Mulligan Mobilization in Lateral Elbow Tendinopathy

The aim of this randomized placebo-controlled trial is to investigate the effects of Mulligan Mobilization with Movement (MWM) combined with an exercise program in individuals with lateral elbow tendinopathy. The study will compare MWM plus exercise with sham MWM plus exercise and exercise alone. A total of 45 participants will be randomly allocated to one of the three intervention groups. The study will evaluate whether adding MWM to exercise provides greater improvements in pain, physical function, muscle performance, proprioception, and biomechanical outcomes than sham mobilization or exercise alone. Assessments will be performed at baseline, 2 days after completion of the 4-week intervention, and 24 weeks after completion of the intervention.

Inclusion Criteria: * Inclusion Criteria * Age between 18 and 60 years * Presence of unilateral lateral elbow pain and tenderness for at least 3 months * Diagnosis of lateral elbow tendinopathy confirmed by the following four criteria: * Local tenderness over the lateral epicondyle * Positive Cozen's test * Positive Maudsley's test * Positive Mill's stretch test Exclusion Criteria: * History of surgery around the elbow * History of elbow dislocation, fracture, or extensor tendon rupture * History of fracture of the humerus, ulna, or radius within the past year * Receipt of any treatment for LET within the past 6 months (e.g., physiotherapy, exercise, manual therapy, dry needling, orthosis) * Presence of cervical referred pain and/or radiculopathy (positive Spurling test) * Signs of peripheral nerve involvement * Corticosteroid injection within the past 6 months * History of rheumatologic disease * Presence of cancer or tumor