Pickleball

Is pickleball safe?

Yes. Pickleball is a low-risk sport, and for older adults the exercise it brings almost certainly outweighs the risk. Deaths on court are rare enough that no one counts them. The thing to watch is falling. US emergency departments treated about 24,500 pickleball injuries in 2023, against about 1,300 in 2014, and most were older players who fell.

The growth explains much of the rise. The Sports and Fitness Industry Association counted about 24.3 million Americans who played in 2025, nearly three times as many as three years earlier. In 2022, when the US had about 8.9 million players, emergency departments saw about 17,000 pickleball injuries, roughly 2 for every 1,000 players. If a typical player gets on court about 14 times a year, that is in the region of 1 emergency visit per 10,000 games. This is our rough estimate from SFIA's casual and core player counts, not a measured rate.

Who gets hurt

Older players, mainly. In a study of US emergency data for 2020–2022, 73% of injuries were in people aged 60 to 79, with an average age of 64. Hospital admissions rose faster than injuries, from about 1,000 in 2020 to 3,500 in 2022, and patients aged 65 or older were about 2.5 times more likely to be admitted.

The pattern differs by age. A ten-year analysis found falls caused about two-thirds of injuries overall, and older players were nearly three times as likely to be hurt in a slip, trip, fall or dive. Fractures were the most common diagnosis, at about a third of cases, and 69% of fractures were in women. The wrist was the most injured body part. Younger players more often strain a muscle or twist a knee or ankle in a sudden stop or lunge. Children are more often hit by a paddle.

A separate analysis of fractures from 2002 to 2022 estimated about 5,400 fractures a year by the end of that period, 87% in players over 60. Most were arm or wrist fractures after a fall. Women had most of the fractures, but men who broke a bone were 2.3 times as likely to be admitted, and fractures of the trunk or legs were the most likely to need a hospital bed.

Hearts and heat

The deaths that do happen are mostly cardiac. A study of NEISS emergency records from 2014 to 2023 found 5 deaths from cardiac arrest among sampled pickleball cases. Another analysis counted exertional cardiovascular events, mainly chest pain, as about 14% of pickleball injuries, and 16% among players over 60.

To put a number on it, the best general figure comes from the Physicians' Health Study of 21,481 US male doctors. It found one sudden cardiac death for every 1.51 million bouts of vigorous exercise, or about 0.7 micromortsMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary. Men who exercised regularly had a much lower risk during exertion than those who rarely did. A friendly doubles game is usually less strenuous than the vigorous exercise in that study, so most games probably carry well under one micromort. That compares with about 0.6 micromorts for a 5 km run.

Eyes and Achilles tendons

Two smaller risks deserve a mention. Eye injuries are rising fast: an estimated 1,260 US emergency visits in 2024, with severe cases including retinal detachment and orbital fractures. A hard plastic ball at close range at the kitchen line is enough. Achilles tendon ruptures are the other. At one large US orthopaedic group, pickleball went from 0.5% of Achilles repairs in 2018 to 6.7% in 2021, and 82.5% of those patients were over 50.

How to play pickleball more safely

1. Never run backwards for a lob. Turn and move sideways, or let it go. Backpedalling is the classic way to fall onto a wrist or the back of the head.
2. Wear court shoes with lateral support, not running shoes, which grip forward but roll sideways.
3. Warm up for five to ten minutes, including the calves and Achilles tendons.
4. Keep courts clear and dry. Stray balls, wet patches and dust on outdoor courts cause many falls.
5. Wear sports glasses, especially in doubles at the net.
6. Build up gradually if you are new to sport or returning after years off.
7. Know where the defibrillator is at your club or park, and learn CPR. If you have heart disease or chest pain on effort, talk to your doctor before you start.
8. Mind the bones. Players with osteoporosis are most at risk from a simple fall, so balance training and bone health matter as much as technique.

How we scored it

Fatality risk (88) sits in the 0.1–1 micromortMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary band per game, close to running. Injury risk (72) is the weak point, driven by falls and fractures in older players. Controllability (78) is good, since footwork, shoes and court conditions prevent most falls. Rescue and environment (92) is strong, as games are played on public courts with people nearby. That gives 83 overall.

Our confidence is medium. The injury figures come from a national hospital sample with wide error margins for single years, and there is no direct count of deaths or of games played.