Introduction to Spine Injuries in the Pickleball Athlete

Pickleball is one of the fastest growing sports in the United States. Despite its popularity, there is limited research on pickleball-related orthopaedic injuries, particularly in the spine. This study aims to provide a deeper understanding of spinal injuries in pickleball players and offers insights into injury patterns and risk factors.

A retrospective review from our urban tertiary medical center's electronic medical record from 2013 to 2023 was done using OpenAI's Generative Pretrained Transformer-4 model to identify pickleball-related orthopaedic injuries. After artificial intelligence-driven identification, a manual review of medical records identified injuries related to the spine. The resulting medical records were manually reviewed for variables such as injury year, age, sex, spinal region affected, and treatment. Artificial intelligence did not generate any data, participate in writing, or assist with statistical analysis. Statistical analyses were done using Stata software, with significance set at P < 0.05.

Among 1,527 pickleball-related orthopaedic injuries, 135 (8.8%) involved the spine (77% women, median age: 62 ± 12.4 years). Pickleball-related spinal injuries increased 56-fold from 2013 to 2023. Most injuries involved the lumbar spine (84%), followed by the cervical spine (15%) and thoracic spine (1%). The most common complaint was lumbar radicular symptoms (63%). Forty-six percent of patients had a body mass index over 25, and this was associated with lumbar radiculopathy and acute disk herniation ( P < 0.05). Most patients sought outpatient care (98%) and 10% required surgical intervention, primarily spinal decompression.

Pickleball-related spine injuries are relatively uncommon but increasing as the sport grows in popularity, with the lumbar spine being the most frequently affected region. Elevated body mass index emerged as an important modifiable potential risk factor, and the study found a relatively high rate of surgical intervention at 10%. These findings can help guide counseling and treatment for pickleball athletes, although further research is needed to better understand risk factors, treatment options, prognosis, and return-to-play guidelines.