Mobilization With Movement Verses Cyriax Techniques Among Athletes With Lateral Epicondylitis
Mohammad Affan
56 participants
Feb 25, 2026
INTERVENTIONAL
Conditions
Summary
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.
Eligibility
Inclusion Criteria5
- Both male and female population including sports persons(only throw ball players e.g racquet players)
- Population with age range of 25 - 40 years.
- Include only clinically diagnosed lateral epicondylitis patients
- Patients with proprioception impairments in affected limb
- Symptoms duration less than 3 months, not longer than 3 months
Exclusion Criteria5
- Other Elbow Pathologies such as cubital tunnel syndrome, radial tunnel syndrome, or osteoarthritis of the elbow.
- Recent Corticosteroid Injections in the affected elbow within the past 3 months.
- Neurological conditions affecting proprioception (e.g., multiple sclerosis, peripheral neuropathy).
- Autoimmune diseases, diabetes, or connective tissue disorders that may influence healing or proprioception.
- History of surgical intervention in the affected upper limb.(Karthikeyan) Pregnant or planning to become pregnant during the study period
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Interventions
Mobilization with Movement (MWM) group will receive interventions five times per week. In the first week, the primary focus is on applying lateral glide mobilization to the elbow joint. The patient performs pain-free gripping or wrist extension activities while the therapist provides a sustained lateral glide, enhancing joint mechanics and reducing pain. This is complemented by isometric strengthening exercises for the wrist extensors (3 sets of 10 repetitions with 5-second holds) and proprioceptive neuromuscular facilitation (PNF) rhythmic stabilization techniques to begin improving joint position sense. Ice therapy may be used post-session to control inflammation. In the second week, the MWM technique is continued with increased repetitions and resistance based on patient tolerance. Eccentric wrist extensor strengthening using resistance bands is introduced, performed in 3 sets of 10 repetitions. Light sport-specific tasks such as racquet swings with minimal resistance are incorporat
Participants in the cyriax techniques group also receive treatment five times per week over four weeks. In the first week, the primary intervention is deep transverse friction massage (DTFM), applied for 10-15 minutes over the common extensor origin to break down adhesions and reduce localized pain. Isometric strengthening exercises for the wrist extensors are introduced with 3 sets of 10 repetitions, each held for 5 seconds. Ice therapy follows each session to reduce any post-treatment inflammation. Mill's manipulation is not used in the first week to allow tissue acclimatization to DTFM. In the second week, DTFM is continued on alternate days. Mill's manipulation, a high-velocity, low-amplitude technique that stretches the affected tendon, is introduced once per week immediately following DTFM. Resistance ball exercises are added for grip strengthening, encouraging the return of functional muscle performance. Isometric exercises are continued to maintain muscle recruitment without ag
Locations(1)
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NCT07424794