The Pickleball Injury That Sends Players Over 60 to the ER Is the Fall
/I love pickleball. I want you playing it at 80.
That's exactly why I want to talk about the injury that doesn't get enough attention. When people think "pickleball injury," they picture a sore elbow or a cranky shoulder. Those are real, and we've covered them in our Pickleball Series. But if you're over 60, the injury most likely to send you to the emergency room is the fall.
I spent over 10 years in professional sports, most recently as head of rehab for LAFC. Now I bring that same level of care to everyday athletes, and a lot of them play pickleball. Here's what I want every one of them to know.
The numbers behind pickleball falls
A study published in the journal Sports Health looked at pickleball injuries treated in U.S. emergency rooms. In 2014, there were about 1,300. In 2023, there were more than 24,000.
The largest group of injured players was 60 to 79 years old. In that age group, falls were more than 2x as likely.
That's not a reason to quit. It's a reason to prepare. The good news is that almost every link in a pickleball fall is something you can train.
Link 1: The Backpedal Trap
Almost every fall on a pickleball court starts the same way. Not with a dramatic dive. With a backpedal.
Your opponent throws up a lob. Your eyes go up to the ball. Your feet start moving backward.
Think about what that means. You're moving in the one direction you can't see. Your heels are leading. Your weight is sitting back. The ball is pulling your chin toward the sky. One heel catches the court, and down you go.
I call this the Backpedal Trap. It feels like the fastest way to the ball. It's actually the riskiest way to get there.
Link 2: The balance gap nobody measured
The backpedal is only the trigger. Whether you catch yourself comes down to three things most people have never had measured:
Balance
Reaction time
Leg strength
All three decline with age, slowly and quietly. You still feel like the same athlete. Your legs just answer the call a split second later.
Here's a quick way to check. Stand next to a kitchen counter, close enough to grab it. Lift one foot off the floor and hold for 10 seconds. Then switch sides.
A 2022 study in the British Journal of Sports Medicine tested more than 1,700 adults between 51 and 75. About 1 in 5 couldn't hold that position for 10 seconds.
If it was harder than you expected, that's useful information, not a verdict. Balance is trainable at any age.
Link 3: The wrist, and the bone underneath it
When you lose your balance going backward, your hand shoots out. That's a reflex. Your body is protecting your head, and it's a good reflex.
But now your whole body weight lands on one small joint: your wrist.
Here's the part most people never think about. The bone under that wrist may already be thinner than you think. Bone density drops as we age, especially for women after menopause, and you can't feel it happening. For a lot of people, a broken wrist from a simple fall is the very first sign of weak bone.
The same Sports Health study found that women had more than 3x the odds of a hand or wrist injury.
So the whole chain looks like this:
A backpedal for a lob
A balance and reaction gap nobody measured
An outstretched hand landing on bone that has quietly gotten thinner
Break any one of those links, and the chain doesn't hold.
The most encouraging finding in the research
A 2025 study in Sports Medicine Open surveyed 1,758 pickleball players. The players who said injury prevention wasn't that important to them were 2x as likely to get hurt.
Read that again. One of the biggest risk factors is something you control: how seriously you take prevention.
4 ways to lower your risk of a pickleball fall
1. Get a baseline
Test, don't guess. Have someone actually measure your balance, your leg strength, and how fast you react. You can't improve what you've never measured, and you can't know where you stand by how you feel.
2. Fix your footwork
When the lob goes up, turn your hips and run to the ball instead of backpedaling. And sometimes, let it go. Call it for your partner. No point is worth a broken wrist.
3. Load your bones
Bone responds to load, and walking alone usually isn't enough. The LIFTMOR trial out of Australia tested supervised heavy strength training in postmenopausal women with low bone mass, and it improved their bone density. The key word is supervised: the right program is built around you.
It's also worth asking your physician whether a bone density scan makes sense for you. Knowing your bone health changes how you train.
4. Get hands-on care early
When a wrist, an ankle, or a knee first starts to ache, get it looked at then, not six months later. A small ache changes how you move, and how you move is the whole chain.
How we look at pickleball injuries at HealthFit
At HealthFit, we look at every injury in two layers.
The Source is where it breaks. In a pickleball fall, that's the wrist, and underneath it, the bone.
The Cause is why it happened: balance, reaction time, leg strength, and that backpedal habit.
Treat only the wrist, and you're just waiting for the next fall. Train the cause, protect the source, and you change the whole chain. That's our Source-Cause-Stack approach, and it's how we help pickleball players in Pasadena stay on the court for years, not weeks.
Every plan is individual. Your history, your bone health, and how you move all shape what we recommend.
Want help keeping your feet under you?
Here are 3 ways to take the next step:
Come to our free Pickleball Class, in person at HealthFit in Pasadena on Thursday, October 22nd, at 6:00pm. Seats are limited. Save your seat here: [PICKLEBALL CLASS LINK]
Visit healthfitinc.com to learn more about how we work.
Call us at 626-365-1380, and we'll get you started.
The lob is always going to come. Let's make sure your feet are ready when it does.
HealthFit Physical Therapy & Chiropractic | 145 Vista Ave, Suite 103, Pasadena, CA 91107 | 626-365-1380 | www.healthfitinc.com
This article is for general education only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your physician or provider with questions about a medical condition.
