Tennis And Bone Health: What You Need To Know

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Learn about the health benefits of tennis, whether tennis is good for your bones, and whether or not tennis is safe for someone with osteoporosis.

Disclaimer: If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Well Guide contain information from peer-reviewed research, medical societies and governmental agencies; however, these articles are not a substitute for professional medical advice, diagnosis, or treatment.

Tennis is a popular sport enjoyed by millions worldwide. It requires a combination of physical fitness and strategic thinking and can be exciting to watch and fun to play. However, when it comes to individuals with conditions such as osteopenia or osteoporosis, questions arise about the safety of engaging in this high-impact activity.

Understanding the specific movements involved in tennis and their potential impact on bone health is crucial for determining whether or not it is safe for individuals with these conditions. In this article, we’ll help you sort through all the information to help determine if tennis is a safe activity for you.

Is tennis good for osteoporosis?

There is a lot of conflicting information out there, so it is no surprise that determining whether or not tennis is good (or bad) for someone with osteoporosis can be confusing. A quick Google search will likely give you mixed information. So how do you determine if it’s safe for you?

While there are many health benefits to playing tennis, including its impact on cardiovascular health and overall fitness, there are some elements that make it less safe for individuals with weakened bones. For people who have been diagnosed with osteoporosis, tennis can be a potentially risky endeavor. Below we have outlined a few of the reasons why:

The downsides of tennis for bone health

  • High-impact exercise: While the high-impact nature of tennis can be good for building bone density in a healthy, young person, it can actually work against bone health in someone with already weakened bones. This is particularly the case for those who have been diagnosed with osteoporosis. Unfortunately, the forces exerted on the bones during high-impact activities can sometimes be too much for osteoporotic bones to handle, and could lead to fractures.
  • Twisting movements: Tennis requires a lot of twisting at the spine and waist, which can be problematic for someone with osteoporosis (LeBoff, 2022). These movements are the movements that put the spinal bones at a higher risk of fracture, so it is generally advised to avoid these movements. The spinal bones are particularly vulnerable  in someone with low bone density, so these movements can put excess stress on the vertebrae leading to potential compression fractures. This can be particularly dangerous for individuals who have already experienced spinal fractures.
  • Sudden movements: Tennis often involves quick and sudden movements and changes in direction. While controlled shifting of your weight can help with balance and coordination, the more sudden changes in direction that can occur during tennis – especially when combined with twisting and other fast movements – can put you at a higher risk of falls and fractures (Kaiser, 2021).

The health benefits of tennis

Tennis isn’t all bad – far from it. There are several health benefits of playing tennis for someone who isn’t at high risk of falls or fractures.

As a weight-bearing sport, tennis stimulates bone-forming cells, building bone mass or slowing bone density loss. Because it involves multidirectional movements around the court, tennis can also help increase your balance and coordination. Additionally, tennis can strengthen muscles in the upper and lower body that are essential in supporting and protecting your bones. Lastly, it is an aerobic exercise, which means it can benefit the heart and lungs, contributing to improved overall health.

How can tennis benefit bone health?

The physical demands of hitting a tennis ball and moving around the court stimulate the bones and get the heart rate up, which can help in maintaining or even increasing bone density while also improving cardiovascular fitness and strength. This is particularly beneficial for individuals prior to any bone loss, in the early stages of bone density loss or those who have osteopenia, as the sport has been shown to increase bone density in the lumbar spine and hip femoral neck (Ermin, 2012; Wang, 2021).

However, because of  the sudden movements and twisting mentioned earlier, tennis is not recommended for people with osteoporosis (LeBoff, 2022). If you’re seeing mixed information about this, that is because it’s true – this is not a black and white rule. There is a grey area. That said, it is important to recognize the risks involved in playing tennis for those who have bones that are more vulnerable to fracture.

At Wellen, we recommend that anyone with compromised bone density discuss with their doctor or healthcare provider whether or not tennis is appropriate for them before engaging in this sport.

What about tennis and osteopenia?

As mentioned, for someone with osteopenia, the story is slightly different. People with osteopenia may be ok to pick up a racquet and hit the courts. However, if you have any concerns, you should consult with your doctor about whether or not tennis is appropriate for you. The answer depends on an individual’s bone health, general health history, strength and fitness levels.

If you have been cleared to play, tennis could not only be a safe exercise, but a bone-building exercise you can enjoy. Engaging in tennis as part of a broader bone health strategy that includes strength training, balance exercises and a balanced diet, may be the best approach.

Is pickleball safe for osteoporosis?

Pickleball has recently experienced a spike in popularity. While the sport may seem like a nice, casual way to spend a summer day, don't be fooled: Pickleball, like tennis, involves quick, bounding movements, as well as bending and twisting. For this reason, and for the same reasons mentioned above, it is advised that people with osteoporosis do not participate in pickleball unless they have been told by their doctor that it is ok. That said, as always, there may be exceptions. Your medical history, fitness level, falls history and general experience with the sport could impact whether or not it is safe for you.

Alternatives to tennis

While tennis can be a great way to stay active and socialize, there are numerous other activities that are both social and physically beneficial for those who are advised not to play tennis. Walking, hiking, and dancing can provide the same social benefits as tennis, while also helping to strengthen your bones. In addition, a bone-building exercise program such as Wellen’s is the best way to make sure you are safely building and protecting your bones.

While tennis can be beneficial for one’s physical and emotional health, it's still important to consider your bone health before stepping on the court. Ultimately, being active is important for one’s overall health and happiness. Now that you know the risks and benefits of tennis, it is up to you and your doctor to make the best decisions you can for your health.

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  1. LeBoff MS, Greenspan SL, Insogna KL, et al. The clinician's guide to prevention and treatment of osteoporosis [published correction appears in Osteoporos Int. 2022 Jul 28]. Osteoporos Int. 2022;33(10):2049-2102. doi:10.1007/s00198-021-05900-y
  2. Kaiser P, Stock K, Benedikt S, et al. Acute Tennis Injuries in the Recreational Tennis Player. Orthop J Sports Med. 2021;9(1):2325967120973672. Published 2021 Jan 5. doi:10.1177/2325967120973672
  3. Ermin K, Owens S, Ford MA, Bass M. Bone mineral density of adolescent female tennis players and nontennis players. J Osteoporos. 2012;2012:423910. doi: 10.1155/2012/423910. Epub 2012 Jul 1. PMID: 22811951; PMCID: PMC3395175.
  4. Wang HS, Tsai YS, Chen YC, Chao HH, Lin HS, Chiang YP, Chen HY. Effects of backhand stroke styles on bone mineral content and density in postmenopausal recreational tennis players: a cross-sectional pilot investigation. BMC Womens Health. 2021 Jul 29;21(1):275. doi: 10.1186/s12905-021-01416-z. PMID: 34325678; PMCID: PMC8320033.

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