So why has pickleball suddenly become so popular? After a slow period of growth, it suddenly exploded in recent years. Racquet sports have become somewhat more popular, but tennis can be challenging and frustrating for a beginner. Pickleball has a much shorter learning curve, and almost anyone can be playing, and enjoying the game, on day one. Initially, it was mostly seniors and mature athletes, but younger and younger individuals have taken a bite of the pickle. According to SFIA, growth from 2020 to 2021 was the fastest among players under 24 years of age (21%). Both men and women are taking it up in droves. Pickleball has also been shown to be a wonderful workout. Recent scientific research has placed pickleball in the moderate intensity level exercise category, confirming numerous fitness-related health benefits. Pickleball will also improve balance and hand-eye coordination. It is also extremely social, another important factor in healthy aging and improved longevity. The pandemic also helped fuel the growth of this relatively new sport. Unlike many team sports and gym workouts, racquet sports allowed for “social distancing” and were considered safe not only outdoors, but indoors as well.

As with all sports, there are pluses and minuses in terms of your health. Pickleball clearly has activated a large segment of the population which is wonderful. This will lead to improved health and longevity. Racquet sports (especially tennis) have been shown, according to two recent large scientific studies, to be the best overall activity and/or sport in terms of improved longevity. The reasons are many- improved fitness, strength, agility, and even fall prevention. Also, the social element, which has been shown to be a critical part of healthy aging. The downside is a significant increase in injuries. In my orthopedic office, I am seeing more and more pickleball players every week. My specialty is knee disorders, but there is a wide range of injuries that can occur. I also believe that many of those are preventable. Common orthopedic injuries include strains and sprains (especially ankle), contusions, knee injuries including meniscus tears and ACL tears, shoulder tendinitis and rotator cuff problems, elbow tendinitis, muscle pulls (especially calf), and even fractures from falls. Wrist fractures are far more common in females, most likely related to weakened bones from osteopenia and osteoporosis, which is more prevalent in adult women. Serious eye injuries can also occur.

Certainly, the benefits of pickleball far outweigh the risks, which can be easily mitigated with some simple preventive measures. Here are my recommendations to stay out of the sports medicine office, and on the pickle courts:

• Warmup and stretch: Even before you step onto the court, you should warm up (jumping jacks or run in-place) for a few minutes to break a sweat. This greatly reduces the risk of muscle or tendon injuries. Next do both passive and active stretching of key muscle groups including shoulder, forearm/elbow, lower back, hamstrings, and calves. This is especially true for older athletes and anyone who has had prior injuries. Once on the court, do some light hitting for a few minutes before starting the game.
• Overall fitness: Fitness protects against injuries and improves athletic performance. Never rely on your sport for overall fitness. Your weekly workouts should include equal amounts of cardiovascular/aerobic training, strength training (including core), and stretching/flexibility. Balance exercises such as yoga tree pose (or even take up yoga) help with agility and fall prevention.
• Proper footwear: Wear sneakers specific for racquet sports. Running shoes are not appropriate as they do not have enough side-to-side stability and ankle sprains or falls will happen. Go to a local tennis shop for proper footwear and sizing. Also, unlike tennis, pickleball can be played if it is raining lightly or if the court is wet, something I do not recommend because of the higher risk of slipping and falling. Also, sometimes pickleball is played on a paddle tennis court, which has a gritty surface, and it is much easier to twist your knee.
• Eyewear: Consider wearing protective goggles. Rallies and volleys in Pickleball can be close-up and fast. Although serious eye injuries are more common in tennis than in pickleball, they can occur and are sometimes catastrophic. This is especially true in beginners or individuals who have not yet developed great hand-eye coordination. I strongly recommend protective eyewear.
• Get checked: For any individuals with medical conditions, check with your primary care physician to be cleared medically to participate in any new sport or fitness activity. This will significantly lower your risk of a medical issue that sends you to an emergency room.

I believe pickleball is here to stay. There are now professional leagues and tournaments, and even LeBron James has invested in a new Major League Pickleball team. Regarding my patients who sustained pickleball-related injuries, all were very anxious to get back to the new sport they love, and that is a very good thing. If you are looking for a new fun activity with plenty of health benefits and social interaction, give pickleball a try! Learn more at www.usapickleball.org

Nicholas DiNubile, MD is an orthopedic surgeon with Premier Orthopedics, specializing in sports medicine and knee disorders in Havertown, PA. He is a best-selling author of the FrameWork series of health and wellness books, served on the President’s Counsel on Physical Fitness and Sports, and has advised two U.S. Presidents in matters of health policy. He is an avid tennis player and is certified by the United States Professional Tennis Association (USPTA).

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Give yourself goals: Develop a plan and aim to make it part of your daily schedule. Whether you want to move more to combat the extra holiday indulgences, or just stay active for your mental health, start small. Take it one day at a time and soon enough you’ll find yourself with a healthy habit! By beginning with a fitness goal in mind you’re more likely to see success.

Create a home exercise space: Bring fitness indoors! Invest in some simple home gym tools like weights, a yoga mat, or even a mini elliptical or treadmill. If you don’t have enough indoor space for equipment, try some body weight resistance workouts using your furniture or a wall. During the winter months, your outdoor exercise may be limited, but there are plenty of ways to improvise activity while keeping warm.

Mix up your movement: High Intensity Interval Training (HIIT) is a great style of exercise that you can easily implement into your schedule. Equipment is not required, but optional, plus your workout can be as short, long, or intense as you need. For example, choose five exercises (like jumping jacks, lunges, mountain climbers, squats, and high knees in place) and spend 30 seconds or more on each, as quickly and intensely as you can. Keep it interesting and choose new exercises each round, add weights, or use a treadmill to run varying speeds. Once you get more used to it, adjust the timing and frequency of reps, and length of rest time in between sets. Intense cardio workouts like HIIT are challenging, but you’ll see results while never getting bored!

Casually burn calories: You’d be surprised at how many calories you can burn without working out. Stuck shoveling snow? See it as a great opportunity to work your arms and shoulders. Need to grocery shop before a snowstorm? Park farther away, walk briskly through the stores, and take the stairs when possible. Then when you get home, put on some upbeat music and have a dance contest with your kids. Making your daily to-do list more energetic can be fun and easy, and you will hardly notice the effort.

Don’t hibernate: Give your social life a workout too! Start a home exercise “club” with your friends, in person or virtually, and help each other reach your goals. Find a local batting cage, basketball court, or indoor field, and practice your skills. If you’re more into individual fitness, join a gym workout class like kickboxing, yoga, Zumba/dance, or spinning. It will extend your bluesy winter schedule well into the spring!

The key to any successful exercise program is to discover something that you enjoy. When you are having fun, it won’t feel like a chore, and you will be more likely to make it a habit. Whatever that is, set daily or weekly goals to complete it consistently!

To learn more ways to maintain your best health, visit us at premierortho.com. Contact us at 1-855-ORTHO24 to schedule an appointment.

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Fall sports season is well underway. Football, cheerleading, soccer, cross country, and even fall baseball are all full tilt.

Despite taking all precautions, athletic injuries are inevitable. Let us review the most common injuries and best treatment options for your fall athlete.

Concussion:

Every fall athlete is at risk of concussion. Football is the most prominent sport associated with this injury, but every athlete is susceptible to this injury. Whether it is two soccer players colliding on a head ball or a cheerleader taking a bad tumble, head injuries can happen everywhere. This injury is not always immediately apparent, so it is essential for loved ones to keep an eye on their athlete after a blow to the head. Look for any changes in behavior including sleep. If you notice your athlete acting differently, complaining of dizziness, headache, vomiting, or has vision issues see a physician immediately.

Hand and wrist fractures:

Falls are common during the fall. Every athlete takes a tumble from time to time and instinctually extends their arms to break their fall. This can result in hand and wrist fractures, especially distal radius fractures. Depending on the severity and location of the break conservative options should attempted first. Splinting, casting, and braces are all viable conservative treatment options. If the fracture is displaced, breaks through the skin, or is complex, surgical intervention may be required. Your athletic trainer should discuss with you and your family treatment options based on the severity of the injury.

ACL tears:

Everyone has heard of ACL tears. Typically, the anterior cruciate ligament tears when an athlete twists too far or is involved in a collision. Sometimes the ACL can tear from just taking a bad step. There are three grades of ACL tear with the mildest being a sprain, and the worst being a full tear. Symptoms of a tear include swelling, pain, and instability. Treatment options depend on severity of the tear. Mild tears, or sprains, can be treated with bracing, rest, ice, and physical therapy. More severe tears will require surgical intervention. Surgery is usually done through a minimally invasive procedure. Your new ACL will either be tissue from your own body or a donation from a cadaver.

Ankle sprains:

Another common injury, ankle sprains occur in every fall sport. An errant leap from a cheerleader, a bad step on the trail during cross country, or two legs colliding on the soccer pitch all can result in an ankle sprain. Ankle sprains commonly occur when the ankle twists, rolls, or turns in an uncomfortable way which results in a stretching or tearing of the ligaments that hold the ankle together. Most sprains can be treated with the R.I.C.E. method (Rest, Ice, Compression and Elevation), along with over-the-counter pain relievers. More serious ankle sprains may involve a ligament tear or broken bone and should be evaluated by a sports medicine physician.

Fall sports offer student-athletes many great opportunities, but along with the thrill of victory comes the agony of injury. If you or a loved one suffers any of the above injuries and would like to be evaluated by Dr. Walsh, please call 610-520-6170 or visit premierortho.com.

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Bowling is a fun sport that can be enjoyed at all ages, amongst friends, or played in a professional tournament! However, whether you’re bowling leisurely or professionally, it’s important to understand the most common injuries associated with the activity and learn how to prevent them.

When bowling, the shoulder repeats fast swinging motions frequently, which can lead to shoulder tendonitis. The repetition of the bowling motion makes this injury very common, whether you’re a professional or amateur. Shoulder tendonitis can occur from improper technique, such as throwing the ball with too much force. To avoid this injury, players need to stretch their arm muscles. This will aid in preparing their shoulders for the repetitive swinging movement.

While it’s not as common as shoulder tendonitis, bowlers can suffer from wrist tendonitis. This typically occurs from the swinging and twisting motion of the wrist, which can cause sprains and inflammation in the wrist tendons. The best way to avoid this form of injury is by stretching and ensuring proper form when playing. If a bowler is feeling pain or discomfort in their wrists or is diagnosed with wrist tendonitis, it’s imperative that they rest to prevent further damage or serious injury.

“Bowler’s elbow,” also known as epicondylitis, is a common injury amongst professional bowlers. This is when the tendons in the elbow become inflamed due to the constant movement of their wrist, which puts strain on the elbow. This injury occurs from overuse and repetitive motions – specifically when bowlers swing and release the ball. Treatment for “bowler’s elbow” typically requires rest. However, in some cases, physical therapy and/or surgery may be needed.

“Bowler’s thumb” is another injury that occurs amongst experienced players, typically when adding spin to the ball or throwing it too hard. To avoid this injury, it’s important that players find a ball that best fits their fingers. Having a thumb hole that is too small will cause strain, resulting in an injured finger.

Kevin Walsh, M.D., is a non-operative sports medicine physician. He sees patients in our Bryn Mawr and King of Prussia offices. To schedule an appointment, please call 610-520-6170.

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Measuring your heart rate ensures an efficient routine during training. While exercising, monitoring the heart’s rate can help athletes determine whether they’re pushing themselves too hard, or need to increase the intensity to attain their strengthening goal.

To accurately analyze your heart rate, you must first define your target zone – the ideal heart rate to get the most out of your training sessions. Knowing this will help you track your health and fitness levels.

However, before determining the target zone, take your resting heart rate – the number of times the heart beats per minute when at rest. The perfect time to check this is first thing in the morning, before getting out of bed. The American Heart Association defines the normal range as between 60 and 100 beats per minute (bpm). A lower resting heart rate is generally better because it typically means the heart is better conditioned. Heart rate can be affected by stress, anxiety, medication and your level of physical activity. An athlete’s resting rate can drop as low as 40 bpm.

The maximum and target heart rate zones differ depending on your age. The target zone is the heart rate during moderate intensity exercises, while the maximum rate is during high intensity activities. Subtract your age from 220 to get your maximum heart rate, the highest number of times your heart should beat during a minute of exercise. To better understand what your target zone and maximum heart rate should be, look at this chart provided by the American Heart Association.

Once you’ve found your target, you should continuously monitor your heart rate when training. The easiest way to do this is by wearing a heart rate device or fitness watch. If that’s not an option, measure manually by finding your pulse on the inside of your wrist and count the number of beats in 30 seconds, then multiply by two. Knowing your heart’s rate during a workout will aid in determining whether you should slow down or pick up the pace.

With all that being said, it’s important for athletes to pay attention to their cardiovascular health to stay in tip-top condition, and further their athletic careers. Contrary to popular belief, athletes can compromise their heart’s health through improper training and diets. So, to maintain a healthy and happy heart, follow these easy tips from our specialists:

• Do not overconsume protein. Keli Donnelly, D.O., a sports medicine physician at Premier Orthopaedics in Bryn Mawr, explains that, “too much protein can increase the risk for heart attack and heart disease. It’s important to maintain a well-balanced diet, including foods that are high in heart-healthy nutrients. Some examples include salmon, almonds, walnuts, brown rice, spinach, broccoli, oranges, etc.”

• Alternate workout routines. Premier sports medicine physician Kevin Walsh, M.D., voted #1 in Non-Surgical Sports Medicine by Main Line Today magazine, states, “consistent long-distance running can lead to arterial damage, and increase the risk for heart attack. While working out, be sure to include both resistance training and cardiovascular exercise.”

If you or someone you know needs further assistance from a sports medicine specialist, contact Dr. Donnelly and Dr. Walsh’s Bryn Mawr office at 610-520-6170.

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