Manipulative Therapy: Musculoskeletal Medicine, 1e
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Manipulative Therapy provides a systematic overview of chain reactions which are the basis of a rational holistic approach. These reactions are closely related to the upright human posture and to the "deep stabilisation system" as shown in the work of Richardson et al in Therapeutic Exercise for Spinal Stabilisation in Low Back Pain. This approach has meant a considerable advance in the therapy and rehabilitation of patients.
It gives a balanced picture of the importance of musles, joints and soft tissues, under the control of the nervous system, the textbook aims to treat disturbance of function, the most common cause of pain in the motor system, in the most effective way.
Locomotor system dysfunctions are shown to be treated very effectively using manual medicine techniques. Spinal column and joint mobility can be restored, and pain triggered by the autonomic nervous system can be positively influenced.
This is a comprehensive source of information relating to pathogenesis, diagnosis, indications and treatment methods, incorporating the latest research findings. Radiological diagnosis is is shown as laying the foundation for successful diagnosis and treatment with manual medicine techniques. Typical conditions associated with pain in the locomotor system is presented and described in functional terms for the first time. The book concludes with chapters covering preventative aspects and expert assessment.
Manipulative Therapy: Musculoskeletal Medicine is the follow on from: Manipulative Therapy in Rehabilitation of the Locomotor System, published by Butterworth Heinemann, 1985.
manipulation of the capitate relative to the lunate: (A) making contact; (B) taking up the slack and delivering the HVLA thrust. 190 Therapeutic techniques up by very gentle traction with slight dorsiflexion of the patient’s hand; once the barrier is engaged, an HVLA thrust is delivered along the axis of the patient’s downward-hanging arm but taking care to allow no further dorsiflexion. There are two errors to be avoided at all costs: first, excessive traction while engaging the barrier and
effects referred to here can not only be observed clinically, but can also be objectively demonstrated by physiological methods (see Figures 2.10–2.13). 2.4.7 The pathogenesis of restriction Overload and abnormal load In the case of the most minor restrictions, we know from our own experience how these come about: sitting or working for a long period in an unfavorable position, we sense a need to stretch 17 Manipulative Therapy Figure 2.10 • Changes in skin temperature after root
atlantoaxial joints and cranial base and of the cervicothoracic junction are inadequate for the evaluation of function. 3.5.2 Assessment of X-ray films The technique described here provides sufficient criteria to evaluate all the images and to repeat them for comparison, even if all structures are asymmetrical. In the AP projection (see Figure 3.24) the first task is to make sure that both Figure 3.24 • Anatomical structures of the craniocervical junction, anteroposterior view. 1, Inferior
pathomorphology) we cannot expect to arrive at helpful findings. Instead, diagnosis should be based on characteristic symptoms. Precise criteria for the patient history have been laid down by Gutzeit (1951). Following the patient history, the next step is the physical examination. There is no clinical field in the whole of our experience in which the purely clinical examination plays such a decisive role; nor does any other make such high demands as the examination of motor function. The
lumbar kyphosis, or whether the main action is flexion of the lumbar spine with shortened ischiocrural muscles. Certain kinds of flattening of the bend during anteflexion are common and can be normal variations. These occur at the thoracolumbar junction and at the lumbosacral junction. The examiner compares the prominence of the transverse processes as well as that of the erector spinae muscles that are stretched over them. This provides a sign of rotation as found in scoliosis, or possible