Case study: Finding the source of Shoulder Pain

Around Barcelona there are many incredible climbing spots, so… as a physiotherapist, I get to see a lot of climbers and I get to help a lot of people optimise their upper limb biomechanics.
Climber on Rock
Recently I saw a guy who was complaining of right shoulder pain during and after climbing. Digging into his history, he also mentioned an old finger ligament injury that seemed to have healed fine.
Understanding muscle chains, I knew I wanted to assess the entire upper limb chains connecting the shoulder to the long finger muscles that climbers need to use in abundance. I used Neurokinetic muscle testing to help me narrow down the causes and effects of his movement dysfunction and found that his shoulder pain was caused by an imbalance between his front and back arm lines. As his problem was at the shoulder, initially I worked there to improve his rotator cuff balance however this didn’t clear the problem completely. It wasn’t until I went down to resolve the old lingering in-balance between deep finger flexors and extensors and the ligament did the whole pattern come back online.
Hand massage
See the images from Thomas Meyers Anatomy Trains showing connections between fingers and shoulder. In this case I gave homework to work on the finger problem and a couple of pilates based weight-bearing exercises using HAND TRIPOD theory to integrate this into shoulder mechanics as well.
Moral to the story, ALWAYS check out the whole chain
Hand Tripod
For a deeper dive into upper limb biomechanics, check out the Arm Analyst series of workshops. These workshops are for anyone who helps clients to achieve optimal movement e.g.: Physical Therapists, Physiotherapists, Pilates Teachers and Personal Trainers. 
In December I will complete the Arm Analyst series with a practical class on the Hand Tripod – putting all the  biomechanics and muscle chain theory into practice.
Previous case studies illustrate this theory in practice: