Racket sports track with longer lives, and pickleball’s injury surge shows the catch

Key takeaways

• In a study of 80,306 British adults, people who played racket sports had a 47% lower risk of dying over about nine years, though the study can’t prove the sport caused it¹.
• Seventeen trials found that recreational soccer raised aerobic fitness by about 10%, with gains in people aged 19 to 76⁴.
• U.S. emergency rooms treated an estimated 78,000 pickleball injuries from 2013 to 2022, a 2025 study found, and about 9 in 10 were in players 50 and older³.
• A structured 20-minute soccer warm-up cut injuries by 39% in randomized trials, and its building blocks fit into a 10-minute pre-game routine¹².
• Call 911 after a head hit if a headache keeps getting worse, vomiting repeats, speech slurs or the person can’t be woken¹³.

In late 2016, researchers published a study of 80,306 adults from England and Scotland in the British Journal of Sports Medicine. They wanted to know whether some sports go with longer lives than others¹.

One group stood out. People who played racket sports, such as badminton, tennis and squash, were 47% less likely to die during the study than people who didn’t. Their risk of dying from heart and blood vessel disease was 56% lower¹.

Soccer and running showed no clear link. That doesn’t mean they don’t help. Cambridge statistician David Spiegelhalter pointed out that so few runners and soccer players died that the study couldn’t tell the sports apart².

Meanwhile, pickleball, one of the country’s fastest-growing sports, has been sending more players to emergency rooms. Most of the injured are 50 or older³⁹.

Sport offers something a treadmill can’t: a score, teammates and a reason to show up. Here is what the research says about the benefits, the injuries and how to start.

Why racket players look so healthy on paper

The British study pooled national health surveys from 1994 to 2008 and followed people for an average of 9.2 years, during which 8,790 died¹. Only 3.6% of people played racket sports¹.

The researchers adjusted for age, smoking, drinking, education, body weight, long-standing illness and other exercise. In one check, they also dropped deaths in the first two years, so people who were already sick wouldn’t skew the results¹.

Still, the study is observational, meaning it watched what people did rather than assigning them a sport. People described their activity once, on a single survey form, and outside experts flagged that as a weak measure². People who are healthy, well off and socially connected may be more likely to play tennis, and those same traits could help them live longer. The authors acknowledged that hidden differences like these could remain¹.

One more detail matters for soccer fans. The study’s “football” group lumped soccer together with rugby¹. So the racket result is a good reason to play, not proof that racket sports beat other activity.

Soccer builds fitness fast, and a walking version brings it to older players

Trials offer firmer ground for soccer. In 2015, a review in Sports Medicine pooled 17 randomized controlled trials, where people are assigned by chance to play soccer or to a comparison group⁴. The 380 players were aged 19 to 76, and some had type 2 diabetes, high blood pressure or prostate cancer⁴.

The key measure was VO2 max, the most oxygen your body can use during hard effort and a strong marker of fitness. Pooled across the trials, recreational soccer programs raised it by about 10%, and soccer beat continuous running by a moderate margin⁴. Untrained older players gained 15% to 18% over 12 weeks⁴.

Two cautions apply. Results varied widely between trials, and a statistical test hinted at publication bias, where studies with weak results go unpublished⁴. Fitness is also not the same as a health outcome, such as fewer heart attacks.

Walking soccer, called walking football in Britain, slows the game to a walk. The Compendium of Physical Activities, the standard reference for exercise effort, rates it at 3.5 METs, versus 7.0 for casual soccer⁵. One MET is the energy you burn sitting still.

Don’t let the low number fool you. A 2025 review of 21 studies found walking football kept older players near 80% of their maximum heart rate, with gains in well-being and social connection, especially above 120 minutes a week⁶. Effort is relative, and federal guidelines note that activity that is moderate for a younger person can feel vigorous to an older or less fit one⁸.

Another 2025 review of 10 studies, with players averaging 68.7 years old, found gains in grip strength, belly fat or aerobic fitness in six studies⁷. Only three were randomized trials, and 85% of players were men⁷.

Pick your sport

The federal guidelines call 3 to just under 6 METs moderate and 6 or more vigorous, and they list doubles tennis as moderate and singles as vigorous⁸. Use this table to match a sport to your body, budget and social life.

Sport	Effort in METs5	Social	Contact and joint load (our rating)	Cost (our rating)
Pickleball	No separate entry; use the talk test	High	Quick stops; falls cause most fractures910	Low
Tennis, doubles	4.5 to 6.0, moderate	High	Moderate; less running than singles	Medium
Tennis, singles	8.0, vigorous	Medium	High; sprints and sharp turns	Medium
Badminton, social	5.5, moderate	High	Moderate; lunges and jumps	Low
Table tennis	4.0, moderate	Medium	Low	Low
Walking soccer	3.5, moderate	Very high	Low to moderate	Low
Soccer, casual	7.0, vigorous	Very high	High; a contact sport8	Low
Basketball, game	8.0, vigorous	Very high	High; jumping and contact	Low
Volleyball, casual	3.0, moderate	Very high	Low to moderate	Low
Golf, walking and carrying clubs	4.3, moderate	Medium	Low	High

To check your own effort, the guidelines offer a simple rule: during moderate activity you can talk but not sing, and during vigorous activity you can say only a few words before pausing for breath⁸.

Pickleball’s boom has brought a wave of broken wrists

Pickleball participation jumped 85.7% in 2022 alone, to more than 8.9 million Americans aged 6 and up. Those figures come from an August 2023 report by the Sports & Fitness Industry Association, a trade group⁹. Injuries followed.

A 2025 study in the Journal of the American Osteopathic Academy of Orthopedics used a federal sample of emergency rooms to estimate about 78,000 pickleball injuries from 2013 to 2022³. Some 91% of injured players were 50 or older. Fractures and sprains each made up 27% of injuries, and the wrist was the most common bone broken³. Most patients, 83%, went home from the emergency room the same day³.

In research presented at the American Academy of Orthopaedic Surgeons’ 2024 meeting, a University of Central Florida team reported that pickleball fractures alone rose about 90-fold between 2002 and 2022, and 92% came from falls, according to summaries of the findings⁹¹⁰. The average player with a fracture was 66, and about two-thirds of the breaks were in the arms¹⁰. Women had about 69% of the fractures, and researchers have pointed to lower bone density after menopause as one possible reason³⁹.

Eyes are at risk, too. A JAMA Ophthalmology study published in October 2025 estimated 1,262 pickleball eye injuries in emergency rooms in 2024 alone, including detached retinas and broken eye sockets, according to a summary by the clinical news service Epocrates¹¹. No rule requires eye protection in casual games or in pro play, and the authors called for standard eye-protection guidelines¹¹.

Part of this rise reflects how many more people now play. Still, the pattern points to simple steps: wear court shoes, add sports eyewear, warm up, and play with people at your level. If you are a woman past menopause, ask your clinician whether a bone density check makes sense.

A warm-up that cut soccer injuries by more than a third

FIFA’s medical research center designed a warm-up called FIFA 11+. It takes about 20 minutes and builds strength, balance, jumping and landing exercises into a structured warm-up, each with three levels of difficulty¹².

A 2017 review in the British Journal of Sports Medicine pooled four randomized trials of the program among recreational and lower-level competitive players¹². Teams using it had 39% fewer injuries. Knee injuries fell by about half, and ankle injuries by about a third¹². An older version of the program showed no benefit¹².

The trials included teenage girls and boys, young men and men 32 and older¹². Teams were asked to do the routine at least twice a week, but they averaged about 1.2 times, and they still saw benefits¹². The review authors reported no competing interests, though FIFA created the program they studied¹².

No one has tested these routines for pickleball or tennis. The idea behind them, priming muscles and practicing safe landings, is a sensible start.

A 10-minute pre-game warm-up (adapted from those building blocks, not itself tested)

1. Minutes 0 to 2: move. Brisk walk or easy jog around the court or field, adding side shuffles. Effort: 3 or 4 out of 10.
2. Minutes 2 to 4: loosen. Leg swings while holding a fence, walking lunges with an overhead reach, arm circles and trunk turns.
3. Minutes 4 to 6: strengthen. Ten slow squats, five lunges per leg, and a 20-second plank or 10 wall push-ups.
4. Minutes 6 to 8: balance and land. Stand on one leg for 30 seconds per side, touching the fence if needed. Then do six small hops, landing softly with knees over toes. If you have balance or bone concerns, swap hops for heel raises.
5. Minutes 8 to 10: rehearse. Three short bursts at half, two-thirds and three-quarters speed, then your sport’s first moves: easy rallies, shuffles or passes.

Hard hits to the head: know the danger signs

Collisions, falls and stray balls can all cause a concussion, a mild traumatic brain injury. The CDC lists adult symptoms including headache, dizziness, balance trouble, fogginess, sensitivity to light or noise, irritability and changes in sleep¹³. Some symptoms show up hours or days later, and most people are feeling better in two weeks or so¹³.

Our advice: if you suspect a concussion, stop playing for the day and tell someone. Call 911 or go to an emergency department right away for any of these CDC danger signs¹³:

• a headache that keeps getting worse
• weakness, numbness, poor coordination or seizures
• repeated vomiting, slurred speech or unusual behavior
• one pupil bigger than the other
• confusion, agitation, or not recognizing people or places
• passing out, deep drowsiness, or being unable to wake up

For free concussion training and a return-to-sports guide for athletes, see CDC’s HEADS UP campaign.

Teams may do more for the mind than solo workouts

A 2023 review of 29 studies of adults aged 18 to 84 found sport linked to better well-being and less depression, anxiety and stress¹⁴. Players also reported a stronger sense of belonging and better communication. Team sports generally showed more benefit than solo ones, and people who played more often reported less distress¹⁴.

The catch is familiar. Nearly half of the studies captured a single moment in time, so it’s hard to know whether sport lifts mood or happier people join teams¹⁴.

This fits values many natural-health readers hold. Play is one of the oldest forms of movement, needs little equipment and builds the kind of community that keeps habits alive. Be as skeptical of sports marketing as of any industry: a costly paddle or shoe deal won’t do what showing up each week does. If you’re struggling emotionally, sport can help, but it isn’t a substitute for care; call or text 988 in a crisis.

What the evidence shows

Claim	Evidence level	What the research shows
Recreational soccer improves aerobic fitness	Strong evidence	Consistent gains across 17 small trials, with some signs of publication bias4
Soccer-style play improves health markers like blood pressure	Promising but early	Some small walking-soccer studies reported better blood pressure, glucose or cholesterol7
Playing racket sports helps you live longer	Promising but early	Lower death rates in one large observational study; can’t separate sport from the people who play it12
Walking soccer benefits older adults	Promising but early	Small, mostly male, mostly short studies67
Structured warm-ups like FIFA 11+ prevent soccer injuries	Strong evidence	39% fewer injuries across four randomized trials12
The same warm-ups prevent pickleball or tennis injuries	Not enough evidence	Not tested in those sports
Team sport protects mental health	Promising but early	Consistent links, but many one-time surveys14

An eight-week plan to get in the game

• Weeks 1 and 2: Two sessions of 30 to 45 minutes. Warm up, then practice skills and play short, low-stakes games. Keep effort at 4 to 6 out of 10, and rest whenever you can’t talk.
• Weeks 3 and 4: Add a third session or a full doubles game. Leave a day between your hardest sessions.
• Weeks 5 to 8: Join a regular game or league. Federal guidelines call for 150 to 300 minutes of moderate activity or 75 to 150 minutes of vigorous activity a week, plus muscle strengthening on two or more days⁸.

The guidelines also note that injury risk climbs with how much you do, and that people who are usually inactive face more heart strain from sudden vigorous effort⁸. Start with doubles, walking versions or social nights before competitive play.

To find a league, check your city’s parks and recreation department, community centers, workplaces and local clubs. Before you sign up, ask the organizer:

1. Is there a beginner or social division?
2. Can I join alone and be placed on a team?
3. What does the fee cover: court time, referees, a shirt?
4. Is there a walking or age-group version?
5. What happens if I miss a week or get hurt?

Questions readers ask

The bottom line

Recreational sport packs exercise, friendship and fun into one habit. Trials show soccer-style play builds fitness quickly, and a big British study linked racket sports with longer lives, though it can’t prove the sport did the work.

The costs are real but manageable. Most of the broken bones in pickleball’s boom come from falls, largely among older players, and a warm-up, good shoes, eyewear and a level-matched game lower the odds. Pick the sport you’ll look forward to, start slowly, and keep showing up.

Keep exploring: how to prevent exercise injuries.

Related reading

• Why observational studies got smoking right and hormone therapy wrong
• Walking clubs work, and you need fewer steps than you were told
• Your heart counts the weekly total while your habits count the repeats
• The symptoms that mean call 911 now
• People come to wellness groups for answers and stay for belonging

Sources

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2. Science Media Centre. “Expert reaction to study reporting associations between different types of sports and mortality.” November 29, 2016. sciencemediacentre.org
3. Tobin J, Abbasi T, Nguyen J, Dunn P, Cashin I, Chung M. “Rising Orthopedic Injuries in Pickleball: Insights from a 10-Year National Study.” Journal of the American Osteopathic Academy of Orthopedics, Spring 2025;4(1). aoao.org
4. Milanović Z, Pantelić S, Čović N, Sporiš G, Krustrup P. “Is Recreational Soccer Effective for Improving VO2max? A Systematic Review and Meta-Analysis.” Sports Medicine, 2015;45(9):1339-1353. link.springer.com
5. 2024 Adult Compendium of Physical Activities. “Sports.” Updated May 2026, accessed October 2026. pacompendium.com
6. Barreira J, Saia ME, Leme R, Gomes MSP. “Walking football for older adults: A scoping review of research and health benefits.” Cogent Gerontology, 2025;4(1). doi.org
7. Rodrigues PSM, Ribeiro Neto A, do Espírito Santo LA, Tribess S, Virtuoso Junior JS. “Walking Football as a Multidimensional Intervention for Healthy Aging: A Scoping Review of Physical and Functional Outcomes in Older Adults.” International Journal of Environmental Research and Public Health, 2025;22(10). ideas.repec.org
8. U.S. Department of Health and Human Services. “Physical Activity Guidelines for Americans, 2nd edition.” HHS, 2018. odphp.health.gov
9. Foundation for Orthopaedic Research and Education. “As More People Begin to Play Pickleball, More of Them Are Sustaining Fractures” (on Ghattas YS et al., AAOS 2024 Annual Meeting; participation data from the Sports & Fitness Industry Association, 2023). FORE, February 16, 2024. foreonline.org
10. HealthDay. “AAOS: Pickleball-Related Fractures Up Significantly in Older Adults” (on Ghattas YS et al., University of Central Florida). HealthDay, February 2024. healthday.com
11. Epocrates. “Pickleball boom drives surge in eye injuries” (on Lacher CR, Koc I, Tsui JC, “Pickleball-Related Ocular Injuries Among Patients Presenting to Emergency Departments,” JAMA Ophthalmology, October 16, 2025). Epocrates, October 20, 2025. epocrates.com
12. Thorborg K, Krommes KK, Esteve E, Clausen MB, Bartels EM, Rathleff MS. “Effect of specific exercise-based football injury prevention programmes on the overall injury rate in football: a systematic review and meta-analysis of the FIFA 11 and 11+ programmes.” British Journal of Sports Medicine, 2017;51(7):562-571 (Aalborg University record). vbn.aau.dk
13. Centers for Disease Control and Prevention. “Symptoms of Mild TBI and Concussion.” CDC, reviewed September 15, 2025. cdc.gov
14. Eather N, Wade L, Pankowiak A, Eime R. “The impact of sports participation on mental health and social outcomes in adults: a systematic review and the ‘Mental Health through Sport’ conceptual model.” Systematic Reviews, 2023;12:102 (Victoria University repository). pubmed.ncbi.nlm.nih.gov
15. Leeds Beckett University Carnegie School of Sport. “Health screening guidance” (applying ACSM preparticipation screening recommendations, Riebe et al., Medicine & Science in Sports & Exercise, 2015). Leeds Beckett University, 2020. Www.Leedsbeckett.Ac.Uk