The McKenzie method of Mechanical Diagnosis and Therapy (McKenzie 1981, 1990; McKenzie and May, 2000, 2003) is well known and commonly applied in the management of spinal disorders (Foster et al., 1999; Gracey et al., 2002; Jackson, 2001). The system uses a mechanical evaluation involving end-range repeated movements performed whilst symptom and mechanical responses are monitored. The effect of the repeated movements is then used to classify patients in one of three mechanical syndromes: derangement, dysfunction, and postural syndrome. According to the classification different exercises and postural concepts are then used to reduce derangement, remodel dysfunction or correct adverse postural loads. The mechanical evaluation when used with spinal patients has demonstrated reliability amongst trained clinicians (Razmjou et al., 2000; Fritz et al., 2000; Kilpikoski et al., 2002), and prognostic validity (Long, 1995; Sufka et al., 1998; Werneke et al., 1999; Werneke and Hart, 2001). When McKenzie (1981) described his original concept he maintained that the system could equally well be applied to extremity problems. However there remained little evidence of clinicians using the system with nonspinal musculoskeletal problems, and more recently an explicit description of how the same principles could be applied to extremity problems was published (McKenzie and May, 2000). The purpose of this case report is to describe a new method of assessment and management, using the principles of Mechanical Diagnosis and