26 Comments

I played pickleball hours a day for two years, and then my knees were a mess. I quit playing and it took a couple more years for my knees to return to relative normal. As John McEnroe has suggested, it’s much harder on the legs than tennis. Constant abrupt stoping from a run. I have suggested that orthopedic surgeons invest into pickleball facilities throughout the land.

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I have never played! But my older patients who do are usually very enthusiastic. Not much to add except that it seems like a tradeoff between good exercise enthusiasm, balance + coordination, bursts of muscle recruitment as exercise... and a good number of orthopedic injuries and sometimes falls. I'm neutral when patients ask me about it. Ping pong is gaining popularity lately too, and I think a national league is getting off the ground soon.

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Pickleball is indeed a game changer. I have been playing it for the last 5 years. I had heel pains, tennis and golfer elbow that lasted at least one year, but I persisted. I had physical therapy, I applied guasha, a Chinese method as well, heat and ice. I finally got rid of them but I found that bracing is essential and even nowadays when I don’t suffer for those anymore, I always play wearing braces. Meanwhile, I plan to go on playing happily, As long as my body allows me. It’s a game changer. It’s a new way to face old age. 💃🏼🕺👯‍♀️

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Happy to hear Pball is bringing you so much happiness and eudaemonia.

I purchased a knee brace (Dr. Brace) after my last knee escapade. Perhaps I should start wearing it.

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Table 2 suggests wearing running shoes. Running shoes generally do not provide very good lateral support. To avoid ankle sprains a good pair of tennis shoes would be preferable. There are also shoes now made specifically for Pball.

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Totally agree!

I started out playing in my running shoes and quickly turned my ankle due to the lack of lateral support. Currently playing in "pickleball shoes" without any ankle turning. However, my wife has determined that they are incredibly dorky in appearance.

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Court shoes are another option. Volleyball shoes are very similar to pickleball and might provide more stylish options. Emphatically NOT running shoes that often have almost a ledge extending behind the heel that can be a trip hazard in non-forward movement.

No back-pedaling! Instead, turn and run back to the ball. As I was first learning two years ago, I fell and hit my head on the court. A close call I don’t wish on others. Pickleball players should consider a refresher on falling. Friends and I have avoided injury by rehearsing our fall technique: tuck in the arms, if possible, fall on your backside and roll to absorb the impact.

And get out there and play pickleball!

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Nice. I’ll check the more stylish shoes out. If stylish enough, my wife may become more enthusiastic at the PBall.

I learned the NO back-pedal lesson the hard way also. Early in my PB journey while still wearing running shoes and without having taken a clinic or lesson I took a few steps backwards for a lab and hit the gym floor. I didn’t tuck and roll, however, and extended my left arm, absorbing most of the blow in my hand. Nothing injured but my basal thumb arthritis was exacerbated and my pride decimated.

When I told a patient about this, he was horrified and helped me get proper tutelage.

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As a physician I believe Pball has other potential benefits for seniors. Aerobic capacity is not the only measurement for healthy aging. Hand eye coordination, balance, cognition, speed. All these I believe may be improved in seniors. Other forms of exercise be it weightlifting, walking, biking do not activate the CNS in the same way PBall does.

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Agree 100%. After my Pball sessions I feel more alert, smarter, more dexterous and swifter.

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Great sport, but I know of one tragic story involving someone getting hit in the head by their partner's tennis racket while on blood thinners. While not the current look on a pickleball court, wearing some sort of head protection is something to think about if you're on thinners, as you're often playing very close to your partner.

Jim

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Welcome to the game. I’ve been playing for almost 10 years since I was in my early 60’s and was fairly active before then. When I first saw my PCP after playing pretty actively (10+ hours a week) he literally said, “what the h&* have you been doing?”. I had dropped 10 lbs, BP, cholesterol, resting heart rate were all significantly lower. I have a theory about PB injuries which is that people who haven’t played any competitive sports for 20-30 years take up the game and think that their bodies will do things that they used to do. They soon find out that they don’t. I had some injuries in my early time with the game, but nothing in the last 5 years. One other thing that is never mentioned is how good the game is for improving your dynamic balance-something that usually drops as we age and is a major cause of injuries in the elderly.

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What was the PB scene like 10 years ago?

I like your PB injury theory. After ceasing regular competitive tennis 15 years ago, it seems like I would hurt something every time I played a competitive sport (like Spikeball ). The competitor in me thinks that I'm 40 or 50 years old and has to learn that I'm now much older.

The improvement in dynamic balance also a major plus an an excellent point.

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The PB scene 10 years ago was much smaller and close knit. In Naples, I got to meet, watch, train with, and get to know many of the top pros at the time, as well as some young kids like Ben and Anna Leigh who were teens at the time. In both Naples and Boston, I felt like I knew and got to play with many of the better amateur players. With the explosion of players, definitely not so much now. One cardiac related thing: I’ve seen HR’s (on myself and others) way above the 70% you mention and have seen a few cases of dehydration/hyponatremia when the temps get up to 90*. I’m a huge Apple watch fan and definitely recommend staying properly hydrated.

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I've definitely recorded higher heart rates in other PBall sessions than the one I described. And the heart rate is going to get higher depending on temp/humidity , how well you hydrate, duration and difficulty of the match (is match an appropriate term in Pball?).

During intense games I've hit HRs of 140 BPM regularly. As I've gradually increased my Max VO2 (measured by Apple Watch) over the last 6 months and as I've gained more experience (more efficient movement) the peak HRs achieved have dropped.

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Pickle ball, where you are constantly stopping and starting, changing directions; is better for bone density than walking or running where you’re constantly doing the same motion.

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I’m saving it for when I’m older and maybe I can coax my wife into it.

You can get hurt during most sports that get your heart rate up so maybe the increase in injuries is because more people are active in general.

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I had played tennis previously so pickle ball was easy to pick up. It does not seem as vigorous however, maybe I am not playing well 😝

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I would deem singles PBall less vigorous than singles tennis. There is a lot of court to cover in singles tennis and points can last a long time.

I've seen doubles tennis matches that are clearly in the low moderate intensity range and I've seen doubles PBall matches that are in the very high intensity range but on average PBall is less intense.

Perhaps you need to step up y=the level of your opponents ?

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I started playing this past summer. It’s fun. It’s social. It takes little practice to get to a somewhat serviceable level. Even 4 beginners can get into a functional match. It seems like a natural sport to move into for former racket sport players who need to reduce wear and tear, or for those who can no longer cope with the rigors of their former sports. I never tracked my HR, but from a very non-scientific “getting my sweat on” metric, it beats a generic “brisk walk where you can still speak in short sentences” recommendation, imo.

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I recently subscribed to the youtube channel of Cara Beth Lee (CBLeeMD), an orthopedic surgeon in Seattle. I think she's well above the quality of many youtube medical channels (I know that's a low bar, but she's good) who thinks pickleball is the no. 1 best physical activity for long life.

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Is she basing on that on any scientific publications, or it her gestalt?

Does she comment on orthopedic injuries from pickleball?

In addition to my recent knee issue, my hallux rigidus on the right is worse and I've developed a biceps tendinitis.

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Sorry, she does not address pickleball-related injuries (perhaps surprising for an orthopod). Her references were:

https://www.sciencedirect.com/science/article/abs/pii/S002561961830538X

and

https://pmc.ncbi.nlm.nih.gov/articles/PMC9403775/

Link to Lee's video:

https://www.youtube.com/watch?v=nCQu5sZzoAI

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Thanks,

I'll check out the links and likely add that info to a second PB post

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"A common treatment for the aches, strains, and pains experienced playing pickleball is to take a non-steroidal inflammatory drug like ibuprofen. "

I think you meant to say "antiinflammatory" drug.

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you are correct and i have corrected the online version.

thanks

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