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Some Action on a Pickleball Court Can be Fun & Safe, Even With a Heart Condition

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Pickleball has been a fast-growing sport in the U.S.: The number of players has more than tripled since 2020, reaching 13.6 million in 2023. Image for illustration purposes
Pickleball has been a fast-growing sport in the U.S.: The number of players has more than tripled since 2020, reaching 13.6 million in 2023. Image for illustration purposes
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By Emily Halnon, American Heart Association News

Following his heart transplant in 2015, John Daniel tried to take advantage of the tennis courts at his condominium to stay healthy and active.

“But it was an abysmal failure,” he said. Neither he nor his wife, Leslie, enjoyed playing tennis when they tried it.

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A friend suggested they try pickleball, a game similar to tennis but played on a smaller court. So the Daniels grabbed a couple of paddles and gave it a shot. It was such a success that they and some neighbors set up makeshift playing areas on the tennis courts. And earlier this year, the couple opened a pickleball facility in Bartlett, Tennessee, because they believe the game offers so much value for players – including those with a cardiovascular condition, like 69-year-old John.

Pickleball has been a fast-growing sport in the U.S.: The number of players has more than tripled since 2020, reaching 13.6 million in 2023, according to the Sports & Fitness Industry Association. It’s even popular with people in their 60s and older, likely because the game typically is a low-impact, social way to be active. The COVID-19 pandemic accelerated pickleball’s popularity, as people looked for outdoor activities close to home that allowed them to connect with others.

And while the action can get competitive, exercise experts say pickleball is one way to boost heart health even if you have a cardiovascular condition. Just be mindful of a few things.

It gets your heart pumping

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Pickleball combines elements of racket sports like tennis, badminton and pingpong. Players lob a plastic whiffle ball over a net, then try to outmaneuver their opponents so they can’t return the shot. The sport is known for being simple, social and easy to learn – and it can accommodate everyone from beginners to competitive athletes.

And it gets the heart pumping. In a 2022 study in the Journal of Aging and Physical Activity, the average heart rate for pickleball players with an average age of 62 reached 112 beats per minute.

Like all other forms of exercise, pickleball can help people prevent or manage heart conditions, said cardiologist Dr. Lili Barouch, director of sports cardiology at Johns Hopkins Hospital in Baltimore.

“Playing pickleball, and participating in other sports and exercise, is great for people with heart conditions because it improves cardiorespiratory fitness, reduces risk of recurrent cardiac events such as heart attack, atrial fibrillation and heart failure, lowers blood pressure, and improves sleep quality, just to name a few,” she said.

But if you have a heart issue, your first step should be to contact your medical team before trying pickleball.

“Anyone with a cardiovascular condition should talk to their doctor before engaging in a new activity,” Barouch said.

While most people with cardiovascular conditions or risk factors such as high blood pressure or high cholesterol should be fine to play, there may be rare conditions that could require more restrictions, she said. And always check with your doctor if you experience symptoms such as chest pain or dizziness while playing.

Boosting mental health and social connection

When the Daniels got into pickleball in 2019, they found it was an incredible way to make new friends and get to know their neighbors.

“The whole game is played close to the net, so it’s easy to have a conversation while you’re playing,” John said.

Heart transplant recipient John Daniel (right) and his wife, Leslie, turned to the tennis court at their condominium in Bartlett, Tennessee, to play pickleball. (Photo courtesy of John Daniel)

It gives people, especially older adults, a “vital social connection” that can boost their emotional well-being, said Mike Zehner, a clinical exercise physiologist and manager of Cardiac Rehab at Penn State Health’s Milton S. Hershey Medical Center in Hershey, Pennsylvania.

“When people age, they retire, their children move out, and they naturally self-isolate as their life changes, which can increase rates of depression and anxiety,” he said.

But, Zehner said, “we also know that exercise is a proven way to improve depression and boost your mood.” A 2023 study published in the journal Frontiers in Psychology found that playing pickleball led to significant improvements across personal well-being, life satisfaction and happiness, depression and stress.

A potential downside: Its social aspect can also increase the temptation to partake in less heart-healthy food and drink, as many sessions typically end at a bar or restaurant. Moderation is key during post-pickleball festivities, Zehner said.

“It’s great to go out and keep socializing after a game,” he said, “but choose healthier options from the menu to continue boosting your heart health off the court.”

Getting started with pickleball

Few adults in the U.S. get the 150 minutes of moderate-intensity aerobic activity or 75 minutes of vigorous exercise recommended by federal guidelines. Exercise can help improve sleep, cognition, mental health and bone health – and lead to a better quality of life.

For older adults, pickleball is an ideal activity because it’s easier on the joints than tennis and other sports. And it builds balance, which helps offset the natural decline that can happen with aging, Zehner said.

“Pickleball can help develop front, back and lateral movements so you can improve your balance and lower your risk of falling,” he said.

Barouch recommends warming up to get your joints, muscles and bones ready to play, then cooling down afterward. And avoid doing too much too soon. That can be a recipe for injury, she said.

“If you haven’t been exercising at all, start building a baseline fitness with brisk walks, bike rides or other gentle activities,” she said.

Once you’re ready to get going, John and Leslie suggest looking for beginner’s lessons at a community center, YMCA or a public park facility.

“Most people find that once they show up, it’s not an intimidating game, and groups are very welcoming of newcomers,” Leslie said. “It really is such a fun way to exercise.”

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