Older climber with sudden onset finger pain with no mechanism of injury.

Pain when climbing shooting up wrist into elbow.

Generally strong (F7a/b) and no previous history during 30 years of climbing.

On assessment there was no significant finger pain on palpation but they did present with a distinct ‘climber’s posture’ i.e. significant apeing, kyphotic upper thoracic, massive traps and over flexed elbows and fingers in relaxed stance.

Interestingly his grip was also significantly weak – 38kg on dynamometer and was the same as his non-injured side. This does not correlate with population norms. It was also a surprise given his ability to climb was so high.

I assessed their neck and after initial tone and stiffness had been worked through he had considerable pain in his cervical spine. Neural tests all positive.

Treatment consisted of: neural glides, SNAGs at the neck and STM of traps, scalenes. Also 1st rib MET.

Home exercise programme of stretching and neural glides

Plan – reassess 1 week