There is an abundance of evidence that illustrates that engagement in physical activity promotes healthy ageing, reduces the risk of multiple long-term conditions and reduces the risk of a premature death (Daskalopoulou et al., 2017; Anderson & Durstine, 2019; Zhao et al., 2020). Further, physical activity engagement offers protection of cognitive decline and prevention of the onset of poor mental health or disorders (Iso-Markku et al., 2024 Schuch et al., 2018). Despite these benefits, large proportions of the population do not meet the recommended guidelines for physical activity for health (Bull et al., 2020).

Participation in sports is one way where individuals can attempt to master a sport, experience fun and often have social connection. There is good evidence that various forms of sports participation have multiple health benefits (Oja et al., 2015). A previous meta-analysis (Oja et al., 2015) investigated the health benefits of 26 sports on adults and found support that running, and football were associated with a range of physical health and fitness benefits. Substantially less research has considered the mental health and wellbeing benefits of sports participation. For instance, a recent systematic review on the mental health benefits of sports participation (Eather et al., 2023) found that there is emerging evidence for the mental health benefits of sports participation for adults but for most sports, limited conclusions could be made.

Worldwide, tennis is one of the most participated sports with an excess of 87 million people playing worldwide (International Tennis Federation [ITF], 2022). Despite the popularity of tennis, previous research is sparse on the health and wellbeing benefits of tennis participation on health and wellbeing. For instance, a previous systematic review (Eather et al., 2023) investigating all sports and mental health identified only one study that reported the wellbeing benefits of tennis. The study included 793 adults in Australia and focussed on multiple sports and suggested in their cross-sectional survey playing tennis is positive for mental health (Eime et al., 2014). An earlier systematic review on all health benefits of tennis did not identify any study that investigated the mental health benefits of tennis in the general population (Pluim et al., 2018). Despite the lack of published research, opinion pieces and media articles have repeatedly talked about the mental health benefits of tennis (Sayer, 2023).

Given the popularity of playing tennis, the potential to influence mental health and paucity of evidence to support this widely held claim, we set out to conduct a survey of tennis participation and wellbeing in adults in the United Kingdom (UK). Specifically, we sought to understand if playing to understand the potential association between playing tennis and wellbeing across genders, age groups and based on the tennis player characteristics (frequency of play and number of years playing tennis). Given the high levels of dropout from sports participation in adolescence (Back et al., 2022), we also sought to understand how the reasons for playing tennis differed among those who dropped out of tennis during adolescence and those that did not.

A cross-sectional study design was developed, and data collected between April and June 2024. An a-priori minimum sample size of 1,000 adults was set. The survey adopted a naturalistic approach. There was not set quotient made for the number or proportion of people according to age, sex or type of tennis player. Healthy adult volunteers who were resident in the UK were invited to complete the anonymous survey via the secure survey platform Qualtrics. Participants were recruited via a snowball method online and via social media platforms (LinkedIn, X, Instagram). The inclusion criteria included people who had never played tennis or were tennis players (of any type, but not professional tennis players), residents in the UK, adults aged over 18 years of age and able to understand English. After reading the participant information sheet and people confirming they met the eligibility criteria, informed consent was taken, and University ethical approval was gained (MRA-23/24-43024). The survey was designed in line with GDPR regulations.

The sample was composed of 2287 participants (907 women), from which 9.8% were 18-27 years old, 30.9% were 28-43 years old, 43.9% were 44-59 years old, 12.6% were 60-69 years old, and 2.6% were 70-78 years old (Table 1). The total state of mind (SOM) score according to gender is presented in Figure 1 (panel A). Men presented with a 6% higher SOM score than women (67 vs. 63; p=0.026). Panel B from Figure 1 shows the state of mind scores according to age groups. The group aged 44-59 years (score = 66) presented higher scores than the groups aged 18-27 (score = 66) and 28-43 (score = 60), while the group aged 60-69 (score = 74) and 70-78 (score = 72) presented higher scores compared with the three younger groups.

Figure 2 shows state of mind scores according to tennis participation (panel A), frequency of playing tennis (panel B), years playing tennis (panel C), and type of tennis player (panel D). Tennis players presented 13% higher scores than their peers (69 vs. 61; p<0.001). There was a linear increase in the state of mind scores according to the frequency of tennis playing, with the group playing once a week presenting a 13% higher score than those playing less than once a week (69 vs. 61) and the group playing more than once a week (score = 71.5) presenting 4% higher scores than those playing once a week and 17% higher scores than those playing less than once a week. Considering how long the participants reported playing tennis, the groups playing tennis for 0-5 years (score = 70), 5-10 years (score = 69.5), and >10 years (score = 69) presented higher state of mind scores than those that never played tennis. Regarding the profile of tennis player, those that self-reported being a competitive tennis player (score = 71) and training regularly but not competing (score = 73.5) presented higher state of mind scores than those playing tennis for leisure (score = 64) and for fun (score = 61).

The reasons for playing tennis according to whether the participant have ever stopped playing tennis during adolescence are presented in Table 2. There was a higher frequency of agreeing that tennis makes the participant feel help, manage stress, improve self-care, enjoy playing, make or meet friends, helps optimize their routine, makes them feel part of a team, enjoy competing, and helps to stay in shape. Table 3 shows the reasons for playing tennis according to the frequency of playing tennis. There was a trend for increasing agreement according to the frequency of playing tennis for self-care, improving sleep, enjoying playing, mental wellbeing benefits, being part of the participants’ life, make/meet friends, to improve routine, to be part of a team, to compete, to lose weight, to stay in shape and to make the most of the weather. The reasons for playing tennis according to whether the participants stopped playing tennis at adolescence or not are presented in Table 4. Participants that did not stop playing tennis at adolescence presented higher report agreement to feel happy, manage stress, self-care, enjoyment, make or meet friends, routine, to be social, competing and to stay in shape.

The association between playing tennis and related variables with state of mind are presented in Table 5. In the analysis adjusting for gender and age, playing tennis was associated with a 10% higher state of mind. The association was also consistent across all the categories of years playing tennis. Comparing with a frequency of playing tennis lower than weekly, only those practicing tennis at least twice a week presented higher state of mind (8%). In addition, comparing with the participants playing tennis for fun, only those training regularly but not competing presented higher state of mind (7% higher).

To the best of our knowledge, this is the largest study to attempt to understand the relationship between playing tennis and wellbeing in adults. They key findings are that participants playing tennis presented higher state of mind compared to participants that do not play tennis. This finding was consistent across all the categories of years playing tennis, while those playing at least twice a week presented higher state of mind scores compared to participants playing tennis less frequently than once a week. In addition, participants reporting training regularly presented higher state of mind compared to participants playing for fun.

This finding that playing tennis was associated with wellbeing is consistent with wider findings on sports participation and wellbeing. For instance, a recent systematic review found that playing sports in adulthood is associated with better wellbeing (Eather et al., 2023). A previous cross-sectional survey among 793 women who predominantly played tennis or netball, found a suggestion that playing tennis was associated with greater health related quality of life and life satisfaction, but no apparent dose response relationship was evident (Eime et al, 2014). Whilst it is not possible to determine this from cross sectional data, we found some evidence that the association of a positive relationship with tennis and wellbeing was relatively stable regardless of length of time people had played or frequency people played tennis for. A number of other cross-sectional surveys have investigated multiple sports and wellbeing, including tennis, but have had small numbers of people playing tennis and not sought to understand the relationship between tennis and wellbeing specifically (Gerber et al., 2014; Sorenson et al., 2014).

The reasons why playing tennis may be associated with greater wellbeing are unclear. However, this could include many of the wider neurobiological factors that have been reported from general physical activity participation such as changes in inflammation, increased released of brain derived neurotrophic factor, reductions in cortisol and possible changes in key emotional processing areas of the brain in the short and long term such as the hippocampus (Kandola et al., 2019). The psychosocial potential mechanisms how tennis influences wellbeing could include influencing social support, a key factor that wider research has shown exercise can improve mental health (Kandola et al., 2019). Tennis is a social sport, and such interactions are known to promote better mental health (Eather et al., 2023). Tennis is also a sport that requires a relative high degree of skill and participation allows people to develop a skill, overcome challenges and work towards mastering this skill (Eather et al., 2023). We found relatively consistent wellbeing associations regardless of the type of player. One previous survey among tennis professionals did not find an association with playing tennis and mental health (Spring et al., 2020) and wider literature has often found high levels of poor mental health in elite athletes (Rice et al., 2016). Our study of benefits among competitive (but no professional players) suggests that such players whose career does not depend on the outcome continues to have a favourable association with wellbeing.

The findings of a potential difference in the reasons people play tennis among those that do and do not dropout from participation in adolescence is interesting. Previous research has consistently shown that dropping out of sport at this time is high and critical. We noted a trend for a higher frequency of playing tennis and a greater endorsement of playing tennis for self-care, improving sleep, enjoying playing, mental wellbeing benefits, being part of the participants’ life, make/meet friends, to improve routine, to be part of a team, to compete, to lose weight, to stay in shape and to make the most of the weather. These measures are all typically associated with greater mental health and could play a role in helping people to remain engaged in tennis.