File: - Tennis.elbow.4.zip ...

If your intent is to "make" (create) a mod or paper-based layout for the game, the developers provide official Software Development Kits (SDKs) on the Mana Games Modding Forum:

For most Tennis Elbow 4 patches (like the popular XKT Patch), follow these steps: File: Tennis.Elbow.4.zip ...

Move the extracted folders into your game's directory. This is typically located in: If your intent is to "make" (create) a

Documents\Tennis Elbow 4\Mods (for some configuration setups). File: Tennis.Elbow.4.zip ...