Amanda Wilde (Host): Pickleball has become a popular sport for people of many ages and abilities. It's a fun and accessible sport that provides a low-impact cardio workout while enhancing heart health and boosting overall fitness. All good, except as pickleball's popularity has increased, so have the number of injuries among players. So, to discuss safety and how to reduce the risk of injury, joining us today is Dr. Christopher Hamilton, orthopedic surgeon on behalf of Dignity Health.

This is Hello Healthy, a Dignity Health podcast. I'm Amanda Wilde. Dr. Hamilton, it's so good to have you here.

Chris Hamilton, MD: Well, Amanda, thank you very much for having me. I'm glad to be here.

Host: Let's start at the very beginning, because I am one of the only people in the world who has not yet taken up this sport. What should I know before even beginning to play a new sport like this?

Chris Hamilton, MD: Well, first of all, you should be prepared to make sure you're healthy enough in order to be able to pick up a new sport. And that goes along with any other old injuries that you may have. You don't want to just walk out and start to play completely unprepared, especially since pickleball is the fastest growing sport in the United States right now.

Host: Yeah. It has exploded since the pandemic, hasn't it?

Chris Hamilton, MD: Well, yeah. And in fact, many places, they're converting most of the tennis courts. Tennis players are actively fighting against that in many communities as well. But, for instance, in my hometown, they've recently converted one of the parks, all of the tennis courts to pickleball courts, and they're already full.

Host: Right. And it doesn't look like there's any sign that it's going to decrease.

Chris Hamilton, MD: No. In fact, it still continues to increase. And, unfortunately, as we started this, we're certainly seeing that injury rates are going up. Pickleball rates for injuries have probably doubled over the last two years and are responsible for more than 60,000 to 100,000 ER visits a year.

Host: Oh, wow. Well, what are some of the common injuries that pickleball players experience?

Chris Hamilton, MD: You know, it's interesting because we've seen more serious or more significant injuries that vary a little bit between men and women and vary more as more older patients start to play. One of the nice things about pickleball is it is accessible to almost all ages. And so, some of our older patients are playing, which is great. They get out and they do more activities. I mean, the common injuries are really sprains and strains that you would think with any athletic injury, sprained ankles, occasional knee injuries, very rare major knee injuries, are all common things that we'll see.

Host: Okay. We just talked about common injuries that pickleball players experience that are not too severe that you can heal from. Are there more serious injuries that you see also?

Chris Hamilton, MD: Yeah. Unfortunately, one of the things that we do see is a little more serious injuries, particularly in women, and older women. Because of osteoporosis, there's a little higher risk of fracture, both of the upper extremities, so wrists or shoulders for women. And interestingly, men tend to have more lower extremity injuries, such as ankle fractures, and end up in the ER more, but are more common as patients get a little older. So, if there's any question about whether you may be a little bit deficient in terms of your bone, make sure you talk to your primary care doctor about prevention for osteoporosis as well.

Host: So, as we spoke about a little earlier, be prepared and be aware of your vulnerabilities such as previous injuries or where your body's at.

Chris Hamilton, MD: Correct. And certainly, if you're really new to the sport, one of the things you might consider is whether to take a lesson. Get good advice about footwork, about how to prevent getting hurt, about what balls you should go for and what balls you shouldn't. And that can certainly help you enjoy the sport at a higher level and have more fun with your friends.

Host: And so, how do you treat patients who have suffered an injury?

Chris Hamilton, MD: Most of them are very commonly and pretty easily treated. Simple sprains and strains, you treat with rest, ice, compression, elevation, give it a little bit of time. And mostly, be aware of the fact that you can get hurt. And if you do get hurt, don't keep playing, but take a little bit of time off to give yourself a little bit of a chance to heal.

Host: Right. So, if you have injured yourself playing pickleball, how do you safely return after experiencing an injury?

Chris Hamilton, MD: When you look at having an injury, you want to make sure, first of all, that if you're using any braces or supports, that you keep using those braces or supports to help protect you. Before you start, make sure that you stretch and that you warm up, walk around, a little bit of light jumping, rotating your wrists, shoulders, your hips and ankles, side stretches, stretch out your legs, anything that you would do before you start an athletic activity.

Host: I'm glad for the reminder of warming up, which is something I've forgotten, and certainly over time, you can't just get out there and run without warming up. You can't get out and play pickleball or any sport without warming up first. So, thanks for that information too, about the kind of stretches we should incorporate into a warmup routine. Are there risk factors that increase the chances of experiencing an injury when playing pickleball?

Chris Hamilton, MD: Probably the biggest risk factor would be a previous injury. So, if you've had an injury before, you may exacerbate it. Again, one of the things that we see as some older patients are playing pickleball, is that we will occasionally see flare-ups of arthritis or degenerative change. And the pickleball is not going to make it worse, but it may aggravate some of your pre existing injuries as well.

Host: What recommendations can people follow to help avoid injury in the first place?

Chris Hamilton, MD: There's some simple things to do. One of the really kind of obvious ones that people don't think about is make sure that before you play, clear your court. So, you want to make sure there aren't any leaves or dirt or sand on the court, especially if you're playing in a community courts that may or may not be as well taken care of.

You always want to make sure that you're actually wearing good equipment. So, you need to have good tennis shoes or court shoes before you play. Don't try to play in your flip-flops out at the beach. So, make sure that you have good shoe wear and footwear. And probably one of the most important things, especially if you live in the central Valley, like we do or other places that are warm, is make sure you hydrate, because one of the issues can be heatstroke or dizziness in the hot weather.

Host: Dr. Hamilton, is there anything we haven't covered that you would like to add?

Chris Hamilton, MD: The only other thing is to have fun. After you play, make sure you hydrate. Get in a good cool down or a stretch. And most importantly, if you have aches or pains that aren't going away, make sure you talk to either your primary care doctor or your orthopedist so that they can help keep you active and keep you out on the pickleball court.

Host: Well, doctor, thank you for your suggestions and insights that will help us all enjoy pickleball safely.

Chris Hamilton, MD: You're welcome.

Host: That was orthopedic surgeon, Dr. Christopher Hamilton. Learn more at dignityhealth.org/bakersfield/ortho. If you found this podcast helpful, please share it on your social media and check out the entire podcast library for other topics of interest to you. This is Hello Healthy, a Dignity Health podcast.