Health effects of tennis participation: benefits, injury patterns, and implications for lifelong physical activity – a narrative review

Abstract

Introduction: Tennis is widely recognized as a lifelong form of physical activity that combines intermittent high-intensity effort, repeated directional changes, weight-bearing loading, and complex motor coordination. The purpose of this narrative review was to summarize current evidence on the cardiovascular, metabolic, musculoskeletal, and longevity-related effects of regular tennis participation, while also considering its injury profile.

Brief description of the state of knowledge: The reviewed literature indicates that regular tennis participation is associated with favorable cardiorespiratory and metabolic effects, including improved aerobic fitness, lower body fat, and beneficial effects on selected health indicators. Tennis also appears to support bone health, particularly in loaded skeletal regions. Observational evidence suggests that tennis and other racket sports are associated with lower all-cause and cardiovascular mortality, although these findings are based mainly on cohort studies and remain vulnerable to residual confounding. At the same time, tennis is linked to acute and overuse injuries, especially involving the shoulder, elbow, and lower extremities.

Conclusions: Tennis appears to be a valuable component of lifelong health promotion, but its overall health value depends on technique, training load, conditioning, recovery, and injury-prevention strategies. Further prospective and interventional studies are needed to clarify dose-response relationships and distinguish tennis-specific effects from broader racket-sport associations.