Shoulder injuries are common among athletes involved in repetitive overhead arm movements, particularly baseball pitchers and tennis players. Due to the similarities between pitching and serving, both athletes often present with similar types of shoulder injuries. However, subtle differences in neck and shoulder movements between the pitcher and tennis player may be responsible for additional mechanisms of injuries specific to tennis players. This paper outlines the similarities and differences between the pitch and serve and discusses how these differences may relate to additional neck and/or shoulder injuries specific to tennis players. In the analyses of mechanisms of injuries sustained by tennis players, such detailed analyses of movement patterns occurring during the serve may optimize a clinician's sport-specific rehabilitation protocol.