Story By Elizabeth Moore
Photo By Town of Chapel Hill
The first time Teresa Starr set foot on a pickleball court, she pulled a muscle.
“I admit, I’m a little competitive,” she said. “I went to lunge for a ball, and I popped my calf muscle.”
Starr, a 58-year-old former tennis player, was killing time at the UNC campus courts in spring 2018 while her daughter packed up to move out. Maybe it worked out in Starr’s favor, though. After the injury, she couldn’t help her daughter move boxes.
Pickleball, the fast-growing racquet sport akin to tennis, has historically been dominated by Baby Boomers who think they still got it but wind up with hamstring, shoulder and joint injuries.
Players aged 50 and older accounted for 90.9% of pickleball patients in a dataset from National Electronic Injury Surveillance System spanning 16 years, according to a February 2020 study in the Journal of Emergency Medicine.
The most common injuries were strain or sprain and fracture, similar to other racquet sports except for the increasing trend of injuries and the patient age.
Pickleball can make many a Boomer jock get cocky. The court for play is smaller than a tennis court. And a pickleball serve is underhand, in a motion like bowling that is much easier for beginners than the overhand serve in tennis. So many older players pick up the game fast – and attempt to play fast and hard. What they don’t realize is they’re more prone to injuries than they were in their heyday.
“I believe a bulk of the injuries are because people don’t realize at an older age, your body’s not what it was at 25,” said Leesa Walker, director of Pickleball Charlotte. “You’ve got to prep it for any type of exercise.”
Though the spike in pickleball popularity is slightly ahead of injury data, health experts suggest payers can protect themselves — and their pride — while taking part in the movement.
For Starr, even though she was sore for a few weeks after the injury, it didn’t stop her from playing pickleball again. In fact it was the opposite: She wanted even more to get back on the court.
Pickleball can be easy for people to pick up. But players can get into trouble when they jump on the court without proper footwear, warm-up or fitness training.
At Pickleball Charlotte, Walker teaches four to five clinics a day and emphasizes safety. She said that helps lower the rate of injuries — many of which are typical for older people but highlighted by being active.
“These aren’t pickleball specific injuries,” she said. “They’re aging issues that are brought to the forefront, because now they’re active and running around and playing a sport.”
Chapel Hill-based personal trainer and health coach Thurmond Buckelew had not heard of pickleball until summer 2021 when his clients told him they were playing. He said one 50-year-old client feels like he’s the youngest one on the pickleball court.
According to the USA Pickleball Association, in 2021 pickleball grew to 4.8 million U.S. players, a two-year growth rate of 39.3%.
Many of those were young adults. But a good portion of those folks were retirees trying to keep up with them — and getting hurt.
One October 2020 study in the journal Current Sports Medicine Reports urges clinicians to have a low threshold for continuing to work with patients with pickleball-related musculoskeletal complaints, even though the sport seems low-risk.
“Providers need to be aware of the increasing variety of alternative sports available to the general population and the growing participation especially in masters athletes and older adults as the baby boomer generation ages,” it says.
Buckelew warned that sitting on the couch and hunching over the computer are not exactly the best training regimen.
“The position that people often find themselves in for the longest period of their day just isn’t conducive to the activities that they want to do on the weekends,” he said.
Buckelew works with his clients to restore shoulder mobility, and he encourages posture checks throughout the day. From then he said he works to layer on strength-building components to workouts.
“Not What We Once Were”
An orthopedic surgeon at Pinehurst Surgical clinic, Neil Conti, told the story of one 90-year-old pickleball player who was seen for a flare of knee arthritis and treated with a cortisone injection. He was able to get back to playing with what he called “the younger guys” — people in their 70s.
Conti has seen many pickleball injuries that send people to the emergency room, such as wrist and ankle fractures. He said these injuries may require surgical repair, several weeks of casting and significant down time.
He’s also seen other injuries that don’t send people to the ER but require x-rays or MRIs, like arthritis flares or aggravating rotator cuff tendinitis.
“Some of these may need cortisone injections, therapy, and more elective-type surgeries,” he said.
Ann Smith, assistant director of scholar selection for the Morehead-Cain Foundation, has been playing pickleball for about five years. She was injured after playing for a couple hours on a hot summer morning.
She took a break in the shade then returned to play without warming up or stretching. She reached forward for a low shot and felt and heard a pop. Two of the three hamstring tendons tore off from her pelvic bone, known as proximal hamstring tendon avulsion.
She had surgery followed by physical therapy twice a week for five months.
Tony Spicer, an 82-year old Air Force veteran and retired engineer, picked up pickleball a little over a year ago. It wasn’t uncommon for him to play five or six times a week.
“I tell you what, it is very addictive,” he said. “I mean, it’s better than chocolate.”
Spicer lives in a 55+ community called Sun City Sun City Carolina Lakes, six miles outside Charlotte in Fort Mill, South Carolina. He said they’re all old people.
“For the most part,” Spicer said, “we know we’re not what we once were.”
Last summer, he had a reverse shoulder replacement — not because of pickleball, (“That was due to being old”), then he got back to the game. One month ago, he had to have surgery to fuse three vertebrae (also caused by being 82 years old).
But Spicer won’t be down for long. He’s determined to recover so he can start playing again.
On a recent warm afternoon he was thinking about going to hit some balls. Just don’t tell his surgeon.
