Getting Back to the Pickleball Court with mTrigger Biofeedback

Pickleball is one of the fastest growing sports in the country, especially with the 60 and up crowd.(1) In 2019, there were roughly 3.3 million pickleball players in the US alone.(1) Now that more people are playing, pickleball injury rates have increased rapidly.(1) With 85% of those injuries occurring in those over 60.(1) Due to its slower speed of play, the injuries sustained in pickleball are typically less severe than in tennis.(2) However, the most common injury is a strain or sprain (33.2%) followed by a fracture (28.1%).(1) A fall/trip/slip or dive are the most frequent mechanisms for sustaining an injury on the pickleball court.(1) More specifically, ankle sprains, knee strains/tendinitis, rotator cuff strains, Achilles tendinitis, lateral epicondylitis, and plantar fasciitis are all high on the possibilities list.(3)

Thankfully, the majority of pickleball injuries are treated conservatively with physical therapy.(2) Even fractures requiring surgery, most often sustained at the wrist (distal radial ORIF), need physical therapy after surgery to restore range of motion and strength. mTrigger biofeedback is a tool that can easily be utilized in rehabilitation to improve outcomes and better address pickleball injuries.

Working on injury prevention and management strategies during the season is important for both injured players and those looking to stay healthy.(3) The first three months of the season are when most injuries occur as players are still building fitness.(3) Let’s look at how biofeedback can be used to enhance the way pickleball players prepare for an upcoming season or comeback from an injury.

For pickleball players, making sure the appropriate muscles needed for play are strong will help to avoid strains and sprain. Targeting the hamstrings, hips, and calves is a good place to start.(4) Here are some exercise examples targeting these muscle groups with the enhanced benefit of mTrigger biofeedback to maximize muscle activation and proper movement.

These exercises examples target the hamstrings, an important muscle for deceleration, changing direction, and running.

This next exercise is important for maintaining strength in the calf muscles to help prevent Achilles injuries, plantar fascitis, and ankle sprains. Performing the exercise with mTrigger biofeedback enhances the strength building portion of the exercise and encourages patient engagement.

The hip muscles work to control and stabilize the knee and ankle joints during the dynamic movements of a pickleball match. Try performing these exercises with mTrigger biofeedback to ensure they are done with correct form and maximal muscle engagement.

Additionally, pickleball requires players to move laterally, forwards, and backwards placing specific demands on the hamstrings, hip abductors, Achilles tendons, and quadricep muscles as they are tasked with eccentrically loading and changing directions.(3,4) This example demonstrate how biofeedback helps enhance patient muscle activation during eccentric and lateral movements specific to the demands of pickleball.

The upper body is just as important to address in physical therapy. Incorporating exercises that improve rotator cuff activation and better match the demands of pickleball are recommended for players both before and during the season.(3,4) A wrist tendinitis developed from repetitive over extension of the wrist joint has cleverly been termed “pickleball wrist” and is another common issue in the upper extremity of players.(4) Exercises with biofeedback that target this motion can help to develop the muscles necessary for this rapid and repetitive motion.(4)

Finally, with age we see a decrease in coordination, diminished strength, and poor motor skills, all of which can all be a contributor to pickleball injuries.(5) Giving special attention to strength, balance, and core stability is critical for older pickleball players to decrease the risk of injury.(4)

Summary
Pickleball injuries are growing across the US in the over 60 population. mTrigger biofeedback is a rehabilitation tool that can be utilized by players and therapist to help improve muscle activation following an injury, promote proper movement patterns, and address the strength and motor skills necessary for staying healing on the pickleball court.

Hamstring Strain Protocol

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Why Measure Muscle Activation