Pickleball, the fastest-growing sport in the U.S., could cost Americans from $250 million to $500 million in medical costs in 2023 tied to higher injury rates, particularly among seniors, according to a report from UBS.

UBS analysts, led by Andrew Mok, said they wanted to examine the issue after UnitedHealth Group, whose stocks the Wall Street firm covers, said that healthcare rates had risen recently among Medicare patients.

Pickleball, a game played since the 1960s, gained popularity during the pandemic when many people embraced outdoor activities. Over the last three years, the number of recreational pickleball players in the U.S. has soared 159 percent, from 3.5 million in 2019 to 8.9 million in 2022, according to the Sports and Fitness Industry Association’s (SFIA) data.

UBS forecasted that pickleball participants would double again this year to more than 22 million. Seniors comprise one-third of the most avid players, defined as those playing at least eight times per year (according to UBS). Pickleball appeals to seniors because it’s less strenuous, easier to access and learn than other racquet sports, including tennis and squash.

UBS analyzed Pickleball’s rapid growth while also examining common pickleball-related injuries and the related rise in spending on surgeries such as joint replacements to project the medical costs directly attributed to Pickleball. UBS estimated that $377 million of medical expenses in 2023 will stem from playing Pickleball. The investment bank said that roughly 80 percent, or $302 million, of the total relates to outpatient treatment in emergency rooms and doctor’s offices.

UBS analysts partially reached their estimates by citing a 2021 study published by the National Library of Medicine, which found that “Non-fatal senior pickleball and tennis-related injuries treated in United States emergency departments, 2010-2019.” The study focused on pickleball players ages at least 60 years old and found that 21.5 percent of players experienced “non-injuries” such as cardiovascular events. Injuries such as sprains were suffered by 33.2 percent of picklers, followed by fractures 28.1 percent and contusions 10.6 percent, with wrists and lower legs at the most risk of being hurt.

UBS analysts also explored a 2020 study in the Journal of Emergency Medicine titled “Pickleball-Related Injuries Treated in Emergency Departments,” where, again, the most common suffered were strains, sprains or fractures. The report found that patients 50 years and older accounted for 90.9 percent of the patients treated for pickleball-induced injuries.

“While we generally think of exercise as positively impacting health outcomes, the ‘can-do’ attitude of today’s seniors can pose a greater risk in other areas such as sports injuries, leading to a greater number of orthopedic procedures,” UBS analysts said in the report. “The heightened injury risk is especially true when considering that seniors’ activity levels were depressed for most of the pandemic.”