619 - The Big Dill with Pickleball: Single-Center Epidemiology of Lower Extremity Musculoskeletal Injury in America’s Fastest Growing Sport

Cross-sectional study of 95 total patients presenting to outpatient Orthopedic or Physiatry clinics at an academic medical center with pickleball injuries to the hip/thigh (n=9), knee (n=52), or foot/ankle (n=34) in the last 5 years. We determined percentages of patient-specific factors among injury cases (e.g. gender, age, laterality, follow up duration), type and mechanism of injury, treatment modality, and return to sport measurements.

Results: We provide tables summarizing injury rates by body part and patient factor. The most common pickleball-related hip/thigh injuries were hamstring strain and iliopsoas tendonitis (33.3% each), knee injuries were meniscal tears (medial 48%, lateral 19%), and foot/ankle injuries were Achilles tendon pathologies (tears 47%, tendonitis 12%). The mean patient age at presentation was older for hip/thigh injuries at 65.9 compared to 53-54 for knee and foot/ankle injuries (p >0.05). There was no statistically significant difference in gender distribution, laterality affected, and follow up duration and treatment modality amongst the cohorts.

Conclusions:

As pickleball remains the fastest growing sport in America, the incidence of pickleball-related injuries continues to rise dramatically. We detail injury mechanisms by body part with corresponding injury prevention recommendations. While many lower extremity injuries resulted from overuse, acute injuries most commonly occurred with sudden motions to reach the ball. Achilles tears correlate with the explosive unipedal pushing off phase of lunging for the ball while meniscal tears correlate with twisting or pivoting while lunging. We recommend correcting muscle strength imbalances, avoiding knee twisting on a planted foot, incorporating multicomponent training programs (e.g. agility, balance, and flexibility), wearing proper footwear, and avoiding sudden increases in intensity to prevent injury.