New conservative method for finger pain

Treatment of finger problems in climbers with the local-osteopathic Isele-method: a Pilot study

The Abstract - Read more
Climbing and Bouldering is a trend sport and is fashionable. The growing number of athletes is connected with an increase of complaints in connection with/of the fingers. However, the scientific literature is mainly focused on injuries of the annular pulley-system of the flexor tendons with an emphasis on major injuries, e.g. rupture of the ring ligaments and their surgical management. Although only a minority of these cases require surgical intervention, and not all symptoms come from a rupture it seems that the field of climbing-related injuries is only insufficiently covered.
To date, none of the conservative therapeutic approaches can be considered gold standard. Conservative finger therapy is mainly focused on the rehabilitation process following the ruptures described above.
In the context of the present pilot- and feasibility-study 61 patients with climbing-related undefined finger symptoms underwent a new local osteopathic therapy, involving the Isele-method and Isele–techniques. In contrast to established conservative therapeutic concepts, all patients were only treated once and received neither advice concerning therapy or behaviour nor a specific training program. The only requirement: climbing was prohibited for a minimum of 48 hours after treatment. Any change regarding the finger injury or symptoms was assessed at three occasions via patient interview and questionnaire including a visual analogue scale.
A clear benefit could be observed for all surveyed areas, specifically regarding possible intensity and extent of the training. Furthermore, a notable relief of pain and other symptoms during climbing and an increase in quality of life were reported by patients. Although the Isele-methods were reported to be painful to some extent they were consistently evaluated positively by the patients.

My approach, my method

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My approach

I am a supporter of the individual norm of the patient. I believe in anatomy and physiology and individually adapted treatment.
There is no perfect treatment. I think that we must listen to our patients much more (rather than just checking their X-ray).
My background as osteopath, physiotherapist and state-approved climbing trainer of course influences my approach on how I deal with climbing related problems.
Bringing a human being back to health does not only include a physical examination, it involves understanding the climber, his sozialisation, his lifestyle in order to get the full image of each athlete.

My method

After my degree in osteopathy (D.O.) I wrote my master’s thesis which is about the „Treatment of finger problems in climbers with the local-osteopathic Isele-method: a Pilot study“.
The reason for that is easy to explain: Due to my work with climbers it became more and more natural to treat fingers „my way“. And I wanted to prove my method on a scientific basis. 
At this point there is no similar method of conservative treatment of fingerpain caused by climbing. 

My study showed that the intensity of boulder or climbing training could be increased the most. From zero to ten (ten is the maximum restriction), climbers indicated seven on average. After one treatment with my method it dropped down to two.
But keep in mind that I only treated once, in my clinic I’d treat a few times (about 2-6 times, depending on the case). And I would not only use my method because that alone would not be a full treatment.

The outcome of my study is extraordinary good so to speak. BUT: Keep in mind that it is only a Pilot study. And I have to admit that I am not very impressed by study results anymore. On the one hand we really need „evidence based medicine“ but on the other hand medicine would just not be possible if we would only work with evidence based medicine (there is no evidence that a parachute works for example!).
Treating patients, touching for „health“ is a cultural thing as well. Experienced medicine is something very valuable. And this is something I always keep in mind and influences the way I work. Let´s say: Anatomy and physiology are the fundaments I stand on, but one half of the building is made of evidence based medicine and the other half of expierience based medicine. The rooftop completes the structure with the fine art and philosophy of an osteopath. By means of the Isele-method I try to give back life quality. That is initially not to interfere much with the lifestyle of the patient.

The method is new and stands at the beginning of its development. But within my studies I could show that it is an unproblematic intervention (there are no noteworthy side effects).

No matter if chronic or acute pain, the treatment was likewise successful. That gives hope to those people who are looking for help for a long time already.

Isele-techniques - Overview

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What did I treat?

I only treated finger problems related with climbing, excluding tendonitis or fresh wounds. Patients with 
chronic pain or fresh injuries reacted very well on the method. 
I treated less pully ruptures but more problems located around the pulleys. From a doctor’s point of view it would be a minor problem. A PhD study from an Austrian sociologist shows that injured 
climbers are suffering much more than other sportive people (as hikers for example). The reason for that: Injured climbers don't want to substitute their sport for another sport.

To locate the pain, the patient is asked to take in a climbing or finger position which causes pain. The exact and individual position of fingers and body in this situation is used as the 
standard therapy position.
There are three ways to treat the finger:

1. „Mädchenthrust“
The first intensity level of the “Mädchenthrust” of the Isele-method is a rather soft testing of compatibility of the following treatment.

2. Chopstick Technique
A chopstick is used to trigger the most sensitive point within the afflicted finger.

3. Flexor-Lifting
The affected hand is placed flat, the palm is pointing upwards. The therapist lifts the most painful region of the finger with his fingers.


  • All kind of finger pain from climbing
  • Acute as well as chronic problems