Can Pickleball Help You Live Longer — or Just Make You Want To?
By Mark C. Engasser, MD — Board-Certified Orthopedic Surgeon
At some point in life, most of us face a choice: settle into a comfortable recliner and watch the world go by, or chase a perforated plastic ball around a court with people half our age while wearing knee braces and pretending our shoulder doesn't hurt.
If you're reading this, you've probably already made your choice. And you may have heard the encouraging claim that pickleball — or racket sports in general — can actually help you live longer.
Is that true? The honest answer, as with most things in medicine, is: it's complicated. But the emerging evidence is genuinely encouraging — with some important caveats worth understanding.
The Copenhagen City Heart Study: Where the Longevity Story Begins
The most widely cited evidence linking racket sports to longer life comes from the Copenhagen City Heart Study, a large Danish population study published in the Mayo Clinic Proceedings in 2018. Researchers followed more than 8,500 adults over 25 years and examined the relationship between different types of leisure physical activity and longevity.
The results were striking. Among the activities studied, tennis was associated with the greatest estimated gain in life expectancy — approximately 9.7 years compared to sedentary individuals. Badminton came in second at about 6.2 years. Swimming, cycling, jogging, soccer, and calisthenics also showed positive associations, but none as large as the racket sports.
Tennis: ~9.7 additional years. Badminton: ~6.2 additional years. These were the largest longevity associations of any activity studied — and both are racket sports.
Why racket sports specifically? The researchers speculated that the social nature of these activities — you need a partner or opponents — may be as important as the physical exercise itself. Social engagement, it turns out, is one of the most powerful predictors of healthy aging we know of.
What Does the Science Really Tell Us?
Before you cancel your life insurance and book a court for every morning, a few important clarifications are in order.
The Copenhagen study was observational. That means researchers tracked what people did and what happened to them — they did not randomly assign people to play tennis or sit on the couch. This is a crucial distinction.
Observational studies can identify associations, but they cannot prove causation. People who play racket sports regularly may differ from sedentary people in dozens of ways that affect longevity — income, education, access to healthcare, diet, stress levels, and general health habits. These are called confounding variables, and even sophisticated statistical adjustments cannot fully account for all of them.
In plain English: the study tells us that people who play racket sports tend to live longer. It does not prove that playing racket sports causes people to live longer. That distinction matters — a lot.
Pickleball, it should be noted, did not exist as a mainstream sport when the Copenhagen study was conducted. The longevity associations were for tennis and badminton. Whether pickleball would show similar associations is a reasonable hypothesis — but it has not yet been studied in the same way.
The 2026 Pickleball Trial: Encouraging Early Evidence
More recently, a 2026 randomized controlled trial examined the effects of pickleball specifically on older adults with pre-frailty — a condition characterized by reduced strength, slower walking speed, fatigue, and decreased physical activity that often precedes more serious functional decline.
Seventy-two older adults were randomly assigned to either a pickleball intervention or a control group. After eight weeks, the pickleball group showed meaningful improvements in physical function, balance, and several markers of frailty.
This is genuinely exciting. A randomized design is far stronger evidence than an observational study — it controls for many of the confounding variables that make observational research difficult to interpret.
Important caveat: the improvements measured in this trial were functional outcomes after eight weeks — better balance, improved strength, reduced frailty markers. The study did not measure lifespan or survival. It tells us pickleball can improve how well older adults function. It does not tell us it extends how long they live.
That said, improving physical function and reducing frailty in older adults is enormously valuable. Frailty is one of the strongest predictors of falls, hospitalization, loss of independence, and death. Anything that meaningfully reduces frailty in a population of older adults is worth taking seriously.
Why Pickleball Might Actually Be Good for You
Even setting aside the longevity question, there are compelling reasons to believe pickleball offers real health benefits for older adults. Let's look at what the sport actually demands of your body and mind.
Pickleball gets your heart rate up. It's not marathon training, but it's genuine aerobic exercise — and consistent moderate aerobic activity is one of the most well-established interventions for cardiovascular health, metabolic health, and overall longevity.
The lateral movements, quick direction changes, and hand-eye coordination required in pickleball challenge your balance and neuromuscular control. Falls are one of the leading causes of injury and death in older adults. Anything that improves balance is genuinely protective.
Pickleball requires strategy, anticipation, and rapid decision-making. There is growing evidence that cognitively demanding physical activities — ones that require you to think while you move — may offer greater brain health benefits than purely repetitive exercise.
This may be the most underappreciated benefit. Loneliness and social isolation are associated with dramatically increased risks of depression, cognitive decline, cardiovascular disease, and premature death. Pickleball is inherently social. You cannot play alone. The friendships formed on the court are not a side benefit — they may be the main benefit.
Unlike many sports, pickleball is genuinely accessible to older adults. The smaller court, slower ball, and lighter paddle make it possible for people in their 60s, 70s, and 80s to play competitively and enjoyably. A sport you will actually play consistently is infinitely more valuable than a sport you theoretically could play.
The Orthopedic Reality Check
As an orthopedic surgeon, I would be professionally negligent if I wrote an article about pickleball and longevity without mentioning injuries. Because pickleball does cause injuries — and the injury rate in older adults is not trivial.
The most common pickleball injuries I see are lateral epicondylitis (tennis elbow), medial epicondylitis (golfer's elbow), wrist injuries, knee problems, and — perhaps most seriously in older adults — falls resulting in fractures. The non-kitchen volley zone line has sent more players to the emergency room than any other feature of the sport.
Most overuse injuries can be managed conservatively with rest, ice, anti-inflammatory medications, and physical therapy. But they do interrupt play, and repeated injuries can discourage continued participation — which eliminates whatever health benefits the sport was providing.
My strong recommendation: add strength training to your routine. Stronger muscles protect joints, reduce injury risk, and improve recovery. If you are playing pickleball three or four times a week and doing no strength work, you are leaving significant health benefits on the table — and increasing your injury risk.
Warm up before you play. Cool down after. Take rest days. And if something hurts persistently, get it evaluated before it becomes a serious problem.
Lifespan vs. Healthspan: The More Important Question
Here is what I think is the most important reframe in this entire discussion.
Most of us, when we think about health and aging, focus on lifespan — how long we live. But the question that matters more to most people, when they think carefully about it, is healthspan — how long we remain healthy, independent, mobile, cognitively sharp, and engaged with life.
Living to 95 in a nursing home with severe dementia and no ability to recognize your grandchildren is not most people's definition of a good outcome. Living to 82 while still playing pickleball three times a week, traveling, and enjoying your family is a very different story.
The evidence that regular physical activity — and pickleball specifically — can extend healthspan is considerably stronger than the evidence that it extends lifespan. Improved physical function, reduced frailty, better balance, maintained cognitive engagement, and strong social connections all contribute to a longer period of healthy, independent living.
The goal isn't just more years. It's more good years.
Dr. Engasser's Perspective
I want to be honest with you about what the science does and does not show. Pickleball has not been proven to extend lifespan. The Copenhagen study's impressive longevity associations were for tennis and badminton, were observational in design, and cannot be interpreted as proof of causation.
The 2026 randomized pickleball trial is genuinely encouraging — it's the kind of rigorous evidence we need more of. But it measured functional improvements over eight weeks, not survival over decades.
What I can tell you, after more than four decades in orthopedic medicine and as someone who plays pickleball myself, is this: the people I see who age best are not the ones who found the perfect supplement or the optimal sleep protocol. They are the ones who stayed active, stayed social, stayed curious, and kept doing things they genuinely enjoyed.
Pickleball checks all of those boxes. It gets you moving. It puts you in a community. It requires you to think. And it gives you something to look forward to.
Pickleball may not yet be proven to add years to your life, but emerging research suggests it can help add life to your years.
That seems like a pretty good reason to keep playing.
Medical References
Schnohr P, et al. Various Leisure-Time Physical Activities Associated With Widely Divergent Life Expectancies: The Copenhagen City Heart Study. Mayo Clin Proc. 2018;93(12):1775–1785.
Randomized controlled trial of pickleball in older adults with pre-frailty. PubMed, 2026.
This article is for general educational purposes only and does not constitute medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider for personal medical guidance.