Pickleball Seen as Driving Up Injuries, Health Care Costs, for Seniors

ZURICH, Switzerland — Pickleball — a silly sounding activity that’s taken the country by storm — may be the leading cause of injuries that have led to a marked increase in people, especially seniors, using health care services, according to a new analysts note from UBS, the global financial services company.

In the note, which was released Monday, the analysts estimated that roughly 22.3 million people will play pickleball this year, about one-third of them seniors.

And according to a recent report from the Sports and Fitness Industry Association, pickleball is currently the fastest growing sport in America.

“Participation nearly doubled in 2022, increasing by 85.7% year-over-year and by an astonishing 158.6% over three years,” the SFIA report said.

While getting out in the fresh air and sunshine and engaging in physical activity is a good thing, UBS has found there’s a dark side to pickleball mania.

For starters, injury data related to pickleball, a sport that combines elements of tennis, badminton and ping-pong — shows that injuries among players 60 and older have been rising rapidly in recent years.

As a result, UBS analysts are predicting that this year, pickleball will lead to 67,000 visits to hospital emergency rooms, 366,000 outpatient visits, 8,800 outpatient surgeries and 4,700 hospitalizations.

They go on to estimate all these treatment visits and procedures will result in about $377 million in health care costs, though the number could be as high as $500 million.

The analysts’ interest in pickleball was stirred by two factors, and both in the name of providing timely information to health care investors. The first is the impact of the maturing recovery from the recent pandemic on the health care marketplace.

The other is a recent surge in the number of seniors enrolled in Medicare who have been undergoing surgeries on their knees and hips.

And what they concluded is that pickleball is “a microcosm for broader trends in the senior population that may have an outsized impact during the reopening phase.”

“Compared to previous generations, seniors are living longer and are more active,” the UBS analysts continued. “They have shown a greater preference to age in place, exercise, play sports and travel. 

“While we generally think of exercise as positively impacting health outcomes, the ‘can-do’ attitude of today’s seniors can pose greater risk in other areas such as sports injuries, leading to a greater number of orthopedic procedures,” they said, adding, “The heightened injury risk is especially true when considering that seniors’ activity levels were depressed for most of the pandemic.”

Pickleball is only one of the examples they cite for how the current generation of seniors is consistently engaging in more active lifestyles. 

The latest trends in both fitness and travel indicate the 65+ adults are engaging more with these lifestyle options.

The percentage of trips taken by older people increased from 11.9% in 2001 to 15.8% in 2017.

The percentage of people between 65-74 who met the current physical activity guidelines promulgated by the Department of Health and Human Services have increased in recent years.

The latest data show that in 2018 17.1% of people ages 65-69 years and 14.1% of people ages 70-74 years were meeting the aerobic and muscle-strengthening guidelines, while 34% of all gym memberships were held by people over 65 years of age in 2019.

Further, the American College of Sports Medicine says that for 2023, fitness programs for older adults ranked as the No. 4 fitness trend, just behind wearable technology, strength training with free weights and bodyweight training. 

The UBS analysts suggest pickleball’s appeal to seniors is based on the fact it is seemingly low-impact and that there are few if any barriers to participation.

Demographically, players tend to be Caucasian (73%) with smaller proportions of Hispanic (13%), African Americans (7%) and Asian Americans (5%). 

Additionally, pickleball players tend to be in higher income brackets: 45% of players earn more than $100,000 in annual income and 76% earn more than $50,000 in annual income.

The analysts say pickleball injuries tend to be strains, sprains or fractures and are generally in the wrist and lower leg, head or lower trunk.

They go on to state that the breakdown of injury diagnoses shows that over 60% of injuries due to pickleball are sprains, strains and fractures; while 20% are contusions, abrasions or internal injuries; and less than 10% are lacerations or dislocations. 

When examining pickleball injuries by body part, the top four impacted areas include the wrist, lower leg, head and lower trunk, which collectively make up 50% of all injuries.

The analysts also conclude that it’s “plausible” that pickleball medical costs are driving 5%-10% of the unexpected medical cost trend this year.

Scrutiny of pickleball injuries is nothing new. In 2019, the Journal of Emergency Medicine published a report on pickleball injuries treated in emergency rooms.

That analysis was performed using data for the period extending from 2001 to 2017 from the National Electronic Injury Surveillance System of the U.S. Consumer Product Safety Commission.

Based on that data, a total of 300 pickleball-related injuries were identified, and that was extrapolated to a national estimate of 19,012 injuries. 

The increase in the annual estimated number of injuries was particularly notable between 2013 and 2017, with patients 50 or older accounting for 90.9% of the patients.

The data also indicated a slight majority of the patients (50.4%) were males and that in most cases (74.3%) the injury occurred at a sports or recreational facility. 

The most common injuries were strain or sprain (28.7%) and fracture (27.7%). The affected body part was the lower extremity in 32% of the cases and upper extremity in 25.4%. 

The patient was treated or evaluated and released from the emergency rooms in 88% of the cases.

“Based on NEISS data, pickleball-related injuries have been increasing in recent years,” the researchers in the older study said. 

“Although pickleball-related injuries have many similarities with those associated with other racquet sports, there were various differences (including the growth rate of injuries and the older patient age) that may need to be considered for the prevention and management of injuries related to the sport.”

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