NEUROPLASTICITY
Table tennis: great treatment for Parkinson Disease
Coaching from a table tennis professional is the best* for promoting neuroplasticity.
by Stephen Allott
Gavin Rumgay is the table tennis Scottish champion 18 times.
The G.O.A.T. in Scotland.
A top professional player, he and Miles Ross have been coaching me for 10 years. It has really helped ameliorate the effects of my Parkinson disease better than anything else.
It does require being coached by a professional, practising a new stroke repetitively and being able to learn new things.
Let me explain how and why table tennis is so special.
The brain’s ability to reorganize synaptic connections, form new synapses, and adapt structurally and functionally is called neuroplasticity. Table tennis stands out because it combines aerobic exercise, high-speed sensorimotor integration, cognitive demands, and unpredictable decision-making in a way few other sports or exercises match.
Table tennis engages multiple brain networks simultaneously:
- Visual cortex and motion processing areas (tracking a ball at high speeds).
- Motor cortex and cerebellum (precise, rapid arm/hand movements and footwork).
- Prefrontal cortex (strategy, anticipation, decision-making, inhibition of wrong moves).
- Parietal areas (spatial awareness and hand-eye coordination).
- Hippocampus (memory for opponent patterns and shot sequences).
This rich, distributed activation creates a strong stimulus for Hebbian plasticity (“neurons that fire together wire together”). Repeated co-activation strengthens existing synapses and encourages new ones to form. Studies show table tennis increases activity and connectivity across these regions more than simpler exercises like cycling
Aerobic Exercise + BDNF and Neurotrophic Factors
Like other moderate-to-high intensity activities, table tennis boosts Brain-Derived Neurotrophic Factor (BDNF), a key protein that promotes neuron survival, growth, and synaptogenesis (new synapse formation), especially in the hippocampus. It also enhances blood flow, oxygenation, and neurogenesis.
What makes table tennis special is its intermittent high-intensity nature (bursts of rapid movement and reaction) paired with sustained play. This may optimize BDNF release and other growth factors better than steady-state cardio alone.
Open-Skill Demands Drive Adaptive Plasticity
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Unlike “closed-skill” sports (e.g., running on a track), table tennis is open-skill: the ball’s path, spin, speed, and opponent’s tactics are highly unpredictable. This forces:
- Constant error correction and motor learning.
- Rapid perception-action coupling (seeing → deciding → acting in fractions of a second).
- Cognitive flexibility and inhibitory control (suppressing the urge to swing at a bad ball).
These demands trigger structural changes, such as increased white matter integrity (better neural communication) and functional connectivity. Elite players show enhanced brain structure in visuomotor and attention networks, suggesting training-induced plasticity.
High Cognitive Load + Fine Motor Precision
The game requires sustained attention, working memory (remembering rally patterns), and executive function. The tiny table and fast ball demand millimetre-level precision, which refines neural circuits for timing and coordination. This level of challenge is ideal for inducing long-term potentiation (LTP) — the cellular basis of learning and memory.
It also involves bilateral coordination and quick switches between dominant/non-dominant sides, promoting interhemispheric communication.
Emotional and Social Engagement (if Played with Others)
Fun, competitive, or social play releases dopamine and reduces stress (cortisol can inhibit plasticity). Positive emotions and motivation amplify neuroplastic effects. Group play adds social cognition layers.
Low Injury Risk + Accessibility for Lifelong Plasticity
Compared to contact sports, it’s gentler on the body, allowing consistent long-term practice. This sustains the “use it or lose it” principle of plasticity across ages, with benefits seen even in Parkinson’s, stroke, and dementia patients (improved motor function, cognition, and brain activation).
Supporting Evidence
Neuroimaging shows table tennis players have superior white matter structure and functional connectivity linked to visual attention and processing speed.
- Interventions improve executive function, memory, and visuospatial skills, sometimes more than other exercises.
- It activates up to 5 brain regions simultaneously and supports neuroplasticity in clinical populations.
Table tennis is the perfect neuroplasticity workout
· physically aerobic
· cognitively demanding
· sensorimotor intensive
· variable
· unpredictable.
Table tennis forces the brain to constantly rewire for faster, smarter, more coordinated action not just build muscle or endurance.
Other racket sports (tennis, pickleball) share benefits, but the smaller table and faster pace in ping pong amplify the demands. If you’re looking to keep your brain young, grab a table tennis racquet!
See the film of Stephen and Gavin doing their table tennis Exhibition
