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The attacker has the target in a grapple. There is a fast moving surface right next to them. The attacker wants to hold the target against it.
It could be a fast conveyor belt-ish device, the side of a passing train, a cliff face that a vehicle is moving alongside, etc.
At the extreme, the attacker could be surfing the target down a slope.
How would you approach calculating damage from actions like this?
Off and I'd say the damage from a Two-Handed improvised weapon in place of normal unarmed damage. That's just a quick pass though for it being late for me.
Depends on the surface in question - as for the passing train, "hold against" is a very poor option, the momentum would throw both, defender and attacker, around... the attacker would need an adamantine stand (if it was a 10 foot metall golem who does that with a halfling, yeah, but I guess we're talking about two humans or something like that)
In this context, the attacker would toss the defender at the passing train (which would cripple the target at least IRL - bones are quite fragile) which in terms of d20 would mean something like doing a maneuver and if it works, the target takes damage based on the train, not on the attackers strength
Same goes for a fight on a moving vehicle when someone forces another one to touch the street below - the strength is irrelevant for the damage, if the attacker would press someone down, that would work like a brake, which means both are tossed out of the vehicle