Tennis: An Activity-Specific Guide (Cardiac-Safe)
- Jamie Pickett
- Aug 24
- 4 min read
Professional, friendly guidance to help you enjoy tennis safely and confidently.
Why tennis?
Tennis mixes rhythmic aerobic movement with balance, agility, coordination and reaction time—great for heart health and overall fitness. Doubles is typically moderate intensity, while singles can reach vigorous levels; research classifies doubles ≈ 4.5–6.0 METs and singles ≈ ~8.0 METs (higher demand).
At a moderate effort you should be able to talk but not sing (the “talk test”).
The American Heart Association recommends 150 min/week of moderate activity (or 75 min vigorous)—tennis can count toward this.
BHF also lists tennis as an aerobic option that can support heart health when played at a moderate pace.
“Start where you are. Use what you have. Do what you can.” — Arthur Ashe
Is tennis right for me?
Most people completing cardiac rehabilitation can return to or start tennis with appropriate pacing. Choose doubles first, rally cooperatively, and match with partners at a similar level. If you’re brand new or detrained, add a few weeks of walking and light drills (see “Build-Up Plan”) before full games. From a cardiac perspective: how it feels matters—play so you can converse in full sentences and finish feeling pleasantly worked, not wiped out.
Safety first (read this bit!)
After open-heart surgery: wait ≥12 weeks for your sternum to heal before racquet sports.
Pacemaker/ICD: typically wait ≥6 weeks for leads to settle; device on racquet-hand side may need specific technique changes—discuss with your CR team/cardiac physiologist.
Stop immediately if you get chest discomfort, unusual breathlessness, palpitations, dizziness or light-headedness. Use GTN as directed; if symptoms don’t settle, seek medical help.
Pre-session checklist
Take prescribed meds; bring GTN if issued.
Wear court-appropriate shoes; bring water; avoid large meals beforehand.
In hot/humid conditions, reduce intensity or play at cooler times.
Only play when you feel well.
“Champions keep playing until they get it right.” — Billie Jean King
Warm-up (8–10 minutes)
Easy walk around the court → brisk walk.
Mobility: ankle circles, knee/hip openers, thoracic rotations (20–30 sec each).
Footwork: side-steps, quick forwards/backs (2 × 20 m).
Shadow swings: forehand/backhand at 50–70% speed; gentle serves without ball.
Short cooperative rally in service boxes, then baseline.
Cool-down (5–8 minutes): slow walk, gentle calves/quads/hips/forearms and shoulder stretches.
Technique & pacing tweaks for cardiac safety
Prefer doubles, short sets or timed play (e.g., 10–15-min bouts).
Use low-compression balls and mini-court lines to keep tempo steady.
Keep rallies cooperative at first; insert planned mini-rests (30–60 s) between points/games.
Avoid “all-out” chasing—let 1–2 balls go each game.
If using monitoring, target your clinician-advised moderate zone; otherwise use RPE 12–14 (“somewhat hard”) and the talk test.
“Just go out there and do what you have to do.” — Serena Williams
Build-Up Plan (8 weeks)
Aim: reach 2–3 × 30–45 min tennis sessions/week at moderate effort, mostly doubles.
Weeks 1–2 – Court Familiarisation (2 sessions/week)
10 min warm-up + footwork.
3 × 8-min cooperative rallies in service boxes/baseline (1–2 min rest).
10 min skills (volleys, gentle serves), cool-down.
Weeks 3–4 – Controlled Doubles (2–3 sessions/week)
10 min warm-up.
2 × 12-min timed doubles (steady pace, call “time” for breaks).
10 min serve/return practice.
Finish with 6–8 min easy rally + cool-down.
Weeks 5–6 – Doubles Sets
10 min warm-up.
Play 1 short set to 4 games; if deuce, sudden-death point.
8–10 min skills (overheads, approach shots).
Optional 8-min gentle rally, cool-down.
Weeks 7–8 – Maintain or Carefully Try Singles (optional)
Keep most sessions doubles. If trialling singles, use half-court or first to 4 games, allow generous recovery. Stop if pace feels too high. METs for singles are typically vigorous; prioritise safety.
Strength & mobility (2 days/week, non-consecutive)
Lower body: sit-to-stands or goblet squats, step-ups, calf raises.
Upper body/posture: standing rows, wall push-ups, banded external rotations.
Core & balance: suitcase carry, anti-rotation press, single-leg balance with head turns.
Shoulders & forearms: wrist extensors, forearm pronation/supination; progress slowly if history of elbow/shoulder pain.
(AHA also recommends adding strength work 2+ days/week.)
“The mark of great sportsmen is not how good they are at their best, but how good they are at their worst.” — Martina Navratilova
Hydration, weather & environment
Hot/humid: shorten play blocks, increase rests, drink regularly.
Cold/windy: extend warm-up; layer clothing.
Between points: keep legs gently moving to prevent light-headedness.
Red-flag FAQ
Can I play singles?
Yes for many people, eventually, but singles is usually vigorous. Build a base with doubles and drills; try short, timed singles with rests and stop early if intensity feels too high.
What if I’ve had bypass/valve surgery?
Wait ≥12 weeks, then restart gradually with guidance.
What if I have a pacemaker/ICD?
Usually okay after ≥6 weeks; speak to your CR team if the device is on your racquet-arm side to avoid repetitive lead strain.
How hard should it feel?
Think “comfortable but purposeful.” You can talk in phrases, not sing; you recover within minutes and feel fine the next day.
Two SMART challenges
2-week (short-term):
Complete two on-court sessions/week using timed doubles (2 × 12-min blocks, 2-min rests).
Track effort with the talk test; finish each session with a 5-min cool-down and note how you feel the next morning.
8-week (long-term):
Accumulate ≥150 minutes/week of moderate activity, including 2–3 tennis sessions plus 2 strength days. Maintain symptom-free play and steady progression.
How My Movement Medicine can help
If you’d like a cardiac-aware build-up to tennis, join our ongoing group sessions or book a one-to-one for a tailored return-to-play plan (including heart-rate education, pacing strategies and tennis-specific strength/mobility). We’ll meet you where you are and progress safely.
References (selected)
ACPICR – Racquet Sports: A guide for people with heart conditions (timing after surgery/devices; warm-up/cool-down; safety tips; pacing).
Ainsworth et al., 2011 Compendium of Physical Activities – MET values for tennis singles/doubles.
CDC – Talk test to gauge intensity.
American Heart Association – Weekly activity and strength guidelines.
British Heart Foundation – Tennis as aerobic exercise; easing back into activity.
This blog post was written by Jamie Pickett, Clinical Exercise Physiologist, with AI assistance.
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