Pickleball has exploded in popularity, with nearly 50 million Americans playing the sport in 2023 and increasing numbers of players in our own home town of Singapore. While it’s often seen as a low-impact, social game, pickleball-related falls are surprisingly common, particularly among older players.
Have you fallen during a pickleball game?
I have found that general fitness, running and bodyweight exercises have helped me stay on top of my game and my health, however, a recent study examined why recreational players fall during games and what factors might increase their risk. We explore the specifics further in this article.
As ever, please talk to your doctor or medical practitioner most familiar with your medical history before implementing any changes in diet, exercise, or lifestyle, especially if you are under treatment. Links to all studies at bottom of page.
The Study: Who Falls and Why?
Researchers examined 92 recreational pickleball players, asking about their fall history and testing their hip strength, balance, and agility. They found that:
42% of participants reported falling while playing pickleball, with 30% having fallen more than once.
The most common reasons for falls were lunging (57%) and moving backward (24%).
Players who had fallen were significantly older than those who hadn’t, with a median age of 50-54 years compared to 30-34 years.
Those who fell were also slower at changing direction, particularly in a test that involved moving forward, sideways and backward.
Strength and Stability: What Matters?
Despite previous research linking weak hip abductor muscles to falls, this study found no significant difference in hip strength between players who had fallen and those who hadn’t. However, stronger hip muscles were linked to faster movement times, suggesting that while strength alone may not prevent falls, it could improve agility and reaction speed.
Similarly, balance and ankle flexibility did not predict falls. The researchers used a single-leg squat test, which is commonly used to assess stability, but it did not distinguish between those who fell and those who didn’t. This suggests that pickleball-related falls may be more about quick, unpredictable movements rather than static balance issues.
Improving Agility to Prevent Falls
One key finding was that players who fell were significantly slower in a test requiring quick changes in direction. This test included backward movement, which challenges balance more than moving forward or sideways. Given that a quarter of falls occurred while moving backward, training in this type of movement may help prevent falls.
The researchers suggest that pickleball players - especially older ones - should consider training programs that include:
Multi-directional lunging to improve stability during quick movements.
Lower body strength and power exercises to improve reaction time and movement control. Learn more about:
bodyweight squats and / or
power training with plyometrics / jumping
Change of direction drills, especially ones that include backward movement, to improve agility and balance.
For comprehensive, pickleball fitness training that will improve your game, read here.
Final Thoughts
Pickleball is a fantastic way to stay active and socially engaged, but it does come with a risk of falls, particularly as players get older. This study highlights that fall prevention in pickleball isn’t just about strength or balance - it’s about being able to move quickly and recover from sudden changes in direction.
For those who love the game and want to keep playing safely, incorporating agility training and backward movement drills into workouts could be a smart way to reduce the risk of falling. While more research is needed, these findings provide valuable insight into how recreational players can stay on their feet and keep enjoying the game. If you are based in Singapore and want to play, learn more about our pickleball community here.
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Alastair
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Related Resources and Studies
Stroesser K, Mulcaster A, Andrews DM. Pickleball Participation and the Health and Well-Being of Adults-A Scoping Review. J Phys Act Health. 2024 Jul 18:1-14. doi: 10.1123/jpah.2024-0092. Epub ahead of print. PMID: 39025467.
Liu Y, Abdullah BB, Abu Saad HB. Effects of high-intensity interval training on strength, speed, and endurance performance among racket sports players: A systematic review. PLoS One. 2024 Jan 5;19(1):e0295362. doi: 10.1371/journal.pone.0295362. PMID: 38180964; PMCID: PMC10769056.
Cádiz Gallardo MP, Pradas de la Fuente F, Moreno-Azze A, Carrasco Páez L. Physiological demands of racket sports: a systematic review. Front Psychol. 2023 Mar 30;14:1149295. doi: 10.3389/fpsyg.2023.1149295. PMID: 37063547; PMCID: PMC10101231.
Cerezuela JL, Lirola MJ, Cangas AJ. Pickleball and mental health in adults: A systematic review. Front Psychol. 2023 Feb 21;14:1137047. doi: 10.3389/fpsyg.2023.1137047. PMID: 36895753; PMCID: PMC9988900.
Pergolizzi J Jr, Matera J, LeQuang JAK. Treating Geriatric Sports Injury Among Pickleball Players: A Narrative Review of an Exercise Craze Among Seniors. Cureus. 2023 Dec 4;15(12):e49909. doi: 10.7759/cureus.49909. PMID: 38174176; PMCID: PMC10763694.
Webber SC, Anderson S, Biccum L, Jin S, Khawashki S, Tittlemier BJ. Physical Activity Intensity of Singles and Doubles Pickleball in Older Adults. J Aging Phys Act. 2022 Sep 10;31(3):365-370. doi: 10.1123/japa.2022-0194. PMID: 36087934.
Watts EL, Matthews CE, Freeman JR, Gorzelitz JS, Hong HG, Liao LM, McClain KM, Saint-Maurice PF, Shiroma EJ, Moore SC. Association of Leisure Time Physical Activity Types and Risks of All-Cause, Cardiovascular, and Cancer Mortality Among Older Adults. JAMA Netw Open. 2022 Aug 1;5(8):e2228510. doi: 10.1001/jamanetworkopen.2022.28510. PMID: 36001316; PMCID: PMC9403775.
Wray P, Ward CK, Nelson C, Sulzer SH, Dakin CJ, Thompson BJ, Vierimaa M, Das Gupta D, Bolton DAE. Pickleball for Inactive Mid-Life and Older Adults in Rural Utah: A Feasibility Study. Int J Environ Res Public Health. 2021 Aug 7;18(16):8374. doi: 10.3390/ijerph18168374. PMID: 34444124; PMCID: PMC8391496.
Vitale K, Liu S. Pickleball: Review and Clinical Recommendations for this Fast-growing Sport. Curr Sports Med Rep. 2020 Oct;19(10):406-413. doi: 10.1249/JSR.0000000000000759. PMID: 33031206.
Forrester MB. Pickleball-Related Injuries Treated in Emergency Departments. J Emerg Med. 2020 Feb;58(2):275-279. doi: 10.1016/j.jemermed.2019.09.016. Epub 2019 Nov 30. PMID: 31796221.
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