Comparing Injury Risks Between Bicycling and Pickleball
Based on the most recent evidence, pickleball appears to cause fewer serious injuries and fractures than bicycling, making it a safer option for most individuals concerned about injury risk.
Injury Patterns in Pickleball
Demographics and Prevalence
- Pickleball injuries have increased dramatically as the sport has grown in popularity, with a 90-fold increase in fractures between 2002-2022 1
- Most pickleball injuries (over 85%) occur in players aged 60 years or older 2
- By 2018, senior pickleball injuries reached parity with senior tennis-related injuries 2
Common Pickleball Injuries
- Most common injuries presenting to emergency departments:
- Gender differences in injury patterns:
- Men are 3.5 times more likely to suffer strains/sprains
- Women are 3.7 times more likely to suffer fractures, particularly wrist fractures (9 times higher risk) 2
- Most injuries (63.3%) result from slip/trip/fall/dive mechanisms 2
- Upper extremity fractures account for 66% of all pickleball-related fractures 1
Injury Patterns in Bicycling
Types and Severity
- Cycling injuries account for approximately 500,000 emergency room visits annually in the US 5
- More than half of bicycle accidents involve motor vehicles, creating higher risk for severe trauma 5
- Head injuries are common and account for most fatal cycling accidents 5
- Serious injuries include:
- Contusions, sprains and fractures throughout the body
- Abdominal and genital injuries from handlebar and seat impact
- Abrasions, lacerations and bruises 5
- Overuse injuries are also common:
- Neck and back pain (up to 60% of riders)
- Ulnar neuropathy (tingling, numbness, weakness in hands)
- Saddle-related problems (chafing, perineal issues, pudendal neuropathy) 5
Risk Assessment and Comparison
Relative Safety
Bicycling carries higher risk of:
- Fatal injuries (head trauma)
- Motor vehicle collisions
- Varied trauma throughout the body
- Overuse injuries affecting multiple systems
Pickleball carries higher risk of:
- Falls resulting in upper extremity fractures (especially in older women)
- Strains and sprains (especially in men)
- Lower extremity injuries
Risk Modifiers
- Age is a significant factor - older adults are at higher risk for fractures in pickleball 2, 1
- Court size in pickleball (smaller than tennis) doesn't appear to correlate with injury rates 3
- Proper equipment and mechanical maintenance significantly reduce cycling injury risk 5
Injury Prevention Strategies
For Pickleball Players
- Implement proper warm-up and cool-down routines
- Focus on balance training to prevent falls (the primary injury mechanism)
- Consider protective gear for wrists, especially for women
- Ensure proper footwear with good traction
For Cyclists
- Always wear a helmet (critical for preventing fatal injuries)
- Use proper protective equipment
- Maintain bicycle in top mechanical condition
- Use appropriate gear ratios at higher cadence to prevent overuse injuries
- Practice defensive riding strategies 5
Conclusion for Medical Decision-Making
When advising patients about sport selection based on injury risk:
- For older adults (60+): Consider individual fall risk when recommending pickleball
- For those concerned about serious or fatal injuries: Pickleball presents lower risk than bicycling
- For those with previous upper extremity fractures: Bicycling may present lower re-injury risk
- For overall injury prevention: Both sports require specific safety measures, but bicycling requires more extensive protective equipment and safety awareness
The evidence suggests that while both sports carry injury risks, pickleball generally results in less severe injuries and fewer fatalities compared to bicycling, making it the safer option for most individuals concerned primarily about injury risk.