An Introduction to Preventing Pickleball Injuries

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Transcript

Hello, everybody. My name is Dr. Eric Lullove. I am a foot and ankle surgeon practicing in Coconut Creek, FL. I have been in clinical practice since 2004.
 
And pretty much what we're going to be talking about today is pickleball, the beginnings, the demographics, the injuries, how to prevent them. We'll talk about some shoes. We'll talk about training and functional methods of how to protect your patients. And then we'll get into some of the newer surgical regenerative treatment options for these patients that are a little bit outside of what we would consider traditional surgery.
 
But one of the things I wanted to explain why I'm doing this today for Podiatry Today is I started playing in 2017, well before the pandemic. And I, my background was hockey, racquetball. So I found a natural fit playing pickleball because I'd always enjoyed playing ping-pong. This was a natural fit for me because I needed the competition. I am not much of a runner, as you can tell. OK, and I had still my hand-eye coordination from playing hockey and ping-pong and playing racquetball. So this sport kind of fell into my lap and something I really, really enjoyed.
 
So when we talk about why me in particular, so I have a very high skill rating. I'm one of probably the only few people that can literally talk about this because I do play national level tournaments and have a few medals to my pocket and but the most part I take care of a majority of the local UPA professional athletes that play in the United Pickleball Association Tour here in South Florida and then I take care of both the regular touring pros and the senior professionals that live in the area. So I've been doing this for a long time. And while there's a lot of stuff out there on the internet that you may or may not read, there's some stuff that's been put out by the other sports medicine groups. I wanted you to hear from the guy who's on the court in between the lines treating these active professional athletes.
 
How has pickleball’s popularity evolved?
 
So let's talk about how really pickleball where we are today in 2024 compared to where we were years ago. So right now, 36 and a half million people are playing the sport. When I started playing, it was like 2 million. So the sports just exploded more so since COVID, but really in the last 8 years it's exploded. The growth of the sport in the last 3 years is 223.5%. I mean, that's like insane. I mean, you don't even see sports grow that much. The largest age bracket, and this is the big misnomer that we think that pickleball is really this older geriatric 50+ population, the largest number of pickleball players age demographic wise in the United States, which represents about 28% of all players, is 18 to 34, which is why the regenerative medicine techniques that we're going to talk about later and some of the surgical treatment options that we've typically done are not that popular for these patients when they sustain an injury.
 
The number of places to play pickleball in the US is over 13 ,000. I mean, literally, we are converting tennis courts into pickleball facilities. The paddle market, when we talk about like monetary and what we're talking about, the paddle market alone is worth $153 million. Now, I don't have a paddle on the market, but I do have a shoe and we'll disclose that later. And really, the forecasted annual growth rate of pickleball is 7.5%. And that's through 2028. So that's where we are kind of, you know, and a total number of players, we're at 48 million players total. So, this is a huge amount, this is a big business venture for those of us who treat these injuries and see these patients. I mean, raise your hand, I mean, I see 10 to 12 of these patients a week. They're mostly my friends and people who know me in the area and they, and I have the branding, as you can see behind me, you know, I have a YouTube channel, I do post a lot online under this brand. So, that's where we're at.
 
So the other important thing is we talk about participation sports, okay? If you think about all the participation sports that we have in the U.S.—football, soccer, baseball, basketball, golf, running, biking. Pickleball is third on the list after biking and running. It's a larger participation sport than baseball, than football, football. When the sport kind of started, when we started tracking the data, which was really 2017, there were only 3 million people playing. I think I said 2, but it's really about 3.1 million people. By 2022, it was up to 9 million. And now we're at 48 million. It's growing at 200-plus percent each year. And this is why it's so important from a business standpoint, if you own your practice, that you start niching into sports medicine in particular, learning how to really treat these patients.
 
What are the most common pickleball injuries?
 
For somebody that plays between the lines, there are 3 major injuries that we see in the lower extremity: Achilles tendonitis, ankle sprains, plantar fasciitis. Now there are other associated injuries that we can refer out to other providers, but the second most common one are going to be shoulder injuries, common flexor tendonitis in the forearm, stress fractures, you know, hyper extension injuries, but a lot of these can be resolved with proper shoe gear and training.
 
How can patients train effectively to prevent injury?
 
The biggest thing in, the biggest harbinger to injury is lack of warmup. If you were to ask any of these patients when they come in with your injury, “Did you warm up before you played?” and the answer is going to be no. Almost 80% of the time they're gonna say “Well, I yeah, I hit the ball a little bit I was I dinked a little bit and I was hitting with the paddle,” I go “No, did you actually physically warm up your body? Did you physically take the time to warm your body up?” And the answer is no.
 
And then you, now is an opportunity for you as a provider to increase your business revenue and increase your E/M service visit because now you're getting into a more complex visit with training and teaching. Now you're in the education component, okay? So you can talk about dynamic stretching. You can talk about dynamic foot movement. You can talk about how to do 3-dimensional stretching and opening up the hips and warming up your, like, there are certain tools here that we need to talk about as far as training. And I'm not endorsing any particular product. But if you, patients do not have one of these, okay, this just happens to be the Hyperice Hypervolt go-to, it's what I particularly use, but there are other companies, there's Theragun, there's the ones from Sharper Image, but these massage pistols help to heat the muscles up before you even start doing anything.
 
The whole idea is to use high-frequency massage therapy to increase blood flow to the muscles to start loosening them up so that when you go to start playing, you're already warmed up. You're not starting static cold. You've already gotten the muscle fibers fired up already. You're already starting to get the muscles warmed up to play and be active, but it's not just hitting the lower legs. It's about doing warming up the quads your calves, hamstrings, peroneals, and I'm not done yet. You need to the lower extremity hip gluteal muscles. So you got to do the glute maximus and medius. So you have to kind of relearn all your anatomy because every single muscle in the lower extremity has a particular fire point in what happens on a pickleball court. And I'll get into why all, all this muscle training is so important.
 
The other thing is to talk to your patients about agility drills, about what type of training are they doing to increase their footwork because better footwork minimizes ankle injuries. Now, there's going to be a lot of guys that are going to be looking at this going, "Come on, Dr. Lullove. If we teach our patients how to injury prevent them, we don't have business." That's not why we do this. That's not why we're doing this. We're doing this to not only educate our clientele, but this also gives you the opportunity to meet with your local pickleball clubs and to do marketing and talk about injury prevention and balance agility drill training and how to do dynamic stretching and to talk about what, how you can prevent your local clubs and get referral business from it. The whole idea of this is to learn how to build a niche business out of pickle ball, even if you don't play.
 
But we are the preeminent foot and ankle medical and surgical experts of the lower leg. We need to make sure that we are the experts when it comes to pickleball injuries, that it's not the orthopedic surgeons, or the general practitioners, or the nurse practitioners. I don't want my local NPs to take this business for me. Make yourself the expert, as you should.

Dr. Lullove is in practice in Coconut Creek, Fla. He is the Chief Medical Officer of the West Boca Center for Wound Healing. Dr. Lullove discloses he is a shareholder of Winners Edge Pickleball Shoes.