Discussions By Condition: I cannot get a diagnosis.

3 Female Athletes--Same Symptoms

Posted In: I cannot get a diagnosis. 10 Replies
  • Posted By: coachdr
  • November 11, 2007
  • 01:01 AM

I am an indoor rock climbing coach who has been working with young female climbers for many years. Over the past few years, 3 of my climbers, all strong competitors, have begun to manifest the same set of symptoms, all with onset about the same age--13 to 14 years. One climber had been climbing for 6 years prior to onset, the other 2 for less than 3. What is most interesting is that the 1st climber is now nearly 18, and has been suffering from these symptoms for 4 years, with no cessation or improvement. She has seen 3 hand doctors, had surgery and been prescribed multiple treatments with no success.

All 3 girls have "loose joints" of varying degrees, though only one--the first--has been diagnosed with Hypermobility Syndrome. All 3 have had occasional problems as a result--sprains, a dislocation or two (wrist and shoulder)--but these injuries are not the real problem.

The puzzling symptoms are:

1. Tingling, numbness and eventual pain starting in the hands, spreading rapidly to the wrists and forearms. These symptoms worsen while climbing, but also affect some day to day activities, including writing, typing, even opening school lockers.
2. Muscle freezing, normally in the thumb. Certain activities, including but not limited to climbing, will result in a situation where the girls cannot move their thumb (wiggling or closing). Usually this is accompanied by pain and numbness, but not always.
3. Rapid muscle fatigue, coupled with reduced muscle strength in hands and forearms.

I know much of this sounds similar to Carpal Tunnel or Cubital Tunnel disorder. However, all 3 girls have been to hand specialists, have been diagnosed with either mild carpal tunnel or cubital tunnel (or both), and been prescribed therapy. One girl was even diagnosed with DeCuervane's syndrome and had surgery (at 15!). No physical therapy (including wrist braces) or the surgery has resulted in even minor improvement. The older girl has been through more diagnostics than the other two, and her last specialist--supposedly the best hand specialist in the East--suggested that she had Erlos-Danlos syndrome Type IV. He suggested that there was no good treatment other than physical therapy. That was 2 years ago and therapy has so far produced no results. Her symptoms remain virtually unchanged.

In her case, I have the most data, since she has had the symptoms the longest. Her symptoms have remained consistent even though she has taken extended periods off from climbing (her most recent break was more than 3 months). She cannot climb long or at high difficulty even when she wants to. More bizarre, even when she does not climb at all, her symptoms remain, though the pain is slightly less. She has additional problems as well: If she engages in non-climbing vigorous activity (such as running), she has increased pain in multiple areas (wrists, elbows, shoulders, back), as well as in ankles and knees. These areas also become sensitive to the touch (especially the shoulders). If she climbs, even at moderate difficulty and for a short duration (equivalent of a 30 minute workout), she has pain in other joints that are not used to a great extent in climbing (knees, especially). This pain and increased sensitivity can last for days following a workout, even if she refrains from non-routine physical activity.

At least one of the other girls has manifested these extended symptoms. In particular, the sensitivity in her shoulders after even a mild workout. This sensitivity is accompanied by severe tightness as well.

Since the symptoms of the other 2 girls are extremely similar, and this type of Erlos-Danlos is fairly uncommon as well as apparently genetically based, it seems statistically unlikely that all 3 of these girls on the same climbing team just happen to have it. I am not at all convinced that this is mere carpal or cubital tunnel, since standard therapies (including time off) have failed to produce more than transient and minor improvement. Further, none of the hand specialists have landed on these conditions as being responsible for all of the symptoms.

My suspicion is that this condition is related to nerve impingement in the shoulder. All 3 girls have "loose shoulders" which can move or sag during climbing. That is as far as I have gotten.

Any suggestions would be a great help.


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