As Pickleball Injuries Surge Among Adults 50+, a Tennessee Titans Team Physician Outlines Which Injuries Demand Surgery

With 24.3 million now playing the country's fastest-growing sport, peer-reviewed research shows pickleball-related ER visits have climbed 91 percent.

FRANKLIN, TN, UNITED STATES, May 14, 2026 /EINPresswire.com/ -- Pickleball is the fastest-growing sport in the United States for the fourth consecutive year, with 24.3 million Americans playing in 2025....that's a 171.8 percent jump over three years, according to the Sports & Fitness Industry Association's 2026 Topline Participation Report. The injury curve has followed.

Peer-reviewed analysis published in Arthroscopy, Sports Medicine, and Rehabilitation (Cheng et al., 2024) found that pickleball-related emergency department visits increased 91 percent between 2020 and 2022, while hospital admissions climbed 257 percent. A ten-year national epidemiologic study found that 91 percent of pickleball injuries occur in players 50 and older. A widely cited UBS Wealth Management analysis estimated 2023 pickleball-related medical costs at between $250 million and $500 million, with 86 percent of associated emergency department visits involving patients over 60.

Dr. Ethan Kellum, MD, a fellowship-trained orthopedic surgeon, sports medicine specialist, and team physician for the NFL's Tennessee Titans, has seen the trend up close in his Franklin, Tennessee practice. A 2022 study from Vanderbilt University Medical Center documented a 6.8-fold increase in pickleball injuries at one Nashville-area health system between 2017 and 2022.

"The patient profile is consistent and it's the same conversation almost every time," Dr. Kellum says. "An active adult in their late 40s or 50s...someone who has finally found a sport that fits their life who picks up a paddle, plays four or five times a week within the first month, and arrives in my office two months later with knee pain, a rotator cuff strain, or a wrist they can't quite trust anymore. The injury isn't really about pickleball. It's about the gap between how active they want to be and what their body was prepared for."

Peer-reviewed research consistently identifies the same injury patterns: fractures and strains/sprains each account for roughly 27 to 30 percent of pickleball-related emergency department visits. Falls cause nearly half of all pickleball injuries. The wrist is the most common fracture site. The lower leg, ankle, and knee are the most common sprain sites. Women aged 60 and older are more than three times as likely to suffer a pickleball-related fracture as men; men in the same age group are more than three times as likely to sustain a strain or sprain, according to research in Injury Epidemiology (Weiss et al., 2021).

Dr. Kellum, who completed his sports medicine, shoulder, and advanced arthroscopy fellowship at New England Baptist Hospital and Boston Children's Hospital and previously served as assistant team physician for the NBA's Boston Celtics, emphasizes that not every pickleball injury requires the same response.

"There's a category of pickleball injuries where surgery is clearly the right call," he explains. "A complete rotator cuff tear in an active 65-year-old isn't going to heal on its own. A displaced wrist fracture needs surgical fixation. An acute Achilles rupture has a narrow window for optimal repair. Those are not the patients I'm trying to keep out of the operating room."

"But there's a much larger category where surgery is not the first answer — and often not the best one," Dr. Kellum continues. "A partial rotator cuff tear, early knee osteoarthritis aggravated by overuse, a chronic Achilles tendinopathy, a low-grade meniscus tear...these patients often respond to regenerative treatments, targeted rehabilitation, and intelligent activity modification."

Asked what he wishes new pickleball players knew before arriving at his office, Dr. Kellum identifies three patterns: volume too fast before tendons and ligaments adapt, treating injury signals as temporary soreness, and skipping the dynamic warm-up that the sport's lateral movement demands.

"This is a generation that doesn't want to be told to take it easy," Dr. Kellum says. "They want to be told how to stay on the court. The worst response to a pickleball injury is the response that ends with someone telling a patient their pickleball days are over. For most of the patients I see, that is not the right answer."

About Dr. Ethan Kellum

Dr. Ethan Kellum is a fellowship-trained orthopedic surgeon and sports medicine specialist based in Franklin, Tennessee. He serves as team physician for the NFL's Tennessee Titans and USA Basketball, and previously served as assistant team physician for the NBA's Boston Celtics, Harvard, and Tufts athletics during his fellowship training at New England Baptist Hospital and Boston Children's Hospital.

He earned his medical degree from the University of Tennessee Health Science Center College of Medicine and completed his orthopedic surgery residency at the Medical College of Georgia. Dr. Kellum is a member of Alpha Omega Alpha, the United States' oldest national medical honor societies. His Franklin practice, Regenerative Solutions Sports & Orthopedics, focuses on non-surgical and regenerative orthopedic treatments. For more information, visit drethankellum.com.

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