Pickleball injuries jump 88% as participation surges nationwide

Pickleball’s boom now has a bill attached. Injuries have risen 88% since 2020, and the surge is hitting the players most likely to show up with a long rec-league grin and leave with a taped ankle, sore knee or worse.

The numbers explain why the risk is rising so fast. The Sports & Fitness Industry Association said 19.8 million Americans played pickleball in 2024, a 45.8% jump from 2023 and a 311% increase over three years. Its 2024 State of Pickleball report said participation grew 51.8% from 2022 to 2023, with the biggest age group now 25-34-year-olds at 2.3 million players and more than 1 million children under 18 added in that span. Every U.S. region added players, which means more beginners, more crowded courts and more bodies trying to stop, pivot and lunge on the same hard surface.

That is where the injuries are coming from. The overwhelming share of cases happens in players age 50 and older, with ankle sprains, knee and joint problems, muscle strains and shoulder overuse injuries showing up again and again. A 2021 NEISS-based study found that more than 85% of pickleball injury cases were in players age 60 and older. In that group, slip, trip, fall and dive injuries made up 63.3% of cases, strains and sprains accounted for 33.2% of diagnoses and fractures made up 28.1%. By 2018, senior pickleball injuries had already reached parity with senior tennis injuries, a stark marker of how fast the sport caught up to the older-adult rec scene.

Fractures have since become a bigger alarm bell. The American Academy of Orthopaedic Surgeons reported a 90-fold increase over 20 years, with a noticeable surge from 2020 onward and most fractures occurring in players ages 60 to 69. Eye injuries are also drawing more attention. The American Academy of Ophthalmology says a pickleball serve can travel up to 40 miles per hour, and close net play raises the risk of corneal abrasions, retinal tears or detachment and black eyes.

Bill Steiner, a recent convert, likes the game but is trying to stay out of the injury column, especially with the knees and ankles. Brooke Rollins, who plays multiple times a day, has already dealt with pulled calves, pulled legs, a hurt back and a black eye. Physical therapist Andy Mohr said the sport’s quick stops and sudden pivots punish players who return to exercise without enough stability or conditioning.

The fix is not complicated, but it has to be done before the first serve. Warm up, take lessons, keep your game inside your current fitness level, build balance and endurance off the court, wear court shoes that support the ankle and replace them when they wear down. Add shatterproof polycarbonate eyewear, especially if you have eye issues or prior surgery. The sport is getting bigger by the month; the players who last will be the ones who respect what the game takes.