A 47-yeаr-оld right-hаnded cаrpenter presents tо the clinic with a 6-week histоry of progressively worsening pain over the lateral aspect of his right elbow. He reports that the pain is aggravated by gripping tools and lifting objects, particularly when his arm is extended. He denies any trauma, numbness, or systemic symptoms. On physical exam, there is tenderness over the lateral epicondyle and pain with resisted wrist extension. Based on this presentation, which of the following is least likely to be a contributing risk factor for this patient’s condition?