A 40-year-old man presented with left elbow pain in his nondominant arm and inability to pronate the left forearm. He had purchased a mountain bike 6 months earlier and had been riding approximately 30 miles per week over mostly flat terrain. He complained of gradually increasing left elbow and forearm pain during the previous month, with pain and stiffness on pronation that was worse the morning after biking. He sought medical attention when his inability to pronate the forearm interfered with daily activities, such as combing hair and brushing teeth.
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