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I work in a fish factory in Alaska. Half the women on my shift are out at least once or twice every week due to "tennis elbow." How is this possible? No one plays tennis up here...we are too busy working! I think they are faking it to get a day off. What do you think?

Tennis elbow (also known as lateral epicondylitis) is a fairly common work- or recreational-related problem caused by repetitive motions (e.g., gripping, bending wrist back into extension). Overuse of the muscles and tendons of the forearm and elbow is the most common reason people develop tennis elbow. Repeating some types of activities over and over again can put too much strain on the elbow tendons. These activities are not necessarily tennis or other recreational or high-level sports competition. Hammering nails, picking up heavy buckets, or pruning shrubs can all cause the pain of tennis elbow. No doubt, there is some aspect of the repetitive factory work you do processing fish that can result in what is commonly called tennis elbow. Men and women are just as likely to develop symptoms of tenderness and pain that starts on the outside bump of the elbow, the lateral epicondyle. Sometimes the elbow feels stiff and won't straighten out completely. Rest is important in the treatment of this condition but a single day off once a week (or even two days off) is not likely to turn the problem around. Degenerative changes at the site where the extensor tendon attaches to the lateral condyle (bone along outside of elbow) from repeated movements need time to recover. Sometimes complete immobilization in a splint or cast is advised. Nonsteroidal antiinflammatory drugs (NSAIDs) are often prescribed but in chronic cases, it's unlikely there is still an active inflammatory process going on. Most cases of chronic tennis elbow deal with this problem for six months up to two years. The average person with tennis elbow lasting more than six weeks seems to recover within a year's time. Treatment may help alleviate the painful symptoms for a time but the condition seems to have its own course and must go through its phases before complete resolution.

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