In this episode, I’m digging into a question that sounds almost absurd until you look at the data: why is pickleball—arguably the “sweetest, safest-looking” sport in the park—sending so many people to the emergency room?

Pickleball looks harmless. The court is small. The serve is underhand. The ball is basically a wiffle ball. And yet, ER records tell a different story: fractures (especially wrists), sprains, strains, and a pattern that’s hard to ignore—older adults showing up for pickleball injuries at rates that started to rival tennis. I walk through what’s really happening, and why the sport’s design quietly creates the perfect setup for falls, tendon overload, and sudden-stop injuries.

I explain how two rules—the double bounce and the kitchen—shape the way your body has to move: quick lunges, short sprints, abrupt decelerations, and reactive steps at the net. It doesn’t look like sprinting, but it often acts like sprinting in bursts. And that mismatch—between what the game demands and what many bodies are prepared for—is where trouble starts.

But I’m not here to villainize pickleball. In fact, I make the case for why it’s one of the most powerful “stealth health” activities out there: it’s fun enough that people actually show up, it can hit moderate intensity, and studies suggest benefits for lower-body power, cognition, and even chronic pain when it’s introduced with a smart ramp-up. The problem isn’t pickleball—it’s the gap between enthusiasm and preparation.

We also get specific about the injuries that worry clinicians: the Achilles rupture story (tendons adapt slowly, even when you feel “fit”), the rare-but-serious eye injuries that can threaten vision, and the overuse problems the ER doesn’t capture—things like tennis elbow and shoulder tendinopathy that creep in when you play back-to-back without recovery.

And then I give you the practical fix: how to make pickleball safer without ruining the fun. I walk through a simple warm-up framework (RAMP), the strength and balance basics that reduce fall risk, and the small decisions that matter more than people realize—court shoes, gradual play-time build, rest days, and yes, eye protection if you’re living at the net.

This isn’t about playing harder. It’s about playing longer.Dr. Marbas Substack: https://drlauriemarbas.substack.com/

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