Adaptive Tennis: A behavioral health perspective

Ron Tankel and Michael-Ray Pallares | August 04, 2023

Michael-Ray Pallares, ITF-certified tennis coach, and Ron Tankel, certified therapeutic recreational specialist, interviewed two leading psychiatrists to elicit their perspective on tennis as a viable treatment for behavioral health issues.


These interviews were conducted with Dr. Charles Raymond Lake from Kansas City, Mo. and Dr. Todd Mekles from New York, N.Y. The views and opinions expressed in this interview are those of the speakers, and do not necessarily reflect the views or positions of any entities they represent.

Meet the Experts

Dr. Charles Raymond Lake received his M.D. & Ph.D. from Duke University. As professor emeritus of psychiatry at Kansas University School of Medicine, Lake published widely about depression, bipolar & anxiety disorders, panic, obsessive-compulsive disorder and post-traumatic stress disorder. He is still currently in practice.

Dr. Todd Mekles is a graduate of the University of Kansas Medical Center's psychiatry program. As founder and CEO of NYC Psychiatric Associates, Mekles has treated all forms of psychiatric conditions, including substance abuse, psychosis, ADHD, depression, anxiety and PTSD.


The following comments, observations and feedback provide the two experts' opinions on why tennis should be considered as one of the leading therapeutic interventions for an individual's overall mental health and wellness.

Dr. Charles Raymond Lake

  • Exercise is one of the best antidepressants there is. Tennis provides numerous health benefits, and is one of the best for overall health, in comparison with other sports and activities. There is ample evidence-based data to support this claim.

  • Tennis burns many calories and is a very thorough workout. It is a much more interesting workout than that of using a treadmill or stationary bike. Tennis is a lifetime sport and the USTA has divisions for all ages in which to participate.

  • The amount of both physical and mental effort in any exercise might be directly related to the degree of antidepressant effect. Tennis requires maximum effort, focus and concentration.

  • The activity of playing tennis provides socialization, personal interaction and mutual enjoyment that leads to developing lifelong friendships on and off the court. For example, playing tennis was one of the few leisure activities that provided respite for countless people during the isolation of the recent COVID-19 pandemic.

  • Tennis would be an extremely beneficial therapeutic intervention for clients experiencing mental health issues, as an integral part of their overall treatment plan.

  • Persuasive data now show that exercise is a potent antidepressant. This certainly holds true for tennis, as it is a very good aerobic workout. Playing sets or doing drills for 90 minutes, four or five times a week, will maintain mental and physical fitness. Such workouts, if they can be accomplished when depressed, will likely enhance improvement in mood.

  • The mood-stabilizing class of medication is now thought to be superior to the anti-depressants in the treatment of depression, both unipolar and bipolar depression. If remission is reached with exercise and medication, it is recommended that both be maintained to reduce the risk of recurrence, in these usually-cycling disorders.

Dr. Todd Mekles

  • If doctors drop out of residency and medical school, mental health reasons are often the leading cause. In my residency, the anxiety and stress was so bad, it caused me to be irritable and unprofessional at times—with my colleagues, my superiors, and most of all, patients.

  • I noticed every time I found my old game of tennis, and took the court, it was like medicine. I parlayed this into a prescription: I had to have consistent play or I would not have made it. Today I captain four USTA League teams, have advanced to the national championships many times, and have developed a tremendous network of leadership skills through tennis. Tennis saved me.

  • There is no question the effects I had can be replicated in others. Exercise in itself is a tremendous booster of serotonin and dopamine. Combined with the camaraderie of tennis, and organized sports, it leads to increased social skills, better fitness, and overall mental wellbeing.

  • There is no doubt that if a treatment study were done to see if tennis has a positive impact on depression and anxiety, the results would beat a placebo. I would be able to lower doses of medications for thousands of people. I look forward to the day when insurance companies will include for sports-recreation therapy as part of their treatment. It is a no-brainer and would benefit society as a whole significantly.


These two expert psychiatrists strongly suggest that tennis is a therapeutic treatment intervention for individuals through their own experiences, as well as clients' perceived needs. Tennis could be a significant treatment option for behavioral health. Whether it be an individual therapy or group treatment intervention, one of the ultimate goals may be to have clients transition into community parks and recreation tennis programs, clubs, leagues, and as a lifetime leisure activity.


Ron Tankel and Michael-Ray Pallares are members of the USTA's national adaptive tennis committee.

Skip Advertisement


Related Articles