Pickleball Injuries on the Rise: Your guide to prevention, repair, and how PRF heals injured tissue

Pickleball, the beloved hybrid of tennis, badminton, and ping pong, has gained popularity at an astonishing rate across all age groups. For the 3rd year running, pickleball is the fastest-growing sport in the United States. From patients at our clinic in Naples, Florida (the pickleball capital of the world) to seasonal summer players at our regenerative medicine clinic in Bloomfield, Michigan, our list of patients grows every year.

One thing these pickleball-playing patients all face?

Risk of injury.

In fact, as pickleball’s popularity soars each year, so do the number of pickleball-related injuries – sprains, strains, tendinitis, bursitis…

Whether you’re a seasoned pro or a casual player just starting out, every pickleball player faces potential injury — either while playing on the court or over time.

Pickleball injuries don’t just set back your playing time — they can also lead to chronic pain and mobility issues. When you’ve been benched from playing because of arthritis, joint pain, tennis elbow or knee pain, you might wonder what your options are to repair and restore your body.

Enter Platelet-rich fibrin (PRF).

PRF is an all-natural, cutting-edge treatment that revolutionizes the way we heal from sports-related injuries. Imagine a world where tendon strains, tennis elbow and even arthritis are no longer setbacks, but mere bumps in the road to getting back on the pickleball court.

Yes, even if you’re over age 60, PRF can help your body work more like it used to.

When it comes to pickleball and tennis injuries, PRF stands head and shoulders above other treatments like cortisone (steroid) injections, anti-inflammatory drugs, and physical therapy. As pickleball’s popularity rises, so will the need for injury treatment and prevention.

But first, why is pickleball so popular, especially with seniors in Naples and Bloomfield?

One big reason behind the surge in pickleball’s popularity is its accessibility to people of all ages and skill levels. Unlike other sports, beginners find pickleball easy to pick up because of its simple rules and quick learning curve.

And compared to tennis, its more strenuous sister sport, pickleball provides a manageable cardiovascular and whole body workout.

In Naples, Florida, the pickleball capital of the world, hundreds of courts are filled with players in their 50s, 60s, and even 80s. For active seniors, pickleball may be the physical activity that truly provides it all: exercise, friendship, competition, socializing.

Plus, pickleball is fast-paced, which keeps players engaged and energized. Our patients tell us pickleball is so addictive and easy to play — with minimal equipment — that they seek out games whenever they’re traveling or seasoning to and from Bloomfield Hills and Naples.

But just because pickleball is so easy to play doesn’t mean it’s risk-free: sports-related injuries playing pickleball are common. Repetitive moves, sudden dashes, or limbs twisted around to reach for the ball can all lead to injury. Both tennis and pickleball players face similar common injuries to their tendons, joints, knees, elbows, and wrists.

What are the most common pickleball and tennis injuries?

Common injuries in both pickleball and tennis include:

  • Tennis elbow
  • Rotator cuff injuries
  • Knee pain
  • Arthritis
  • Tendinitis

These injuries are often caused by overuse of certain muscle groups, improper technique, and inadequate warm-up or stretching routines. Some are acute (sudden), while many are chronic (damage that occurs over time).

  • Tennis elbow is a result of repetitive gripping and swinging motions in both sports, leading to inflammation of the tendons in the forearm and lateral elbow.
  • Rotator cuff injuries are common with overhead shots like serves or smashes, straining shoulder muscles and tendons.
  • Knee pain is often a result of sudden movements, pivoting on hard surfaces, or lack of proper footwear support during play.
  • Tendinitis usually results from overuse, like simply playing a lot over time.
  • Arthritis can result from long-term joint overuse, previous injuries, or simply age. Pickleball players are often stressing their joints more than they used to, which can unmask mild arthritis that wasn’t evident before.

Practical ways to prevent or reduce pickleball injuries and other sports injuries

While these are common injuries among players of all skill levels, you can reduce your risk of injury with proper training techniques and equipment adjustments.

Strengthening exercises for the forearm muscles can help prevent tennis elbow, while focusing on shoulder stability and flexibility can reduce the risk of rotator cuff injuries. Using a thick, well-cushioned grip on the racket handle also reduces squeezing force (excessive forceful squeezing is the main cause of tennis elbow).

Ensuring proper footwork and using supportive shoes can help alleviate knee and ankle pain associated with pickleball and tennis activities.

Even with better training techniques, strengthening exercises or stretches, injuries do happen. Players sidelined by a sports injury may look into physical therapy, cortisone shots or steroids to treat pain.

But none of them have the healing properties of clinically-proven PRF.

RegenCen Medical Director Dr. Gustav Lo: “PRF actually builds new cartilage in joints and repairs tendinitis with new tissue, which pills and steroids can’t do. It’s true tissue regeneration.

What is PRF and how does it help heal and prevent pickleball injuries?

Platelet-rich fibrin (PRF) has emerged as a cutting-edge treatment in sports medicine, particularly in the realm of treating pickleball and other sports injuries.

A natural substance extracted from a patient’s blood, PRF is rich in platelets and growth factors, which are essential for tissue healing and regeneration. When injected directly into injured areas, PRF promotes accelerated tissue repair, reduces inflammation, and enhances overall recovery.

In the context of pickleball injuries, PRF therapy has shown remarkable success in expediting the healing process of common issues such as tendonitis, muscle strains, and ligament damage.

Athletes have reported faster return-to-play times and reduced risk of recurring injuries after undergoing PRF treatments. The targeted application of PRF directly to affected areas harnesses the body’s own healing mechanisms to bolster tissue repair and improve overall performance on the court.

In essence, PRF represents a revolutionary approach to pickleball injuries and sports injury management that aligns with players’ and athletes’ goals of swift recovery and long-term physical well-being.

What are the benefits of PRF over other treatments for pickleball injuries?

Unlike other treatments that focus on symptom management and/or pain relief, PRF harnesses the body’s natural ability to heal itself by using concentrated platelets from the patient’s blood.

This promotes tissue regeneration and accelerates the healing process at the cellular level. Additionally, PRF does not put any foreign substances or chemicals into the body. Because PRF is simply a product of your own blood, it eliminates the risk of allergic reactions, and the long-term side effects that are frequently associated with steroids and cortisone injections.

Furthermore, PRF has been shown to provide longer-lasting results compared to traditional treatments — with results that often last a full year or longer.

By stimulating collagen production and enhancing tissue repair mechanisms, PRF not only addresses current injuries but also strengthens the surrounding tissue structures to prevent future issues.

This holistic approach sets it apart from physical therapy, which often focuses on rehabilitation post-injury rather than promoting comprehensive healing and prevention.

When compared to other convention methods, PRF injections usually brings faster recovery, reduced pain, improved joint function, and decreased reliance on medication or invasive procedures. It’s a superior choice for any player who wants to get back in the game, but also wants to move and feel better in every day life.

The side effects of steroids compared to PRF injections

While steroids are commonly used by pickleball and tennis players to reduce inflammation and promote healing in injuries, their potential side effects can pose significant risks.

The main risk is tissue degeneration with repeated steroid injections (“cortisone shots”). Multiple injections with corticosteroids actually accelerate joint degeneration – repeated steroid injections into an arthritic joint actually make the arthritis progress faster!

The same is true with tendinitis, such as plantar fasciitis (“heels spurs”) or tennis elbow. That’s why most orthopedists will limit the number of injections you can have in a certain area. Sure, steroids help bring immediate pain relief and seemingly speed recovery. But there’s a cost to using steroids to recover from sports injuries or arthritis.

Unlike steroids, with their potential side effects such as weakening of tissues and immune suppression, PRF harnesses the body’s natural healing mechanisms without such drawbacks or side effects. Moreover, PRF injections contain a concentrated amount of growth factors that stimulate tissue regeneration at an accelerated rate compared to steroids.

Studies have shown that PRF promotes long-term healing by enhancing collagen and hyaluronic acid production (the main components of cartilage) and improving the overall quality of healed tissues. In contrast, the effects of steroids may be more short-term and can worsen tissue quality.

Simply put, steroids treat the symptoms, while PRF treats and reverses the cause.

While the appeal of steroids is their temporary relief from pain and swelling in cases of sports injuries, arthritis, and wear-and-tear damage, steroids should used with caution.

At RegenCen in Bloomfield Hills (and at all our RegenCen clinics across Michigan and Florida), we believe that when it comes to healing and restoring the body in musculoskeletal conditions, it’s critical to balance short-term benefits with long-term consequences.

Physical therapy benefits versus PRF benefits

When it comes to treating pickleball injuries and damaged tissue, PRF (platelet-rich fibrin) offers a unique approach compared to physical therapy.

Physical therapy integrates exercises and stretching to improve mobility and strength, while PRF harnesses the body’s natural healing processes to repair tissue damaged by injury or overuse.

Working with a physical therapist can be beneficial in improving every day mobility, increasing mind body awareness and helping prevent future injury. But physical therapy cannot repair damaged tissue.

Compared to physical therapy alone, PRF has shown promising results in stimulating collagen production and enhancing tissue regeneration.

When athletes and pickleball players get PRF injected directly into the injured area (joint, tendon, site of arthritis), they may experience reduced inflammation and pain while the PRF also promotes long-term healing benefits.

Overall, a combination of physical therapy with PRF is a comprehensive treatment approach that addresses both injury causes AND underlying tissue damage.

But how, EXACTLY, does PRF work?

Your own platelets are the active ingredient in PRF. In the past, doctors saw platelets only as important components in the clotting cascade. We now know that platelets actually have dozens of important growth factors and capabilities we are only beginning to understand.

Let’s take an arthritic joint, for example. As we age, our joints produce less collagen, hyaluronic acid, and elastin – the critical components of cartilage that make joint motion smooth and painless. The cells in those joints are still alive – they just don’t repair and maintain cartilage as well as they used to.

So for people in their 50s and 60s, when PRF is injected into a joint, the platelets release their growth factors and seem to turn on dormant cartilage cells. Those cells actually begin to make more of those cartilage components – they begin behaving like young joint cells again.

Getting your cells and tissues to turn on again – behaving youthfully like they used to – is the fundamental principle of regenerative medicine: regenerative literally means “to grow back.”

How does PRF promote faster healing and recovery time?

PRF contains a high concentration of platelets and growth factors that work together to promote tissue regeneration and repair.

When PRF reactivates dormant cells in joints and tendons, this process also attracts stem cells to the injured area. Research shows PRF works as well as steroids for pain, and lasts longer.

Unlike manmade medical treatments such as cortisone, steroids, and topical creams, PRF harnesses the body’s own healing properties. It’s worth mentioning again: because PRF comes from the patients own blood, the body always “accepts” PRF, reducing the risk of adverse reactions or complications.

When PRF is injected directly into the injury area, the concentrated growth factors in platelet rich fibrin help:

  • 1. Increase blood circulation

    Increased blood circulation plays a crucial role in healing injuries. After an injury, blood vessels near the injury dilate to allow more blood flow to the affected area. This brings essential nutrients and oxygen, which are necessary for repairing damaged tissues and cells.

    Additionally, the increased blood circulation helps remove waste products and toxins (a byproduct of inflammation) from the injured area. Think of waste products and toxins like weeds — they take over a perfectly good lawn (body tissue) and compete for resources. Instead of focusing on healing, the body has to focus on addressing this waste.

    PRF’s blood circulation-boosting growth factors help the body heal more efficiently. The result? Faster recovery times.

  • 2. Reduce inflammation

    PRF serum contains multiple times over more platelets than normal blood, and this platelet-rich composition of PRF helps reduce inflammation.

    Platelets are growth-factor filled bits of biological magic. You may have heard the term growth factors. Growth factors are the body’s messengers. They send signals to your body to divide cells, grow cells, and repair cells. They also tell your body to make fibroblasts and endothelial cells, which are specific cells your body uses to subdue inflammation and promote healing.

    But wait a minute — can’t inflammation actually help regenerate new skin and tissue?

    Yes, when it’s controlled, like the micro injuries (and resulting inflammation) intentionally caused by treatments like microneedling. While inflammation is initially a protective response by the immune system, it can become chronic and impede the healing process if not properly regulated.

    Reducing inflammation is crucial for healing injuries because it allows the body to focus on repairing damaged tissues without unnecessary hindrances.

    Excessive inflammation can lead to prolonged pain, swelling, and tissue damage, delaying recovery and increasing the risk of complications. PRF helps improve recovery outcomes with its inflammation-reducing growth factors.

  • 3. Stimulate collagen production

    PRF’s growth factors also stimulate the production of collagen, a key protein in the body that provides a crucial underlying framework for the growth of healthy tissues.

    Collagen helps give all tissues (from skin to joints and ligaments) a strong scaffold. The overall structure collagen provides is vital for flexible, strong and resilient connective tissues (skin, tendons, and ligaments).

    Without collagen, tissues would be floppy and weak. Joints and ligaments wouldn’t flex and spring back.

    Unfortunately, collagen production decreases with age. If you wonder why older faces sink and sag, you can blame collagen loss. Collagen loss is also why as we age, it’s harder to get out of bed or up from a chair. As collagen decreases, joints become less flexible and more stiff.

    By delivering concentrated growth factors directly to an injured area, PRF kickstarts collagen production at any age, leading to stronger, more flexible and younger tissues, ligaments, and joints.

How does PRF reduce risk of infections?

PRF is a minimally invasive treatment to help heal pickleball injuries and other joint and tissue conditions. Most of the time at RegenCen in Bloomfield Hills or Naples, we treat patients for injuries and conditions that aren’t severe enough for surgical treatment. A good rule of thumb is that if an injured part “hurts but it works” then it’s probably a good candidate for nonsurgical treatment. And as you’ve learned above, PRF treatments are at the top of that list.

But PRF also has a remarkable ability to reduce the risk of infection, making it a powerful complement to surgical interventions such as hip or knee replacements, torn ACL replacement, and rotator cuff repairs.

When injected before and/or after surgery, PRF helps reduce the risk of infections post-surgery or invasive procedures. The growth factors released by PRF help create a protective barrier against pathogens. This natural defense mechanism not only accelerates the healing process but also minimizes the chances of bacterial infiltration into the wound site.

Moreover, studies have shown that PRF also enhances the body’s immune response by increasing leukocyte concentration within the treated area. These white blood cells play a crucial role in fighting off infections and maintaining overall tissue integrity. PRF creates an inhospitable environment for harmful organisms to thrive.

So even if you end up needing surgery, PRF treatments may very well help you recover faster!

What are the long-term results and sustainability of PRF?

High on the list of PRF’s amazing benefits?

PRF doesn’t just accelerate and promote healing of damaged tissue — it also helps reduce the risk of re-injury in the same area.

The very same growth factors and concentrated platelets that boost tissue repair also strengthen and youthify the injured tissue and surrounding area, making it less susceptible to future injury.

And with its collagen-boosting regenerative approach, PRF helps continue to improve the structure and resilience of tissue over time.

Furthermore, PRF plays a crucial role in enhancing the recovery process by promoting angiogenesis and tissue remodeling. This, in turn, contributes to better functional outcomes and reduced susceptibility to recurring injuries.

As pickleball players and athletes are often prone to overuse injuries or strains from repetitive movements, incorporating PRF therapy into their treatment protocols can serve as a proactive measure to address underlying issues and reinforce vulnerable tissues.

Many of our patients tell us that multiple PRF injections — a series of 3 over a few weeks, as well as maintenance injections once a year — give the best outcomes. They stop noticing pain or stiffness in their hips, ankles, elbows and knees because those tissues are behaving more like they did in their prime.

How do PRF injections work and do they hurt?

At RegenCen, we make PRF injections as easy and painless as possible. It’s just a few simple steps:

  1. Blood draw
    First, we draw blood, usually from your arm. Note: the more hydrated you are, the easier (and faster) the blood draw will go, and the more PRF we can extract from your blood.
  2. PRF is separated from the blood
    We place your drawn blood in a centrifuge machine that spins it at high speeds to separate the platelet-rich plasma (PRP) from other components. The PRP is further processed to create platelet-rich fibrin (PRF), which contains those concentrated growth factors essential for tissue healing and regeneration.
  3. PRF is injected into the injury area
    Many patients report feeling little to no pain during a PRF injection, and depending on the injury location and a patient’s needs, we can apply a numbing agent to the area prior to injection.

    Injections at RegenCen are quick — from blood draw to final injection, it’s a short, 30-45-minute non-invasive, in-office treatment.

How long until I start feeling better and can play pickleball again?

Most of our patients treated with PRF injections often experience noticeable pain relief and improvement in tissue condition within the first few weeks post-treatment. The growth factors present in PRF play a crucial role in stimulating the body’s natural healing processes, promoting faster recovery times and reducing overall pain levels.

However, the exact timeline for experiencing significant improvement can vary depending on the severity of the injury and individual response to treatment. For some athletes, relief may be felt as early as a few days after receiving PRF injections, while others may require several weeks to fully experience the benefits. Studies show a small minority of patients (about 10-15%) don’t seem to respond at all.

Is one PRF injection enough to heal from a pickleball injury?

The number of PRF injections required to heal sports injuries like tennis elbow, torn tendons or ligaments, or damaged joints can vary depending on the severity and individual response to treatment.

For pickleball and other sports-related injuries, most of our patients see the best results with multiple PRF injections, spaced 4-6 weeks apart, followed by 1-2 yearly maintenance injections.

Research suggests that multiple PRF injections can enhance the healing process by delivering concentrated growth factors to the affected area, stimulating cell proliferation and tissue regeneration.

While some players may experience significant improvement after just one or two injections, others with more severe injuries may require additional treatments to achieve lasting results. A few won’t get better with PRF at all.

Ultimately, as no two patients or injuries are alike, personalized treatment plans are critical for maximizing the effectiveness of PRF for sports-related injuries.

In conclusion, PRF is an optimal choice for pickleball injuries and other sports-related injuries

Modern medical innovations have revolutionized treatment for pickleball injuries and other sports-related injuries. While therapies like steroids and cortisone shots treat pain and mask symptoms, all-natural platelet-rich fibrin (PRF), with its regenerative properties, addresses more than symptoms and treats the root cause of injuries.

For any pickleball player who’s serious about getting back into the game after injury, or playing without pain, PRF is a long-lasting treatment that actually builds tissue and helps your body function more youthfully.

But PRF is only as good as the experience and education of the provider injecting it. That’s why at RegenCen, we personalize every patient’s treatment plan to give the best possible outcomes. We’ve been injecting PRP (platelet-rich plasma, PRF’s predecessor) for years and helped thousands of patients.

Final Comments from our Medical Director

“Patients should always avoid gambling with their health if they can avoid it. Seems obvious, right? Yet every time we take a pill or get a cortisone shot or even rub a medicinal cream onto our skin, we’re rolling the dice. Those are all drugs, which are usually (not always) foreign substances designed to have some intended effect on our biochemistry. But in addition to the intended effects, there are also side effects, and sometimes allergic reactions. In the worst of cases, those can be severe or even deadly.

Platelets come from your own body – you can’t be allergic to them, they can’t cause side effects. The only potential side effect is due to the injection procedure itself. So when people ask me if there is any risk to PRF injections, I say, ‘The only thing you’re gambling with is your wallet.'”

For patients in Birmingham and Naples who love to play pickleball or other sports but are struggling with injury or chronic tissue-related pain, we can help. It’s time to get back on the court and playing even better than you did before your body started to break down.

Click here to book a complimentary consultation about your joint pain or sports-related injury. We’re here to increase not just your life span, but your health span. And to help you function and feel more like yourself again.