When it comes to playing pickleball, there’s good and not-so-good news.

The good news is that pickleball, a hybrid of ping pong, badminton, and tennis, and the fastest-growing sport in America, has activated millions of Americans, including people older than 50, who are typically one of the country’s more sedentary age groups. The Sports and Fitness Industry Association noted that participation in the sport doubled in 2022. The not-so-good news? A recent report speculated that the sport could cost Americans up to $500 million in health care fees stemming from pickleball-related injuries.

It’s advertised as a low-impact sport. So why are so many people getting hurt?

Most pickleball injuries occur among people older than 60 who, because of their age, are more injury prone than younger players. According to Pickleheads.com, a self-described community of pickleball fanatics, in 2021, players aged 55 and up constituted the largest age group of pickleball players. This is great news – finding a new exercise you love (at any age!) helps to improve your overall health and well-being.

The problem is that this population is getting injured because they’re doing a bit too much too soon. As with any sport, it is essential to set aside time to warm up your body and cool down once you’re done.

The majority of pickleball injuries are sprains, strains, and fractures. Contusions, abrasions, internal injuries, lacerations, or dislocations make up the rest.

Many injuries resemble those of tennis and often affect the shoulder. But since pickleball entails quick direction changes and fast footwork that increase the load on the lower body, that’s where the bulk of injuries occur, especially in the Achilles tendon and calf muscles.

Although most of my older pickleball-playing patients are healthy, their muscles and tendons are not prepared to tolerate these demands, particularly if they were idle throughout the winter months or are simply summer weekend warriors who don’t do any other type of exercise. When pickleball season comes, they go from being inactive to playing two to three hours a week, a sudden increase in activity that their tissues aren’t prepared to handle.

If you get on the court cold and ask your body to go from zero to 60 in one second, then you’re setting yourself up for injury. The best way to prevent pickleball injuries is by warming up before you play.

How to warm up before playing:

I recommend finding a training regimen that simulates the movements that playing the sport requires. Since pickleball requires lower-body strength and flexibility, try starting with low-intensity legwork, including high-knee stepping, butt kicks, and calf raises, to prepare your muscles and joints to bear higher level loads. Practice these movements slowly at first, and then gradually ramp up as your body warms, which will prepare your heart and lungs to work harder.

And don’t forget to warm up your shoulders, too. Try a few active movements like shoulder circles, both small and large, and pickleball simulation movements (think swinging a racquet). Utilizing a light resistance band could also help!

It's also important to wear good supportive tennis or running shoes that will prevent you from slipping and sliding or letting your feet wiggle around.

This year, millions of Americans will become pickleball players. If this includes you, then make sure to add a thorough, pre-game warmup before you go out to play.