Don’t get in an injury pickle by overdoing trendy games

pickleball-300x178The newly familiar thwack, pop, and crack of the pastime of pickleball, alas, is increasingly accompanied by some other sounds — the moans and groans of picklers who find themselves with injuries that can be more than annoying for older aficionados of this trendy sport.

Noe Sariban, a pickleball instructor, former pro player, and a physical therapist who markets himself as the Pickleball Doctor, told the New York Times about the rising list of injuries he sees regularly from a game that is played in a constrained space and purports to offer a less-strenuous alternative for those who can’t quite cover an expansive court any more in other racket sports:

“Achilles’ strains or tears, shoulder problems, rotator cuff injuries, lower back problems such as disc injuries, muscle strains …”

The newspaper also reported this:

“The number of injuries [among picklers] ‘grew rapidly’ from 2010 to 2019, according to an analysis of emergency-room visits related to pickleball published last year in the journal Injury Epidemiology. The article focused on injuries among people over 60 because players in that demographic accounted for 85% of the visits, the study found. The most common injuries were sprains, strains, and fractures. The study found that by 2018 the number of emergency-room visits related to pickleball among people 60 and older equaled the number for tennis. Many pickleball players are older; the average age is 38, but half of all ‘core’ players — meaning devotees — are 55 and above, according to USA Pickleball, which calls itself the sport’s governing body. In general, older bodies are more likely than younger ones to have existing strains, which are easily amplified. But pickleball is deceptively demanding at any age. It involves quick stops and starts, and lots of lunging and twisting, said Dr. Neil Roth, an orthopedist in Westchester County, N.Y. Overhead shots tear at shoulder joints. And on a small court the effort seems innocuous, so players tend to reach or bend to make a play that is harder on the body than it looks. In tennis, a new player might not think to chase down a distant ball, whereas in pickleball the temptation is greater to bend, reach, charge.”

This also correlates with a significant category of injury in the game, described by experts who treat these in ERs succinctly as “Slip/Trip/Fall/Dive.” Pickleball has a no-fly zone where its players maximize their prospect for injuries — which may not be greater than in other sports but are perceived to be far less (a risky combination):

“Then there’s the Kitchen. Its official name is the nonvolley zone, a seven-foot strip in front of the net on both sides. (An official pickleball court is 44 feet long and 20 feet wide.) Players are not allowed to step foot in the Kitchen to volley, so when a ball heads there a player might bend forward to return a ‘dink,’ a cunning shot that hops over the net and lands in the opponent’s Kitchen.”

The New York Times reported that responding to Kitchen deviousness can be costly, with players fracturing wrists, herniating discs, and popping knees. Proper stretching can help avert common strains and sprains. So, too, can players’ simple awareness that they should not over compete and may not be as spry as they would hope. Well….

In my practice, I not only see the harms that patients suffer while seeking medical services, but also the clear benefits they may enjoy by staying healthy and far away from the U.S. health care system. It is fraught with medical errorpreventable hospital acquired illnesses and deaths, and misdiagnoses. Patients also suffer far too many harms due to bankrupting and dangerous drugs.

Exercise — including popular sports like pickleball — can provide proven benefits to maintain and improve our health.

But this is a gentle, seasonal reminder that games must stay fun and relaxing, and it helps to pursue them in moderation. With Labor Day arriving and schools, colleges, and universities having students return for classes, the summer comes to an end. Weekend warriors and sandlot heroes now will turn anew to the rough-and-tumble of (touch) football, more tennis, running, lacrosse — and other heart-rate raising, mind-clearing pursuits, including plenty of pickleball.

As we enjoy the in-person camaraderie of sports and sporting events, especially as we’re vaccinated and taking appropriate coronavirus precautions, please be mindful that athletics can lead to injuries severe enough to require ER and other medical interventions, all of which have their own risks. Longer-term consequences can result from athletic over exuberance, including progressive damage to knees, hips, shoulders, and backs. Head harms, especially of the serious, concussion variety, can be a serious hazard of sports involving all manner of contact. Older adults, many of whom participated ferociously in sports in ways their parents never did, are leading a parade to operating suites for knee and hip replacements.

‘Nuf said? Play on! Here’s to a safe, sane, healthy autumn, all.

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