The effects of Mulligan's mobilization with movement technique in patients with lateral epicondylitis

J Back Musculoskelet Rehabil. 2020;33(1):99-107. doi: 10.3233/BMR-181135.


Background: Lateral epicondylitis (LE) is a common problem of the arm. Mulligan has proposed the use of mobilization with movement for LE.

Objectives: To investigate the effects of Mulligan's mobilization with movement (MWM) in LE.

Methods: Forty patients were included in the study and randomly assigned to group 1 (n= 20), who received MWM, exercise and cold therapy, or group 2 (n= 20), who received exercise and cold therapy. The sessions were conducted five times a week for two weeks. All measures were conducted at baseline, after treatment, at 1st and 3rd months follow-ups. Mann-Whitney U test, a visual analogue scale (VAS) for pain intensity, Patient-rated Tennis Elbow Evaluation (PRTEE) Questionnaire for pain intensity and functional disability and a dynamometer for hand grip strength were applied.

Results: VAS activity pain significantly decreased in group 1 after treatment (p= 0.001), at the 1st (p< 0.001) and 3rd months (p= 0.040). There was a significant decrease in VAS night pain in group 1 (p= 0.024), and a significant increase in pain-free grip strength (p= 0.002) after treatment. PRTEE-Pain scores decreased in group 1 after treatment (p< 0.001), 1st (p< 0.001) and 3rd months (p= 0.001).

Conclusions: MWM plus exercise and cold therapy is a safe and effective alternative with positive effects on elbow pain, functional capacity, and pain-free, maximum grip strength.

Keywords: Lateral epicondylitis; Mulligan’s mobilization technique; cold therapy; exercise.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Cryotherapy*
  • Exercise Therapy / methods*
  • Female
  • Hand Strength / physiology*
  • Humans
  • Male
  • Middle Aged
  • Pain Measurement
  • Surveys and Questionnaires
  • Tennis Elbow / physiopathology
  • Tennis Elbow / rehabilitation*
  • Treatment Outcome
  • Visual Analog Scale