Pickleball is a Threat to Public Health

I recently read, with unmitigated horror, the JAMA article, As Pickleball Continues to Gain Players, Injuries Are Increasing. I read of an “alarming increase in eye injuries” and learned that there has been a “3-fold increase in the number of players, but almost a 7-fold increase in the number of injuries.”

I felt terribly for the people who were out enjoying themselves, only to be injured. I was also wracked with guilt for the people I had likely set on the path to harm. As a general internist who believes that humans are meant to be active, I frequently recommend exercise to people who are sedentary. I frequently say:

“Go out and walk briskly, for at least twenty minutes, every day. Push yourself so that you are a little out of breath. You should be able to talk, but not carry on a regular conversation. Over time, you will find that you will be able to walk faster for longer.”

While I used to say these words without a second thought, I now realize I might be, unintentionally but essentially, referring my patients to an ophthalmologist, an orthopedist, or even an undertaker.

Fortunately, the pickleball article provided sound and well-founded advice. One recommendation was to tell people, “Hey, injuries are usually caused by falls, getting hit by the ball, or hit by a paddle.” So that they would be more careful.

The article provided other recommendations:

Individuals should also be wearing the right shoes that offer lateral support and the right type of traction, and if they need it, wrist and knee braces… But even more importantly, older players should get a physical to check their endurance and bone density to make sure they can play safely.

It’s also a good idea for older players to see a trainer or physical therapist who can evaluate their range of motion, strength, balance, and coordination… (An expert) also advised new players take a class or join a clinic to learn proper technique and form…”

These recommendations reassured me. Clearly, people had thought deeply about (if not actually researched) the issue. I now recommend that my patients visit physical therapists, have bone density scans, and complete stress tests before they begin walking. If information from those appointments allows me to “clear them” to walk, I encourage them to visit a running shoe store where an employee can watch them on a treadmill and assess their form. I then encourage them to stretch before going out and hold handrails as they walk down any steps to the street.

I insist that they walk with two “exercise enables.” One should walk ahead to make sure the pavement is free of cracks, and one should walk behind as a spotter in case there is a slip and fall. I recommend that walks only occur on dry days, when the temperature is between 65 and 75 degrees Fahrenheit. The walks should take place from 9-10 AM or 3-4 PM to ensure good light, quiet sidewalks, and a low risk of sun damage. Walks should be canceled if the air quality is poor.

I plan to check in with my patients after a year to ensure I do not need to be more aggressive in my safety protocols. I am considering recommending the Unisex Elderly Anti Fall Airbag Vest Wearable Airbag Smart Vest for Seniors 0.08s Pop Up Protection for Elderly to all my patients. I am on the fence about also recommending both a full-body MRI and Grail’s Galleri test. I would hate for an unexpected cancer diagnosis to occur before, during, or soon after exercise.

If any of my patients are unwilling to take these precautions, I will recommend, in no uncertain terms, that they return to the couch. I am in touch with donors who are willing to fund a supply of Pringles potato chip tubes to incentivize these patients’ rediscovery of inactivity.

Be safe out there, everyone.

Photo Credit: Jon Matthews