THanks ginger for the reply. I appreciate the detail and the time taken to write your reply.

I hear you and agree with what you wrote.

Having said that, your statements above have clarified the classification of patients you treat with these conditions - no direct trauma.

Secondly, i have tried your method on my clients but without significant success. Also having said that, these patients triggered off these events with some form of trauma - e.g. excessive out of the ordinary wrist extension work, lifting heavy grates that unexpectedly shifted etc.

I still maintain that accurate diagnosis and classification is required to determine the best course of action.

Perhaps it is a sad indictment on our profession that not many physios actually check for C/S referral - but if it makes you feel any better, i do!

Thanks again Ginger.