Pickleball has experienced significant growth in popularity in recent years. According to the 2023 Sports & Fitness Industry Association (SFIA) Single Sport Report, there are over 8.9 million pickleball players in the United States, a substantial increase from previous years. The sport has seen an average participation growth rate of 158.6% over the past three years, with an estimated 36.5 million enthusiasts in 2023.

The popularity of pickleball doesn’t seem to be slowing down any time soon, and what’s not to like? Thanks to its smaller court and slower pace, for many, the sport is more easy-going and approachable than tennis. To boot, it’s often centered in a fun atmosphere with great food, drinks and music, as well.

Now, new stats from the Apple Heart and Movement Study, have shown pickleball’s health benefits may even match that of its more competitive older brother, tennis.

The ongoing study compared the health metrics between nearly 5,000 pickleball and 8,000 tennis players, as recorded on their Apple Watches during more than 250,000 games over the course of 32 months. The study revealed that, on average, pickleball sessions lasted slightly longer than tennis sessions (90 minutes versus 81 minutes, respectively), with greater variability observed in the duration of playtime.

In terms of intensity, analysis of heart rate data from the Apple Watch showed that the peak heart rate during tennis averaged 152 beats per minute, compared to 143 beats per minute during pickleball, indicating a difference of nine beats per minute. Additionally, tennis participants spent 9% more time in higher-intensity heart rate zones compared to pickleball players.

Consistency-wise, the study noted a greater seasonal fluctuation in the frequency of tennis games played across the year, whereas the number of pickleball workouts exhibited a consistent upward trend throughout the entire duration of the study period. Notably, pickleball sessions surpassed the number of tennis games starting in July 2023, indicating a sustained increase in pickleball participation over time.

Lastly, every study participant was requested to complete a mental health survey on a quarterly basis, incorporating a depression screening tool. The analysis of average scores revealed that both frequent pickleball and tennis players exhibited a lower likelihood of experiencing depression compared to the overall population within the study.

These metrics may not come as much of a shock to Travis Frantz, M.D., an orthopedic surgeon and physician on the medical staff at Texas Health HEB and Texas Health Orthopedic Specialists, a Texas Health Physicians Group practice, who believes the core of pickleball’s popularity lies in the approachability and social aspect of the game.

“Whether it’s pickleball or any other fitness activity or sport, I will always encourage people to go do it and be active and participate — and not just for the physical side of it,” he says. “There are a lot of things you can do to stay healthy and stay in shape and I think the main reason so many people continue to go back to pickleball is, yes, the physical side, but also the fun, social environment surrounding it, as well.”

The Similarities & Differences

Pickleball and tennis are both racket sports played on a court, but they differ in several key aspects which can contribute to the intensity of each sport.

Pickleball is typically played on a smaller court compared to tennis. The reduced court dimensions mean players have to cover less ground and make shorter movements during rallies, resulting in less strain on the joints and muscles. Additionally, the shorter distance between players in pickleball allows for shorter swings, which can contribute to lower impact compared to the longer and more powerful swings often seen in tennis, especially when it comes to serving the ball. Furthermore, the lower net height in pickleball means players are less likely to have to hit the ball with high force to clear the net, reducing the risk of overexertion and injury. Lastly, pickleball tends to be played at a slower pace than tennis, making it more accessible to players of all ages and skill levels.

“Pickleball still has a lot of the physical benefits without the demanding aspects of tennis,” says Frantz. But that doesn’t mean it is completely devoid of injuries.

“As with most overhead sports and all racket sports, I see a lot of shoulder injuries and strains. Same with the knee. It’s mostly sprains and strains,” Frantz adds. “Similar to tennis, if you are playing a lot and playing repetitively, getting what we call tennis elbow is also common. These sorts of injuries make sense given the nature of the sport, but Achilles injuries seem to be happening quite a bit with pickleball more so than we see in some other sports, including tennis. Whether it’s tendonitis, tears, or even a rupture, we’re seeing a lot of Achilles injuries.”

The Importance of Warming Up, Easing In, and Proper Gear

Frantz believes many of the injuries he sees from pickleball are attributed to poor form, not warming up properly and not easing into the sport.

“I think a lot of people try to jump into it and then realize it is a little bit more explosive than they might initially think having just seen somebody else do it or just watching and not participating,” Frantz explains. “So I think a lot of times people go out, get really into it because it really is a fun sport, and they start to become competitive, then they start to stress their bodies in ways that they haven't in maybe some time.”

Frantz suggests easing into the sport and prioritizing gentle conditioning and learning proper form, all of which will help prevent injury.

• Proper Warm-Up: Begin each session with a thorough warm-up routine that includes dynamic stretches and movements to prepare the muscles and joints for activity. Focus on areas commonly used in pickleball, such as the shoulders, arms, legs, and core.
• Learn Proper Technique: Take the time to learn and practice proper pickleball techniques, including grip, footwork, and strokes. Enlist the help of a certified instructor or experienced player to teach you the fundamentals and correct any errors in your form early on.

“If you have better technique and better form, you’re doing things in a more biomechanically smooth way, your chance for injury decreases,” Frantz explains. “The risk doesn’t completely go away, but there’s a reason why good form is taught. It’s not just for athletic effectiveness but for longevity and injury prevention.”

• Start Slowly: Begin with shorter playing sessions and gradually increase the duration and intensity of your play as your fitness level improves. Avoid overexertion and listen to your body's cues to prevent pushing yourself too hard, too soon.
• Use Appropriate Equipment: Invest in high-quality pickleball equipment, including a paddle that suits your playing style and skill level, as well as comfortable, supportive footwear that provides adequate cushioning and stability on the court.

“I think a lot of times people overlook the type of shoes they’re wearing. A lot of the injuries that I see can be directly traced back to inappropriate footwear that contributed to that injury,” Frantz says. “Look for an athletic shoe that is designed for tennis or racket sports. That’s going to prevent slipping and sliding that can be common in court sports and lead to injury.”

• Stay Hydrated: Drink plenty of water before, during, and after playing to stay hydrated and prevent dehydration, especially in hot or humid conditions. Dehydration can increase the risk of muscle cramps and fatigue.
• Take Breaks: Incorporate rest breaks into your playing sessions to give your body time to recover and prevent overuse injuries. Listen to your body and don't push through pain or discomfort.
• Cool Down: Finish each playing session with a proper cool-down routine, including static stretching and gentle movements to help reduce muscle soreness and promote recovery.

“If you are sore, an anti-inflammatory or Tylenol, or even ice, can go a long way in helping with those aches and pains, especially as you’re just getting into the sport,” Frantz. “Prioritizing recovery will allow you to keep participating and keep you out of the doctor’s office.”

If there is anything health-wise that you’re concerned about when it comes to starting up pickleball, Frantz recommends speaking with your primary care provider, and if it’s ortho-related, reaching out to an orthopedic specialist or sports medicine doctor.

Keep It Safe, Keep It Fun

Overall, the smaller court size and speed of pickleball promote a style of play that is generally gentler on the body compared to tennis, making it an appealing option for individuals looking for a lower-impact racket sport. The social aspect of pickleball can also make it an appealing activity for many, with courts and clubs popping up all over the DFW Metroplex. 

However, it's important to approach the sport with caution and prioritize injury prevention strategies such as proper warm-up, technique development, and appropriate gear. By easing into pickleball, staying hydrated, and listening to your body's cues, you can minimize the risk of injury and maximize enjoyment on the court.

Ultimately, whether for fitness, social interaction, or sheer enjoyment, pickleball offers a rewarding way to stay active and engaged in a welcoming community setting.