“…Although there have been no studies directly linking variation in grip size to lateral epicondylitis, or any other upper extremity overuse injury, the occupational medicine literature has documented an association between repetitive gripping tasks requiring increased muscle activity and the development of upper extremity cumulative trauma. 22,26–28,34,36,38,39 Authors have also demonstrated that increased isometric and dynamic muscle activity directly results in increased force transmission and tension in the tendons and aponeuroses of the involved extremity. 6 Therefore, it appears reasonable to speculate that increased forearm muscle activity could result in increased tendon strain about the elbow.…”