In a recent report by Dines at al, there is a good description of common tennis injuries and why they occur. Tennis has many different movements associated with playing, but frequently there are explosive bursts of energy and there are repeated motions. Over the course of a few months playing this can involve thousands of repeated strokes. This high repletion and high energy can often lead to overuse injuries and many back injuries fall into this category. Specifically, repetitive rotational forces in combination with flexion or extension (very common in tennis, think serving or reaching way in front to get a ball with your back hand) increases the risk for injury to both the discs and joints of the lumbar spine. Usually injuries of this kind are due to tiny forces adding up over a long time. This probably includes forces while playing tennis and in other life activities. As we age this repetitive trauma adds up and can eventually result in pain. Back injuries of this kind are quite common in tennis players because of these factors. Fortunately there are some preventative measures to take, such as working on core strength, flexibility, and body awareness for all movements.