Calum MacRae and Sumbul Desai: Pickleball or tennis? The real winner is your health.

Regular exercise or physical activity can help improve physical fitness, mental wellbeing, and cardiovascular and metabolic health.

(Rachel Rydalch | The Salt Lake Tribune) Multiple pickleball courts are located at Wardle Fields Regional Park in Bluffdale on Wednesday, Feb. 9, 2022.

Maybe you’ve played it. Maybe your friends are playing it, or you’ve seen it on the internet. No matter what, one thing is clear: Pickleball is sweeping the nation.

What started in the 1960s as a backyard game has over the past several years blazed a trail through communities across the country, including here in Salt Lake City. Pickleball combines elements of tennis, badminton and ping pong, and players love its accessibility to all ages and fitness levels. Newly formed pickleball leagues abound and tennis centers have quickly caught on, designating certain courts for the sport.

As fun as it is, some people are still wondering: How does this novel game compare to a long-beloved standby like tennis? Does one have a more positive impact on our health than the other?

When newly popular fitness activities like pickleball come up, it can take years for the scientific community to study their impact on heart health and movement over time. This is one of the many reasons we started the Apple Heart and Movement Study, a collaboration between Apple, Brigham and Women’s Hospital and the American Heart Association that explores the links between physical activity and heart health.

The study uses the Apple Research app available on iPhone and collects activity data from Apple Watch. Over time, more than 200,000 participants have enrolled across the United States and provided consent to share their data to support the study and its objectives. Interim analyses have already shed light on how long participants are sleeping, how cardio fitness levels compare to the amount of physical activity completed and more.

Today, the spotlight is on pickleball. The study team is sharing new insights that explore pickleball and tennis’ popularity across participants and compare the two sports, looking at things like workout duration, intensity and results of mental health screening tools. Put simply, applying science to pickleball so we can better understand the impact it may have on health over the long term.

Let’s start with workout duration and intensity. On average, pickleball workouts were slightly longer, but with greater variability in the time played. Using heart rate data measured by Apple Watch during workouts as an indication of intensity, data showed both sports are often played for long periods of time with heart rate rising over 70% of maximum heart rate. These types of activities are strongly associated with quality of life and healthy aging. A slightly higher average peak heart rate was observed during tennis workouts, which also averaged 9% more time spent in moderate and vigorous heart rate zones when compared to pickleball workouts.

What about mental health? Participants were invited to complete an optional quarterly clinically-validated brief screening for depression, the PHQ-2. Among participants completing the survey, the likelihood of a screening result associated with depressed mood was about 60% lower among frequent pickleball players and about 51% lower for frequent tennis players, compared to the full group of participants completing the survey. While the survey isn’t a comprehensive tool for assessing depression or mental health, the results are consistent with other research indicating physical activity has a strongly positive association with overall mental wellbeing.

Finally, let’s look at popularity. Notably, Utah stood out as the most popular state per capita for pickleball, with just over 1 in every 16 study participants who reported a zip code in Utah giving the sport a try at least once.

Some people say pickleball is one of the fastest-growing sports in the US — and the data suggests this could be true. The number of participants recording pickleball workouts using Apple Watch continued to increase over the course of the past few years, regardless of season — whereas tennis remained relatively stable with considerable seasonal variation.

So where does this leave us? Pickleball fans may argue the small leads in workout duration place their fast-growing sport first, and tennis players will volley back pointing to workout intensity. The rally between the two just might continue, but from the research perspective, we consider both to be a win for health.

Regular exercise or physical activity, such as pickleball and tennis, can help improve physical fitness, mental wellbeing and cardiovascular and metabolic health. And we look forward to following participants in years to come to better understand how repeated play may affect overall health over the longer term.

So whichever type of racquet you decide to pick up today, go ahead and serve.

Calum MacRae

Calum MacRae, MD, Ph., is a cardiologist, Professor of Medicine at Harvard Medical School, and Principal Investigator of the Apple Heart and Movement Study at Brigham and Women’s Hospital.

Sumbul Desai

Sumbul Desai, MD, is Vice President of Health at Apple.

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