Tennis

Is tennis safe?

Yes. For a healthy adult, tennis carries a small injury risk and a very small risk of death. The serious events are almost all cardiac: a player, usually a middle-aged or older man, collapses on court from a heart problem. Trauma, the thing that kills people in contact and speed sports, barely features.

The best long-run count comes from the US National Center for Catastrophic Sport Injury Research (NCCSIR). From 1982 to 2025 it recorded 7 deaths among high-school tennis players across 13.2 million participant-seasons, every one of them from a medical or exertional cause, not an injury. That is about 0.5 micromortsMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary per season, or roughly 0.01 per practice or match. College players had 2 deaths in 682,000 participant-seasons.

For adults no one counts tennis deaths directly, so we borrow the best general figure. The Physicians' Health Study of 21,481 US male doctors found one sudden cardiac death per 1.51 million bouts of vigorous exercise, about 0.7 micromorts. Competitive singles is vigorous exercise, so we use that as the upper end for an older man's session (our estimate). Younger players and most doubles games sit well below it.

Heart risk on court

A French national survey found 4.6 sports-related sudden deaths per million people each year, and more than 90% of them happened in recreational sport, not elite competition. The average age was 46 and 95% were men. Most collapses were witnessed, yet bystanders started CPR in only about a third of cases.

That points to the practical message for tennis. The danger is mostly not the sport itself but hidden coronary artery disease, triggered by a hard rally on a hot afternoon. Men who exercise regularly had a much lower risk during exertion in the US study than those who rarely did, so a sudden jump from no exercise to competitive singles is the pattern to avoid.

A heart check is worth discussing with a doctor if you are a man over about 40 returning to the sport, or have chest pain, breathlessness or fainting on effort.

What injuries do tennis players get?

The common ones are dull rather than dangerous. In US college tennis in 2009–2015, players had 4.9 injuries per 1,000 practices and matches, with almost half in the legs.

Recreational players look a little different. Among 449 people treated for acute tennis injuries at a German university hospital in 2013–2018 (average age 44), half had harmless bruises or strains. The main causes were twisting a joint and falling. Fractures made up 12% of injuries, and about 10% of patients needed surgery, mostly for fractures, torn knee cartilage and ruptured Achilles tendons.

Age changes the picture. US emergency departments treated an estimated 58,800 injuries in tennis players aged 60 and over in 2010–2019. Falls and fractures drive those numbers, and cardiovascular events made up 21.5% of all tennis cases in that age group, more than in pickleball. Children have a different pattern again: of about 48,400 tennis injuries in under-19s in 2014–2023, younger children most often had cuts and facial injuries, while teenagers mostly had sprains and ankle injuries.

Overuse injuries such as tennis elbow and shoulder pain are the chronic cost of the sport. They are painful and slow to heal but rarely put anyone in hospital.

The other side of the ledger

Tennis players live longer. In the Copenhagen City Heart Study, people who played tennis had a life expectancy 9.7 years longer than sedentary people, the largest gain of any sport in the study, ahead of badminton and football. It is observational, so part of the gap reflects who plays tennis, but the benefit dwarfs the tiny risk of a session.

How to play tennis more safely

1. Build up gradually if you are returning after years away. Start with doubles and short sessions.
2. Warm up with easy rallying and some movement drills before serving hard or sprinting.
3. Wear court shoes with lateral support; running shoes roll on the side and set up ankle sprains.
4. Keep balls off the court floor. Stepping on a stray ball is a classic cause of falls and broken wrists.
5. Respect the heat. Drink, sit in the shade at changeovers, and stop if you feel dizzy or confused.
6. Do not play through chest pain, unusual breathlessness or palpitations. Know where the club's defibrillator is, and learn CPR.

How we scored it

Fatality risk (88) reflects well under one micromortMicromortA one-in-a-million chance of death. It lets you compare the risk of very different activities on one scale.More in the glossary per session, mostly from cardiac events in older players. Injury risk (80) is the weakest factor, because sprains, strains and some fractures are common. Controllability (78) loses points for hidden heart disease, and the rescue environment (92) is good on town courts. Compare pickleball, with a similar profile and older players, and running.