By Susie Reiner, PhD & Erik Korem, PhD

In today’s busy world, finding exercise routines that are effective, engaging, and sustainable can be a challenge. That’s where pickleball shines, it offers a heart-healthy workout that feels more like play than work.

This fast-growing sport combines quick lateral movements, sudden bursts of speed, and frequent rest periods that perfectly mimic the exercise patterns research has shown to be the most effective strategies to improve heart health. Studies consistently find that a blend of moderate-to-vigorous aerobic activity, interspersed with short, intense intervals, plus muscle-strengthening exercises, offers the greatest protection against heart disease and improves overall cardiovascular fitness. 

Here, we break down the science behind why pickleball is so good for your heart and how you can maximize those benefits every time you step on the court.

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How Intense Is Pickleball, Really?

While pickleball courts are smaller, studies confirm that it consistently raises heart rate into beneficial zones. A recent scoping review of pickleball activity revealed that players spend over 70% of their playing time in moderate-to-vigorous intensity zones, corresponding to 3-6 metabolic equivalents (METs) or higher (1). This intensity meets the minimum thresholds defined for cardiovascular health benefits (2).

Moreover, the intermittent nature of pickleball, which alternates short rallies with rest periods, mirrors interval training, known to improve cardiovascular fitness (3). This pattern keeps the heart rate elevated intermittently, promoting beneficial adaptations in heart and vascular function. Although individual rallies may be brief, the cumulative cardiovascular workload over a session is significant and contributes to recommended weekly physical activity goals.

Why That Intensity Matters for Your Heart

Regular moderate-to-vigorous physical activity is strongly linked to reduced risk of cardiovascular disease and all-cause mortality. Large cohort studies and meta-analyses show a clear dose-response relationship: people engaging in 150-300 minutes per week of such activity have substantially lower risk of heart attacks, strokes, and premature death (2,4).

Exercise improves vascular function by enhancing endothelial health, reducing blood pressure, improving lipid profiles, and increasing cardiac efficiency (5). The intermittent, varied intensity seen in pickleball also helps improve insulin sensitivity and glucose metabolism, reducing risk factors for metabolic syndrome and type 2 diabetes (6).

The Benefits of Racquet Sports 

Although direct pickleball mortality data are limited, research on racquet sports like tennis and badminton provides strong indirect evidence. One study analyzing over 80,000 adults found that playing racquet sports is associated with a 47% reduction in all-cause mortality and a 56% lower cardiovascular mortality risk compared to inactive individuals (7). These benefits are independent of other physical activity types and underscore the cardiovascular advantages of sports that involve dynamic movement and varied intensity.

Pickleball shares key features with racquet sports: multidirectional movement, rapid accelerations, and bursts of anaerobic effort within an aerobic session. Thus, it is reasonable to expect that regular pickleball participation yields similar heart-health benefits.

How Pickleball Mimics Interval Training

The stop-and-go nature of pickleball resembles high-intensity interval training (HIIT), which combines short bursts of high effort with recovery periods and is well-established for improving VO₂max and vascular function (3,8). Intervals stimulate heart rate variability, improving autonomic control and cardiac efficiency, while recovery phases help sustain overall exercise duration without overexertion.

This interval pattern improves mitochondrial function and muscle oxidative capacity, key drivers of cardiovascular and metabolic health (8). Even without formal exercise programming, pickleball naturally incorporates these principles, providing a heart-healthy workout through enjoyable gameplay.

Strength Training as a Vital Complement

Muscle-strengthening activities independently reduce cardiovascular risk and mortality (10). Resistance training preserves muscle mass, supports metabolic health, and stabilizes joints—critical for injury prevention, especially in older adults playing pickleball.

Meta-analyses reveal that as little as 60 minutes per week of resistance training is associated with a 15-20% reduction in cardiovascular and all-cause mortality (10,11). Given pickleball’s aerobic demands, supplementing play with targeted strength training (e.g., squats, lunges, and shoulder exercises) optimizes cardiovascular, cognitive, and functional benefits (18).

DUPR players can use the code “GRAVL” to get a FREE month of strength training routines tailored for your health and pickleball goals. Claim it here. 

Playing Safe and Maximizing Benefits

While pickleball is accessible, injury risk exists, primarily strains and sprains affecting lower limbs (12). Consistent strength and balance training can help to reduce injury risk and improve longevity in the sport.

Additionally, individuals with pre-existing cardiovascular conditions should seek medical clearance before engaging in moderate-to-vigorous play to ensure safe participation (13). When played appropriately, pickleball provides a sustainable, enjoyable way to meet heart-healthy exercise guidelines.

Putting It Into Practice

Below is a practical, evidence-based plan that aligns directly with peer-reviewed research.

Goal: Hit ~150-300 min/week of moderate-to-vigorous activity and add ~30-60 min/week of muscle-strengthening.

• Frequency and duration
  Start with 3 sessions/week of 30-45 minutes of play (including warm-up and cool-down). Progress to 4-5 sessions or longer sessions until you reach 150-300 min/week total. Pickleball sessions typically contain sustained moderate heart rates with short vigorous bursts, so session time counts (4,14,15).
• Intensity monitoring
  Use a heart rate monitor, ratings of perceived exertion (RPE), or the talk test (moderate = can speak in short sentences but not sing). You’re looking for a moderate to vigorous range, or a heart-rate target of ~50-75% of HRmax, 5-8 out 10 on RPE, or you can only get a few words out on the talk test for most of your session (15).
• Add two short strength sessions weekly
  Two sessions of 20-30 minutes (full-body, focus on lower limb strength, hip/ankle stability, and rotator cuff/shoulder work) to hit ~30-60 min/week. This both helps to reduce injury risk and adds independent mortality benefit (10,11,18).
• Progression and recovery
  Increase on-court time by ≤10-15 minutes per week or add one extra session every 2 weeks. Build lower-body strength and single-leg balance to cut fall and ankle injury risk. If you feel excessive fatigue, prolonged soreness, chest discomfort, or palpitations, stop and see a clinician.
• Warm-up and cool-down
  5-10 minutes dynamic warm-up: brisk walking, lateral shuffles, leg swings, light shoulder circles. 5-10 minutes of walking and mobility after play. A short neuromuscular warm-up reduces acute injury risk and prepares the cardiovascular system (2,16).

Tools to Track and Stay Honest

You don’t need advanced sports science equipment to measure your effort. A heart-rate monitor or smartwatch can provide real-time feedback (17), and the talk test is a free and reliable gauge (14). Wearables have been tested in pickleball and are accurate enough for recreational tracking (1).

Logging your weekly minutes can help keep you accountable. If pickleball is about 5 METs per hour, 3-5 hours per week puts you in the zone linked to lower cardiovascular mortality (14,16). Whether you prefer digital tracking or a pen-and-paper log, the goal is consistency. Plus, that same consistency is going to drive you to boost your pickleball ratings.

Ready to see if your pickleball sessions are hitting those heart-healthy intensity zones? AIM7 automatically tracks your moderate-to-vigorous activity during every match, so you'll know exactly how much cardiovascular benefit you're getting from your time on the court. Plus, with our new sharing feature, you can showcase both your fitness progress and DUPR rating with fellow players. 

Start your free trial and optimize your heart health today! Click here to download AIM7 for free.

Bottom line 

If you want to improve your heart health, pickleball is a fun and sustainable way to achieve it. The science is clear: regular, moderate-to-vigorous physical activity on the court paired with a little resistance training dramatically lowers your risk of cardiovascular disease.

So show up for your games, keep your rallies lively, lift something heavy twice a week, and listen to your body. Do that, and you’ll not only improve your game, but you’ll be investing in a heart that stays strong for decades to come.

Interested in how to complement pickleball in your weight loss journey? Check out this full guide. 

​​References

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