Case Notes 2 – climber with sudden onset finger pain but no injury

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

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