Mobilization With Movement Verses Cyriax Techniques Among Athletes With Lateral Epicondylitis

Mobilization With Movement Verses Cyriax Techniques Among Athletes With Lateral Epicondylitis

This randomized controlled trial aims to compare the effectiveness of Mobilization with Movement (MWM) and Cyriax techniques in athletes diagnosed with lateral epicondylitis (tennis elbow). Lateral epicondylitis commonly causes pain, reduced grip strength, and impaired proprioception, particularly in racquet and throwing sports players. A total of 56 participants aged 25-40 years with symptoms of less than three months will be randomly assigned to either the MWM group or the Cyriax group. Both groups will receive treatment five times per week for four weeks. Outcomes including elbow proprioception (Joint Position Sense test), pain and functional disability (Patient-Rated Tennis Elbow Evaluation), and grip strength (Handheld Dynamometer) will be assessed at baseline, at 2 weeks, and at 4 weeks. The study aims to determine which treatment method provides superior improvement in pain reduction, functional recovery, and proprioceptive enhancement.

This study is a randomized controlled trial conducted at Sukkur Physiotherapy, Rehabilitation and Chiropractor Center and Hidayat Physiotherapy and Rehabilitation Center, Sukkur, over a period of nine months following ethical approval. Fifty-six clinically diagnosed lateral epicondylitis patients meeting inclusion criteria will be recruited using purposive sampling and randomly allocated into two groups using the sealed envelope method. Group A will receive Mobilization with Movement combined with progressive strengthening, proprioceptive training, and sport-specific exercises, while Group B will receive Cyriax techniques including deep transverse friction massage and Mill's manipulation along with strengthening and proprioceptive exercises. Both groups will undergo 16 treatment sessions over four weeks following standardized baseline care consisting of education, stretching, ice therapy, and light isometric exercises. Outcome measures include Joint Position Sense testing for proprioception (measuring absolute angular error), PRTEE questionnaire for pain and function, and grip strength measurement using a handheld dynamometer. Ethical guidelines will be strictly followed, informed consent will be obtained, confidentiality will be maintained, and participants will have the right to withdraw at any time without affecting their standard care.

Inclusion Criteria:

1. Both male and female population including sports persons(only throw ball players e.g racquet players)
2. Population with age range of 25 - 40 years.
3. Include only clinically diagnosed lateral epicondylitis patients
4. Patients with proprioception impairments in affected limb

Symptoms duration less than 3 months, not longer than 3 months

Exclusion Criteria:

1. Other Elbow Pathologies such as cubital tunnel syndrome, radial tunnel syndrome, or osteoarthritis of the elbow.
2. Recent Corticosteroid Injections in the affected elbow within the past 3 months.
3. Neurological conditions affecting proprioception (e.g., multiple sclerosis, peripheral neuropathy).
4. Autoimmune diseases, diabetes, or connective tissue disorders that may influence healing or proprioception.
5. History of surgical intervention in the affected upper limb.(Karthikeyan) Pregnant or planning to become pregnant during the study period