Background: Chronic lateral epicondylalgia (LE) is a common musculoskeletal disorder of the common extensor origin, with a general population prevalence of 1–3% and peak incidence between 35 and 55 years of age. While eccentric loading of the wrist extensors is the established cornerstone of conservative management, accumulating biomechanical evidence implicates scapular neuromuscular impairment in symptom persistence via altered proximal-to-distal force transmission along the upper-limb kinetic chain.

Objective: To compare the effectiveness of scapular neuromuscular control (NMC) training combined with eccentric wrist extensor exercises against eccentric wrist extensor exercises alone on pain intensity and functional disability in patients with chronic LE.

Methods: In this assessor-blinded randomized controlled trial, 30 participants with chronic LE (symptom duration ≥3 months; Patient-Rated Tennis Elbow Evaluation [PRTEE] score >30) were allocated 1:1, via computer-generated randomization with sealed opaque envelopes, to an Experimental Group (n=15; scapular NMC training combined with eccentric wrist extensor exercises) or a Control Group (n=15; eccentric wrist extensor exercises alone). Both groups trained three sessions per week for 8 weeks. Pain (Numerical Pain Rating Scale, NPRS) and functional disability (PRTEE) were assessed at baseline and week 8. Within-group change was analysed with the paired t-test and between-group differences with the independent-samples t-test.

Results: Both groups showed statistically significant within-group reductions in NPRS and PRTEE scores from baseline to week 8 (p<0.001 for all comparisons). On between-group comparison, the Experimental Group demonstrated significantly greater improvement than the Control Group for both NPRS (t=-5.84, p<0.001) and PRTEE (t=-5.62, p<0.001).

Conclusion: Adding scapular neuromuscular control training to eccentric wrist extensor exercise produces significantly greater reductions in pain and functional disability than eccentric exercise alone in patients with chronic lateral epicondylalgia, supporting a kinetic-chain-informed approach to conservative rehabilitation of this condition.