Titans team doctor says many pickleball injuries need rehab, not surgery

By AI, Created 4:51 PM UTC, May 18, 2026, /AGP/ – Pickleball injuries are rising fast as millions of adults 50 and older take up the sport, and a Tennessee Titans team physician says the right treatment depends on the injury. Dr. Ethan Kellum says some cases need surgery, but many can be managed with rehabilitation and activity changes.

Why it matters: - Pickleball is now a major source of overuse and acute sports injuries among older adults, especially players 50 and up. - The surge matters because many new players are active but not yet conditioned for the sport’s lateral movement, quick starts and frequent play. - Treatment choices can determine whether injured players get back on the court or lose access to the sport altogether.

What happened: - Pickleball reached 24.3 million U.S. players in 2025, a 171.8% increase over three years, according to the Sports & Fitness Industry Association’s 2026 Topline Participation Report. - Peer-reviewed research in Arthroscopy, Sports Medicine, and Rehabilitation found pickleball-related emergency department visits rose 91% between 2020 and 2022, while hospital admissions increased 257%. - A ten-year national epidemiologic study found 91% of pickleball injuries occur in players 50 and older. - Dr. Ethan Kellum, a fellowship-trained orthopedic surgeon, sports medicine specialist and Tennessee Titans team physician, says the injury pattern is showing up in his Franklin, Tennessee practice. - A 2022 Vanderbilt University Medical Center study found a 6.8-fold increase in pickleball injuries at one Nashville-area health system between 2017 and 2022.

The details: - Peer-reviewed research shows fractures and strains/sprains each account for roughly 27% to 30% 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. - Research in Injury Epidemiology found women 60 and older are more than three times as likely as men in the same age group to suffer a pickleball-related fracture. - The same study found men 60 and older are more than three times as likely as women in that age group to sustain a strain or sprain. - A UBS Wealth Management analysis estimated 2023 pickleball-related medical costs at $250 million to $500 million. - UBS also estimated 86% of associated emergency department visits involved patients over 60. - Kellum says complete rotator cuff tears in active older adults, displaced wrist fractures and acute Achilles ruptures are injuries where surgery is the right call. - Kellum says partial rotator cuff tears, early knee osteoarthritis aggravated by overuse, chronic Achilles tendinopathy and low-grade meniscus tears often respond to regenerative treatments, targeted rehabilitation and activity modification. - Kellum says new players often increase playing volume too fast, ignore early injury signals and skip the dynamic warm-up the sport requires.

Between the lines: - The public-health issue is not just pickleball itself. The bigger problem is a fast-growing older player base that is often enthusiastic enough to ramp up too quickly. - Kellum’s view pushes back on a one-size-fits-all response to sports injuries. Some cases are surgical, but many are better handled before they become chronic. - His comments also reflect a broader demand among older recreational athletes to stay active without accepting a false choice between pain and giving up the sport.

What’s next: - More adults are likely to keep entering the sport, which means clinics and sports medicine practices may see continued demand for both surgical and non-surgical treatment. - Injury prevention advice will likely focus on gradual ramp-up, early symptom recognition and warm-up routines before play. - Kellum says many patients can stay on the court with the right treatment plan, rather than being told their pickleball days are over.

The bottom line: - Pickleball injuries are rising with participation, but the right fix depends on the diagnosis. For many older players, surgery is only one option — not the first one.