yes you have to keep Tennis Elbow on, but you can swap to another application, or even run a 2nd instance of Tennis Elbow ! (but then, be careful with the auto-saving on exit of options, players, and world tour)
When a player joins your game, Tennis Elbow will play a warning sound, so you'll know you have to get back to it ..!
And be patient, sometimes, there's only 1 player per hour. If everybody is patient at 1st, I'm sure it'll help to build a bigger community, and after, it'll have enough players to not wait more than 10 min to play..!
== Mana Games ==
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