Pickleball and the Risk-Reward Equation
Balancing the Joy of the Game with the Realities of Injury Risk
Pickleball has quickly become a favorite pastime for older adults—and for good reason. It’s fun and social, and supports heart health and mobility—including balance and coordination—while being gentle on joints. Best of all, it’s easy to learn and is adaptable to different fitness levels, making it accessible for beginners and seasoned athletes alike.
From a mental health standpoint, the sport helps with cognitive engagement such as strategy, hand-eye coordination and concentration. And like many forms of exercise, pickleball releases endorphins that combat depression and anxiety. It reduces isolation and increases regular social interaction.
Jason Alvarado, MD, a family and sports medicine physician at Torrance Memorial Physician Network, notes its benefits. “Pickleball is a generally low-impact, weight-bearing sport that can help strengthen bones and improve cardiovascular fitness. It can also help seniors feel less isolated, reducing the risk of depression.”
Its low-impact nature and simple rules make it appealing to those seeking exercise that is easier on joints than tennis or racquetball. Geri Freeman, a 72-year-old Hermosa Beach resident, plays several times a week. She says her bone density numbers have improved for the first time since she was diagnosed with osteopenia a decade ago: “Since I started playing regularly, my osteopenia has improved after years of staying the same.”
However, as with any sport, there are risks, especially as enthusiasm can sometimes outpace physical readiness. But there are also preventive measures. Focusing on form and moderation, seniors can safely enjoy the fast-paced fun of pickleball while minimizing their risk of injury.
“While the stop-and-go movements can strain aging joints and muscles, especially in those with arthritis or a history of injury, warming up, wearing proper footwear and protective eyewear, and regulating the amount of play can reduce the risk of common injuries like sprains, tendonitis, falls and eye trauma,” says Dr. Alvarado.
While the physical boons are notable, the mental health benefits are also what seem to keep players coming back. The socialization factor is frequently cited as one of its biggest pluses.
“It’s the friendships, the camaraderie and the fun,” says Freeman. “Just meeting so many people that are so wonderful and feeling good about being out there, moving your body, being in the sunshine and playing. It’s the greatest.”
Celebrating its 60th anniversary this year, pickleball—the mashup of tennis, ping-pong and badminton—has experienced a meteoric rise in popularity across the United States, particularly among older adults. The Sports & Fitness Industry Association reported 19.8 million players in 2024, up from 4.8 million in 2021, making it the fastest-growing sport for the fourth consecutive year. One-third of its core participants are ages 55 and older.
It’s no surprise the sport’s rapid growth has coincided with a spike in injuries. Forbes reported health care costs associated with pickleball-related injuries, primarily among seniors, were more than $350 million in 2023. Freeman tore her ACL playing pickleball in 2019, although that didn’t stop her love for the game.
Lisa Halvorson, 65, who took up pickleball in 2021, suffered a freak accident. Last December the El
Segundo resident was preparing to serve when her right foot slipped. Her left leg hyperextended, locking at the knee and causing her to fall. She dislocated and fractured her hip.
Halvorson’s injury required a complete hip replacement, which was performed at Torrance Memorial. She is now back on the court serving and dinking and expects to be playing competitively again this summer.
Manhattan Beach resident Beth Allsteadt, 62, also tore her ACL playing pickleball. But she wouldn’t trade playing for anything. Allsteadt, who lives part time on the East Coast, credits pickleball for finding her people here.
“I probably have 50 friends in California because of pickleball. Socially, it’s been great,” she says. Allsteadt’s friends, including Nancy Rey, credit her with introducing dozens of players to the game.
Allsteadt taught Rey, 58, the basics. Rey formed a playing group in 2021, of whom the core eight members and two regular subs continue to play today. “All of my friends here are from pickleball,” she says. “And our activities—celebrating milestone birthdays, going wine-tasting, traveling—have expanded beyond pickleball.”
Rey also shared her interest with her husband, Gonzalo, 62, who now plays regularly. “It’s a great activity you can play with people of different ages and fitness levels, and it’s still fun,” she says. “And because it’s such an easy entry sport, you can quickly explain it and 10 minutes later, you’re having a fun game. And it’s something I can do with family.”
Rey concedes that pickleball is more dangerous than sitting on your couch. But is it? Regardless, it’s recommended to check with your primary care physician or a sports doctor before starting any new activity, including pickleball.
Jason Alvarado, MD, practices at Torrance Memorial Physician Network El Segundo at 2110 E. El Segundo Blvd., Suite 200. He can be reached at 310-517-7030.
