Effects of Nirschl Exercises with and Without Mulligan Taping in Lateral Epicondylitis

Abstract

Background: Lateral epicondylitis is a degenerative tendinopathy of the common extensor origin, frequently involving the extensor carpi radialis brevis, and characterized by pain, functional limitation, and reduced grip strength. Eccentric strengthening (Nirschl exercises) is a first-line conservative intervention, while Mulligan taping aims to maintain joint alignment and reduce pain through positional correction. Evidence on the combined efficacy of these approaches remains limited. Objective: To evaluate the effects of Nirschl eccentric exercises with and without Mulligan taping on pain, functional disability, and grip strength in patients with lateral epicondylitis. Methods: In this randomized controlled trial, 46 patients aged 18–45 years with clinically diagnosed lateral epicondylitis were allocated to either Nirschl exercises plus Mulligan taping (n=23) or Nirschl exercises alone (n=23) for three weeks. Pain intensity (VAS), functional disability (PRTEE), and grip strength (hand-held dynamometer) were assessed pre- and post-intervention. Data were analyzed using paired and independent t-tests with p<0.05 as the significance threshold. Results: Both groups showed significant within-group improvements in pain, function, and grip strength (p<0.05). Between-group analysis demonstrated greater reductions in PRTEE (–40.48 points, p<0.001) and VAS (–1.73 cm, p<0.001) in the combined group, with no significant difference in grip strength (p=0.104). Conclusion: Nirschl exercises combined with Mulligan taping provide superior short-term improvements in pain and disability compared to exercises alone, though grip strength gains were comparable.