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Functional Rehabilitation of Sports and M uscu los keleta I Injuries

Aspen Publishers Inc, 200 Orchard Ridge, Suite 200, Gaithersburg, Maryland 20878, USA 1998 (ISBN 0 8342 061 12 9). Illus. 303 pages ...............................................................................................................................

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by W Ben Kibler, Stanley A Herring and Joel M Press 586 'This hardback book has been compiled by some 20 authors associated with the Rehabilitation Institute of Chicago. The authors' reason for writing such a text is given a. an attempt to justiQ the rehabilitation process both in medical and economic terms at a time when there is increasing pressure of accountability for etkctiveness to ensure continued funding for treatment and research. The book is therefore aimed more at. the whys arid wherefores of rehabilitation rather than being a stepby-step guide.

'The first half of the book covers the general principles of rehabilitation and diagnostic measures; the second half typically describes rehabilitation of various body segments in each chapter.

The first chapter gives the argument for rehabilitation and explains the main aim as rcstoration of function and not simply relief of symptoms. It is supported by various references on the effcct.s of immobilisation and the epidemiology of sports injuries.

The following chapter continues in this vein, describing the p h ys i o 1 o g i c a1 bas is of sports rehab i 1 i ta ti o n . Con cent ri c , eccentric, isometric, isokinetic, plyometric anti open and closed chain exercises are explained, a well as the principles of over- triiiiing arid sports specific t.raining.

Chapter 3 discusses the need to determine the extent o f functional deficit. It covers subjects such as motor control patterns and link stabilisation. I t also explains the difference

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between anatomical and functional deficits. This is a particularly good chapter for physiotherapists, but is unfortunately very short compared to others.

The longest chapter in the book, some 50 pages, is devoted to radiological imaging. The main argument for this is that in the authors' opinion successful rehabilitation rests on adequate diagnosis - which is fine if the facilities are readily available. There are some very good photographs of' MRIs with explanations which would be worh while for anyone looking for a text which explains MRIs and scans for common conditions.

The chapter on efYective use of rehabilitation modalities is six pages long. It gives a basic description of a selection of modalities wi t.h a section on cautions, contra-indications and misuses of each. The reference list at the end is somewhat limited and rather dated. As this is an American text, no references are made to modalities such as laser which do not have a medical licence for use in the USA. If you are looking for information on current thinking on electrical, manual or ice therapy, this is not the book for you.

'The remaining chapters in the first half of the book cover ilexibility training, functional re-conditioning and 'aquatic strategics'. The flexibility section includes a literature review on the physiological basis of stretching and describes methods of stretching such as passive, PNF and ballistic, but does not take into account some of the contemporary thinking in the UK regarding the importance of using a variety of stretching methods.

The section on functional re-conditioning looks at both general and sports specific reconditioning programmes with an emphasis on agility with some good examples of footwork drills.

The chapter on aquatics describes the biological and physiological effects of exercise in water and covers everything from aquajogging to stability work for lumbar spine problems.

The second half of the book includes chapters on the rehabilitation of cervical spine; shoulder, elbow, wrist and hand; lumbar spine; hip, pelvis and thigh; patello-femoral syndrome; over-use injuries of the leg; and ankle and foot injuries.

Many chapters include case histories used as examples for adapting rehabilitation protocols. For instance, a swimmer is used for cervical spine injuries and a tennis player for shoulder damage, which allows for a very good description of protocols in these two cases, but neglects contact and combat sports which are common causes of neck and shoulder injuries in the UK.

Each chapter gives a good synopsis of common injuries seen in the different regions, the likely mechanisms of injury, diagnosis and rehabilitation programmes. As is often the case with rehabilitation books from the USA, the descriptions of functional drills are very good and weil illustrated.

Ovcrall this is a very good book if you are looking for something slightly different from the usual sports injury textbook. It tends to look at the argument.. for and against specific techniques rather than tells you how to do them. If there is a criticism it would be that it possibly tries to cover too broad an area for a text of this size and price range, at the expense of certain areas. The subjects that are covered in greater detail are, however, very well written with extensive references to support the text.

Nicola Phillips MSc MCSP