DON’T FALL FOR IT: THE MOST IMPORTANT THING TO PREVENT PICKLEBALL INJURIES IN OLDER ADULTS

Pickleball is the fastest growing sport in America across all age groups.  With its increased popularity there is also an increase in injuries.  The most common cause for injury in older adults is a fall [4].  Even though there is extensive research on falls and fall prevention in older adults, there is little research on falls while playing pickleball.  

Being that 30% of adults over 65 will fall each year [1] it is critical that preventing falls is taken seriously both on and off the pickleball court.

Fall prevention is a complex issue.  There is more to it than wearing good footwear and warming up before play even though those are good things.

There are 3 key questions to consider first if you are over 65:

1. Have you fallen in the last year?
2. Do you feel unsteady when standing or walking?
3. Do you have worries about falling?

If the answer to any of these questions is yes, call your health professional for advice [1].

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Depending on your situation, there are many things that might need assessment such as:

• Mobility
  • balance (static, anticipatory and reactive)
  • gait
  • muscle strength
  • footwear and foot problems
  • fear of falling
• Sensory function
  • dizziness or vestibular issues
  • vision
  • hearing
• Cognitive function
• Autonomic function
  • orthostatic hypotension
  • urinary incontinence
• Acute or chronic diseases
• Medications
• Nutrition
• Environmental issues

One of the only studies available on falls and pickleball [2] found that those who had a slower speed on a modified T test (running forward/backward and shuffling right and left on a pickleball court) were more likely to fall than those who were faster.  And the best test we physiotherapists have presently for screening for falls for older adults is gait speed [1]. It’s an easy test and if it flags interest in further testing and targeted treatment to keep you on the court, it’s worth it.

Speed, which may also relate to strength [3], appears to be an important piece to identifying risk of falls when playing pickleball. With further research, perhaps there will be a screening test for identifying those at risk of falling specifically when playing pickle ball.  Stay tuned.

But for now, be ready, be steady!

References:

1. Montero-Odasso Manuel et al. World guidelines for falls prevention and management for older adults: a global initiative.  Age Ageing 2022; 51: 1-36. doi.org/10.1093/ageing/afac205.
2. Myers Betsy, Hanks June. Hip Strength, Change of Direction, and Falls in Recreational Pickleball Players.  Int J Sports Phys Ther. 2024 Sep 1;19(9):1116-1125. doi: 10.26603/001c.122490. eCollection 2024.
3. Rodrigues Filipe et all.  Effects of Muscle Strength, Agility, and Fear of Falling on Risk of Falling in Older Adults. Int J. of Environ. Res. Public Health 2023, 20, 4945. https;//doi.org/ijerph20064945.
4. Yu et all. Increasing Incidence of Pickleball Injuries Presenting to US Emergency Departments – a 10-year Epidemiologic Analysis of Mechanisms and Trends. The Orthopaedic Journal of Sports Medicine, 13(1), 2025.  DOI 10.1177/23259671241305364.