Elite tennis players, as well as a large number of active recreational players, are involved in a sport that applies high repetitive loads that can create tension overload situations in certain key anatomic areas of the body and add to possible overload situations in other areas of the body. This results in patterns of inflexibility and weakness that can be demonstrated on a tennis-specific musculoskeletal exam, and that can be correlated with areas of increased injury occurrence. These players report conditioning programs that are, for the most part, inadequate to confer total conditioning of all the muscular parameters important in playing tennis. All of these factors, in addition to the frequency and type of playing, contribute to the occurrence of the overload injuries noted. These aspects need to be addressed in a preventative program for injury reduction. We do not believe that major changes in the way that tennis is played should be implemented until the effects of a proper preventative conditioning program are evaluated. The "ideal" conditioning program has not yet been found. While the exact composition of the program is in doubt, our studies allow us to recommend flexibility, strength, and endurance training for all athletes playing tennis at frequent intervals. This program should be guided by the findings on the preparticipation exam.