Impact of Movement with Mobilization and Triceps Eccentric Strengthening in Tennis Elbow: Case Report

Background: Tennis elbow can be caused by repetitive wrist and arm motions. Pain is the primary symptom. It usually occurs on the outside of the elbow and sometimes in the forearm and wrist. Treatment includes rest, pain relievers and physiotherapy.

Case Presentation: A 28years old male patient presented with a complaint of pain in outer side of the right side elbow. In subjective examination, He gave history of pain while playing tennis mainly in smashing the ball or passing shot, riding bike for more than 2kilometers, difficulty in holding objects sometimes as well. When this pain was unbearable to him he came to Physiotherapy department.

Treatment: A Treatment session initially started with Cryotherapy (Ice Pack) application for 5min. On lateral epicondyle of right elbow. Then Ultrasound 0.8 watt/Cm² for 7minutes given, these helped in pain reduction. After 2days patient is asked to follow the commands to perform Triceps strengthening along with wrist strengthening with the help of Half Kg Dumb bell. There was an effect on the reduction of the symptoms of the patient which were pain, reduce strength and limited range of motion of wrist in right hand. After 1week of treatment, we added Mobilization with movement (Mulligan) technique at elbow joint. The same procedure was continued for 2weeks after which patient's symptoms were minimized as to the day of assessment. Outcome measures used for the evaluation of the symptoms were NPRS Scale for Pain, Manual Muscle Testing (MMT) for Strength.

Conclusion: Triceps strengthening along with Mulligan technique for elbow joint was found to be effective in patients with severe pain and reduced strength.