of a strain or sprain. Women accounted for 69% of fractures in both Ghattas and Yu, yet men with fractures were 2.31 times as likely to be admitted (Ghattas).
• Admission. Patients 65 and older had 2.48 times the odds of admission (Cheng).

These are counts of visits, not injuries per hour played, so they show where injuries concentrate rather than how risky an hour of play is. Massillon's review puts players over 65 at 15.4% of players but says they are disproportionately injured. Cleveland Clinic pain specialist Trishull Kapoor (2026) calls pickleball "still safer than most other sports to play" and links the rise to more people playing.

Eye injuries: two studies, two different causes

Eye protection is not required in pickleball. Mass General Brigham ophthalmologist Nimesh Patel advises sports eye protection every time you play, says everyday glasses and sunglasses are not enough and does not recommend lensless pickleball glasses. According to Mass General Brigham, the American Academy of Ophthalmology recommends that USA Pickleball adopt standardized protective-eyewear guidelines.

Heart and heat events

Not every visit is an injury. In Weiss's data, non-injury cases, mainly cardiovascular, were 11% of senior pickleball cases versus 21.5% for tennis. Cheng's team coded 4% as fainting, heat exhaustion or dizziness and 2% as cardiac arrest or heart attack. The Arkansas summary of Jones and Hammig's study says most admissions were for cardiac arrest, and Jones suggests adults over 50 consult a doctor before taking up the game.

Prevention advice from medical sources

1. Warm up. AAOS OrthoInfo suggests light stretching and bodyweight exercises, then gentle hitting drills before full effort; Pergolizzi's review suggests 5–10 minutes.
2. Wear court shoes. Pickleball or tennis shoes (OrthoInfo); a good fit, cushioning, arch support and grip, with ankle braces as an option (Cleveland Clinic).
3. Pace yourself. Shorter sessions (OrthoInfo), rest between games, and beginners not taking on advanced players (Cleveland Clinic).
4. Hydrate. Dehydration brings fatigue and slower reactions (OrthoInfo).
5. Get coaching. Poor form can lead to injury (OrthoInfo); Massillon's review stresses deceleration and overhead technique.
6. Train balance and strength. Massillon's review recommends balance, rotator-cuff, leg and core work, and Pergolizzi's review advises against running backward.
7. Protect your eyes with sports eyewear (Mass General Brigham).
8. Stop at pain. Kapoor advises stopping at any sign of pain and seeing a physician if it lasts more than a few days.

Checklist before you play

• Court shoes with grip and side support.
• Water on the bench.
• Warm-up done, including easy hitting.
• Sports eyewear on.
• Plan to let deep lobs go rather than backpedal.
• Pain, chest symptoms or dizziness: stop and get checked.

Related: paddle weight, grip size and tennis elbow, court surfaces, including cushioned coatings, how to play.