Effect of Muscle Energy Technique versus Deep Friction Massage Combined with Eccentric Theraband Training in Chronic Lateral Epicondylitis - A Comparative Study

Background: Lateral epicondylosis (LE), otherwise known as "tennis elbow" is often a painful, debilitating and chronic condition characterized by lateral elbow pain. It is an over use stress syndrome characterized with symptoms of pain and tenderness persisting for more than 3 months at the lateral aspect of elbow joint affecting the daily activities such as shaking hands raising a cup, using a hammer, lifting a shovel, dressing and desk or house work typify the particular movement which initiates the pain.

Method: 30 subjects diagnosed as lateral epicondylitis were divided into two groups each of 15 subjects. Group A: (n=15): Muscle energy technique and eccentric theraband training. Group B: (n=15): Deep transverse friction massage with eccentric theraband training. Patient received treatment for 3 alternative days a week for 4 weeks. The patient's pain was assessed by VAS and grip strength using hand dynamometer. Data was collected before treatment (baseline) and after 4 weeks.

Results: The VAS score for MET group in Day 1 was 6.20±0.77 and in Day 28 is 0.53±0.64. The mean difference in VAS score was 5.667 and P value shows the

Significance: at <0.001**. The Hand grip value is 18.27±6.12 in Day 1 and 45.80±11.27 in Day 28. The mean difference is of -27.533 and P value shows the

significance at <0.001**. Similarly for DFM group, VAS score in Day 1 is 6.00±1.00 and in Day 28 is 2.60±1.18. The mean difference in VAS score is 3.400 and P value shows the

significance at <0.001**. Similarly for DFM group, VAS score in Day 1 is 6.00±1.00 and in Day 28 is 2.60±1.18. The mean difference in VAS score is 3.400 and P value shows the significance at <0.001**. The Hand grip value was 19.07±8.93 in Day 1 and34.87±14.63 in Day 28. The mean difference was of -15.800 and P value shows the

significance at <0.001**. Similarly for DFM group, VAS score in Day 1 is 6.00±1.00 and in Day 28 is 2.60±1.18. The mean difference in VAS score is 3.400 and P value shows the significance at <0.001**. The Hand grip value was 19.07±8.93 in Day 1 and34.87±14.63 in Day 28. The mean difference was of -15.800 and P value shows the significance at <0.001**.

Conclusion: MET technique was found to be more effective than DFM for treatment of lateral epicondylitis that could be because of active muscle contraction and passive stretching causing increased flexibility of the structures. Whereas, DFM, mostly causes scar tissue releasing. Muscle contraction was not facilitated nor flexibility was increased. Hence alternate hypothesis was proved.