Genetic and Environmental Factors Underlying Tennis Performance and Injury Risk: A Structured Review

This structured review integrates evidence regarding genetic and exercise-related factors associated with tennis performance and injury risk, focusing on genes involved in explosive power, endurance, connective-tissue integrity, and recovery. The literature was systematically searched across PubMed and Google Scholar, with PubChem and the AlphaFold Protein Structure Database used as supplementary resources for chemical and structural information. Ten candidate genes were examined across four functional categories: ACTN3 and ACE (explosive power), PPARGC1A, PPARA, and NOS3 (endurance), COL5A1, COL1A1, and MMP3 (connective-tissue health), and IL6 and IGF1 (recovery and inflammation). Environmental factors, including training, nutrition, sleep, and heat exposure, were also considered for their potential influence on relevant physiological pathways. Although several genetic variants have been associated with athletic traits in general athletic populations, direct evidence in tennis-specific cohorts remains limited. Overall, the findings are consistent with a polygenic, environment-modulated model, but the reviewed evidence does not establish any single candidate gene as a reliable predictor of tennis performance or injury risk.