In the play "The Tempest," Shakespeare wrote, "How cam'st thou in a pickle?" That's the same question doctors are asking the ever-increasing number of people they see with pickleball elbow (as opposed to tennis elbow) and other overuse and strain injuries. 

In a new article, "What doctors wish patients knew about preventing pickleball injuries," the American Medical Association sets out the most common risks and how to avoid them. If you’re one of the estimated 37 million pickleball players in the U.S., listen up:  

• If you have heart or lung issues, check with your doctor before you hit the courts.

• Avoid overuse and acute injuries. Don't play with pain or binge-play.

Overuse injuries include the above-mentioned pickleball elbow, either on the inside or outside of the joint, as well as ankle strains and shoulder pain. Acute injuries may involve hamstring pulls and sprained ankles, or hip and knee injuries.

Your best prevention is to exercise regularly off the pickleball court. But don't do exercises that use the same muscles and motions as pickleball. Instead, exercise by doing other kinds of aerobic and strength-building activities.

In addition, hydrate well before and during play, and start and end each match with a slow-motion routine that takes you through the movements you will be making during the game. 

It's also important to listen to your body. If you get a flare-up of arthritis pain while playing, stop. Rest and ice will get you back on the court. Pushing through may sideline you for much longer, or worse.