Built for Decades Activities Highlight | Edition 1
Tennis
Tennis counts as cardio. Here is what it cannot do for you.
By Ernest Stokes III, PA-C, M.Ed. | Ernest Health
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Why Tennis Deserves a Serious Look
Tennis is one of the few sports you can play for a lifetime. A doubles match on a Saturday morning, a hitting session with a friend, a league night after work. It is social, it is competitive, and it gets you moving without feeling like a workout. That is why so many adults over 40 keep coming back to it, and why it deserves a serious look at what the evidence says.
All three figures come from observational studies or wearable data. They show associations, not proof of cause.
What the Oura Data Shows
Oura's data science team analyzed deidentified, aggregate data from adult members across 11 global markets between July 17 and August 17, 2026, and published the findings on September 11, 2026. Three results stand out.
Most recreational tennis is aerobic, not all out.
The median average heart rate during a tagged tennis session sat in Zone 2, a steady aerobic zone. Median peaks reached Zones 3 and 4, but Oura found little evidence that most recreational players spend meaningful time in Zones 4 or 5. Members who logged more than 12 sessions in the month reached higher peak heart rates than casual players.
Tennis players showed a younger Cardiovascular Age.
In every market analyzed, tennis players had a larger positive gap between chronological age and Cardiovascular Age than members who did not play tennis. That is an association within one dataset, not proof of cause.
The body keeps working after the match.
Compared with each member's own 14 day baseline, overnight heart rate variability was suppressed and resting heart rate stayed slightly elevated after a tennis workout. The lowest overnight heart rate came about 3 to 4 hours after sleep onset.
What Larger Studies Add
A month of wearable data is a snapshot. Studies that follow thousands of people for years show whether the pattern holds.
Copenhagen City Heart Study: sports and life expectancy
Schnohr et al. Mayo Clinic Proceedings, 2018. 8,577 participants followed for up to 25 years.
Compared with sedentary adults, multivariable adjusted life expectancy was 9.7 years higher for tennis players, the largest gain of any activity studied. The authors noted that sports with more social interaction were associated with the best longevity.
Keep in mind: This is observational, so the authors say it remains uncertain whether the relationship is causal.
Life expectancy gain compared with a sedentary group (years, multivariable adjusted)
Source: Schnohr et al., 2018. Health club activities is a broad category, not a measure of resistance training.
Sports and mortality in 80,306 British adults
Oja et al. British Journal of Sports Medicine, 2017. Pooled Scottish and English cohort, mean age 52.
Racquet sport participation was associated with lower all cause mortality (HR 0.53, 95% CI 0.40 to 0.69) and lower cardiovascular mortality (HR 0.44, 95% CI 0.24 to 0.83). Swimming and aerobics also showed lower risk. Football and running did not reach statistical significance.
Keep in mind: The confidence intervals are wide, so treat the exact percentages loosely and the direction as the takeaway.
Activity types and mortality in 272,550 older adults
Watts et al. JAMA Network Open, 2022. NIH AARP Diet and Health Study, mean age 70.5, followed about 12 years.
At 7.5 to under 15 MET hours a week, racquet sports (HR 0.84, 95% CI 0.75 to 0.93) and running (HR 0.85) were associated with the greatest relative reductions in all cause mortality. Even low amounts of any activity were associated with a large reduction, with diminishing returns after that.
Keep in mind: This cohort was older adults and self reported. The finding that any regular activity helps is as important as the ranking.
The pattern across all three
Regular racquet sport participation lines up with lower mortality risk and better heart health markers at moderate, repeatable amounts. Cause is not proven. Either way, a sport you enjoy is a sport you keep doing.
What It Means for Your Body
After 25 years in cardiac and cardiothoracic surgery, I have spent a lot of time looking at what happens to hearts when people stop moving. So this data is encouraging to me. Steady, moderate effort repeated over time is the kind of work your cardiovascular system responds to. You do not need to grind through every rally at max effort to get the benefit.
The overnight numbers matter too. Lower heart rate variability and a slightly higher resting heart rate after a match tell us your nervous system is working to bounce back. That is expected. The benefit of activity gets built during recovery, so hard play plus poor sleep cuts the process short. For adults over 40, consistency beats intensity. Play often, recover well, and let the effort add up.
What the Data Does Not Tell You
A wearable measures your heart. It does not measure your muscle, your joints, or your power. After 40, muscle declines quietly unless you train it on purpose, and that decides whether you keep playing at 60 and beyond. Cardio keeps the engine running. Muscle is longevity currency. Two bodies of research point the same way.
Muscle strengthening and mortality: a meta analysis
Momma et al. British Journal of Sports Medicine, 2022. 16 prospective cohort studies.
Muscle strengthening activities were associated with a 10 to 17% lower risk of all cause mortality, cardiovascular disease, total cancer, diabetes, and lung cancer. The largest risk reduction, roughly 10 to 20%, appeared at about 30 to 60 minutes a week for all cause mortality, cardiovascular disease, and total cancer. Combining muscle strengthening with aerobic activity was associated with lower risk than doing neither.
Keep in mind: These are observational cohorts, and the authors note the benefit of higher volumes is unclear.
Grip strength as a health signal: the PURE study
Leong et al. The Lancet, 2015. 139,691 adults aged 35 to 70 in 17 countries, median follow up 4 years.
Each 5 kg lower grip strength was associated with a higher risk of all cause mortality (HR 1.16) and cardiovascular mortality (HR 1.17). Grip strength was a stronger predictor of all cause and cardiovascular mortality than systolic blood pressure.
Keep in mind: The study measures strength, not whether training changes risk. The authors call for more research on that question.
The bottom line
Tennis and strength are not competing. Tennis gives you the aerobic base, the social connection, and the reason to show up. Strength training protects the legs, back, and shoulders that keep you playing. The pairing is the plan.
Your Built for Decades Playbook
Use the ABCD Method to turn court time into a long term plan.
Activate
Keep playing. Choose two or three sessions a week you enjoy and can repeat, and let the effort stay mostly moderate. Consistency is the goal, not exhaustion.
Build
Add two strength sessions a week. Current cohort research links roughly 30 to 60 minutes a week of muscle strengthening with the largest risk reductions, so two focused sessions is a realistic, sustainable dose.
Construct
Make recovery part of the plan. Protect sleep on match days, space hard sessions apart, and watch how your body bounces back before you add more.
Drive For The Future
Think in decades. Track how you feel, how you recover, and how your strength changes, then adjust so you are still on the court years from now.
Where Tennis Loads You, and What to Train
| Where tennis loads you | What to train |
|---|---|
| Legs and hips. Sprints, hard stops, and quick changes of direction. | Squat and hinge patterns, split squats, step ups, lateral and single leg work. |
| Back and core. Every swing starts with rotation. | Rows, carries, anti rotation core work, controlled twisting movements. |
| Shoulders and arm. Serves and overheads add up over a season. | Pulling volume, rotator cuff and shoulder blade stability, gradual overhead work. |
| Grip and forearm. Your hand is the link to the racquet. | Loaded carries, hangs, and rows with a firm grip. |
A Sample Week
A starting template only. Adjust the days to your schedule, and build up gradually if you are new to strength training.
One more data point for the long game. An umbrella review of 16 systematic reviews in adults 60 and older found that activity around guideline levels (7.5 to 15 MET hours a week) was associated with roughly 19 to 30% lower all cause mortality, with larger reductions at higher levels (Fukushima et al., 2023).
Ready to Build Your Plan?
If you want a personalized plan that pairs the activities you love with the strength and recovery that keep you in the game, book your Free Built for Decades Health Audit with me. We will look at your goals, your schedule, and what your body needs to stay Built for Decades.
Book Your Free Health AuditFeel Better Today. Build Momentum for Tomorrow. Achieve Greatness! Built for Decades.
Sources
- Oura. "Oura Data Reveals Effects of Tennis on Heart Health, Recovery, and More." Locke Hughes, September 11, 2026. Deidentified, aggregate data from Oura members aged 18 to 69 across 11 markets, July 17 to August 17, 2026.
- Schnohr P, O'Keefe JH, Holtermann A, et al. Various leisure time physical activities associated with widely divergent life expectancies: the Copenhagen City Heart Study. Mayo Clin Proc. 2018;93(12):1775 to 1785. doi.org/10.1016/j.mayocp.2018.06.025
- Oja P, Kelly P, Pedisic Z, et al. Associations of specific types of sports and exercise with all cause and cardiovascular disease mortality: a cohort study of 80,306 British adults. Br J Sports Med. 2017;51(10):812 to 817. doi.org/10.1136/bjsports-2016-096822
- Watts EL, Matthews CE, Freeman JR, et al. Association of leisure time physical activity types and risks of all cause, cardiovascular, and cancer mortality among older adults. JAMA Netw Open. 2022;5(8):e2228510. doi.org/10.1001/jamanetworkopen.2022.28510
- Momma H, Kawakami R, Honda T, Sawada SS. Muscle strengthening activities are associated with lower risk and mortality in major non communicable diseases: a systematic review and meta analysis of cohort studies. Br J Sports Med. 2022;56(13):755 to 763. doi.org/10.1136/bjsports-2021-105061
- Leong DP, Teo KK, Rangarajan S, et al. Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet. 2015;386(9990):266 to 273. doi.org/10.1016/S0140-6736(14)62000-6
- Fukushima N, Kikuchi H, Sato H, et al. Dose response relationship of physical activity with all cause mortality among older adults: an umbrella review. J Am Med Dir Assoc. 2023;25(3):417 to 430. doi.org/10.1016/j.jamda.2023.09.028
Study details for references 2 to 7 were retrieved from PubMed.
About the evidence. Every study cited here is observational. Observational research can show that two things travel together, but it cannot prove one causes the other. Findings are reported in the authors' own terms and should be read as associations.
Disclaimer. Ernest Health provides educational lifestyle coaching and does not diagnose or treat medical conditions. This article is not medical advice. Talk to your physician about heart rate concerns, symptoms, medications, or before starting a new exercise program.
Ernest Health | [email protected] | (843) 995-1688 | @erneststokeshealth