The perils of pickleball: A two decade analysis of upper and lower extremity injuries from America’s fastest growing sport

This study seeks to evaluate the epidemiology of pickleball upper/lower extremity injuries presenting to US emergency departments (E.D). The National Electronic Injury and Surveillance System (NEISS) database was queried from 2003–2022 to identify patients presenting to the ED with injuries sustained during ‘pickleball’ to upper/lower extremities. Patients were subsequently divided into pediatric, adult, and geriatric age groups. Demographic and clinical variables were assessed among age groups utilizing two-proportion z-tests with Bonferroni correction. A total of 749 patients with extremity pickleball injuries were identified from NEISS (33 pediatric, 286 adult, 430 geriatric). Pickleball extremity injuries dramatically increased from 2012 to 2022 by 3,650%. Geriatric and pediatric patients had greater frequencies of upper extremity injuries relative to adults (60.2% vs. 40.6%; p < 0.001 and 63.6% vs 40.6%; p = 0.022, respectively). Adults had a significantly greater frequency of lower extremity injuries (59.4%) relative to both pediatric (36.4%; p = 0.022) and geriatric (39.8%; p < 0.001) patients. Patients who were hospitalized after injury were significantly older (68.8 vs. 62.5; p = 0.033) and most commonly incurred a fracture (88.9% vs 34.8%; p < 0.001). This study provides a critical epidemiological analysis of injury trends captured in this popular sport.