Multimodal Management of Lateral Epicondylalgia in Rock Climbers: A Prospective Case Series

Abstract Objective The purpose of this prospective case series was to describe the outcomes of a set of rock climbers with lateral epicondylalgia (LE) treated with manual therapy directed at the cervical spine, elbow, and wrist as well as trigger point (TrP) dry needling and kinesio tape. Methods Nine consecutive rock climbers presenting to physical therapy with a diagnosis of LE were included. At baseline, all patients completed the Patient-Rated Tennis Elbow Evaluation and underwent pain pressure threshold testing over the extensor carpi radialis, extensor carpi brevis, brachioradialis, and supinator muscles at baseline, after the third visit (week 3), and at 2-month follow-up. Treatment included manipulation of the cervical spine, mobilization with movement directed at the elbow, manipulation of the wrist, TrP dry needling, and kinesio tape. Results Of the 9 subjects who participated in this study, 3 were women (33%), and the mean duration of symptoms was 3 weeks, with an SD of 1.7 weeks (median, 2 weeks; range, 1-6 weeks). There was an improvement in all outcome measures at both the final visit and 2-month follow-up period. Conclusions This group of rock climbers with LE who were conservatively managed with a treatment approach consisting of cervical spine manipulation, mobilization directed at the elbow and wrist, and TrP dry needling as well as kinesio tape exhibited clinical improvement.